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There are unilateral cases, bilateral cases, and those with a "pearl chain" appearance. These are mostly caused by excessive indulgence in alcohol and sexual activity, leading to qi stagnation. In the initial stage, pain occurs on the first day, redness and swelling on the second day, and visible lesions on the third day.
If fine white spots appear, and if accompanied by chills and fever, it is considered a severe (ominous) syndrome of Fei'e (Mandibular Tonsillitis). By the fourth day, the severity is established; if treated properly, recovery can occur within four to five days. The lesions arise on the sides of the throat. The left side is associated with the Heart, and the right side with the Lung. Another view states: Lesions on the right belong to the Hou (throat/larynx), indicating a Lung disease caused by qi dysfunction. Lesions on the left belong to the Yan (pharynx/esophagus inlet), indicating a Stomach disease caused by dietary heat toxicity. Unilateral involvement is termed "single," while bilateral involvement is termed "double." When two white spots connect vertically, resembling a wrapped bag or a silkworm cocoon, it is called "Lianzhu" (Pearl Chain). Single cases are mild, double cases are severe, and Lianzhu cases are even more severe. If accompanied by chills and fever, the prognosis is ominous. If occurring after a Shanghan (Cold Damage) illness, combined with Emei (Tonsillitis) and Bi (Throat Closure), it is difficult to treat. There are also acute cases where onset in the morning leads to death by evening. Chronic Emei Feng may be treatable within four to five days. For Xue'e (Blood Tonsillitis), pricking the blood blister with a silver needle leads to immediate cure. [Author's Note: In the autumn of the Jiayin year, Mrs. Zhang Lanzhang suffered from phlegm condensation and qi stagnation, with Liver Wood depression failing to disperse. She recently contracted wind pathogen, which trapped internal heat, causing it to accumulate without resolving. She presented with white putrefaction on the right side of the throat, headache, and dry cough. This was a severe case of unilateral Emei. The pulse was fine and wiry, and the tongue coating was white. The treatment method involved diffusing the Lung, soothing qi, resolving phlegm, and clearing heat. The prescription consisted of Stir-fried Jingjie (Schizonepetae Herba), Sangye (Mori Folium), Hangju (Chrysanthemi Flos), Xingren (Armeniacae Semen Amarum), Lianqiao (Forsythiae Fructus), Xiang Beimu (Fritillariae Thunbergii Bulbus), Guang Yujin (Curcumae Radix), Zhi Xiangfu (Cyperi Rhizoma Prepared), Hei Shanzhi (Gardeniae Fructus Charred), Zhu Chiling (Poria Cocos with Polyporus), Sheng Jueming (Cassiae Semen), Geke (Tridacninae Concha), Bai Jili (Tribuli Fructus), Boheye (Menthae Haplocalycis Folium), and Yu Jiegeng (Platycodonis Radix). External application used Zhongbai San (White Powder), Liuhua San (Willow Flower Powder), and Bingmei Dan (Ice Plum Pill) combined. After one dose, she recovered completely. (The formulas for Zhongbai San are recorded separately in the Supplemental Volume One).

This condition arises from excessive worry and melancholy, leading to blood heat and qi stagnation. It is commonly seen in women. The lesions resemble floating duckweed, slightly elevated and purulent, appearing purple, located on both sides of the throat. Rapid cure is difficult; mild cases take half a month, while severe cases may take over a month. Practitioners must employ proper methods, and patients must observe strict prohibitions, including dietary restrictions, abstinence from desire, and avoidance of all toxic substances. [Author's Note: For this condition, formulas such as Siqi Tang (Four Seven Decoction), Wuchen Tang (Black Sinking Decoction), Erchen Tang (Two Aged Things Decoction), Banxia (Pinelliae Rhizoma), Beimu (Fritillariae Bulbus), Xuanfuhua Tang (Inula Flower Decoction), and Xiaoyao Wan (Free and Easy Wanderer Pills) may be selected.]