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Throat Bi (throat obstruction) refers to a condition characterized by swelling and blockage of the throat, bi-syndrome pain, and inability to swallow food or fluids. It arises from dysfunction of the Spleen and Lung, with accumulation of heat-toxin internally, compounded by sudden exposure to cold pathogen which constrains the heat. The heat is closed by the cold, Qi mechanism fails to circulate freely, and stagnates in the throat. Symptoms include fever and aversion to cold, wheezing, chest tightness, and distension. If not treated urgently, it can be fatal. Acupuncture bloodletting and nasal insufflation to induce vomiting of phlegm are emergency treatments.

Lord Wen (Wen Yanbo) once suffered from throat swelling and pain. Throat specialists treated him for three days, but the condition worsened. The Emperor summoned Sun Zhao for treatment. Sun Zhao said, "Obtain one of the Chancellor's letter-writing pens, remove the tip, dip it in water with medicine, and apply it into the throat; the disease will heal." Sun Zhao proceeded with acupuncture. The Chancellor fainted and lost consciousness, causing his attendants to panic and sweat. Sun Zhao smiled and said, "It is not that I cannot save the Chancellor, but time is needed." After a moment, the Chancellor vomited more than one sheng of pus and blood, and recovered completely after ten days. I once treated a man with throat Bi, pricking the Shaoshang point (LU-11) to release half a cup of dark blood, resulting in recovery. Thus, throat Bi is caused by the failure of evil blood to disperse.

In treating this disease, acute cases must first be addressed with dispersing methods. If dispersal fails, then resolve phlegm. If resolving phlegm fails, then remove stagnant blood. (Lou Quanshan, citing *Bencao Gangmu*.) Fire depression requires dispersal, which implies releasing the exterior; significant bleeding leads to cure. For needle wounds, rinse frequently with ginger juice mixed with warm water.

For acute sore throat, prick the outer corner of the thumbnail at the nail root level. Regardless of gender or side, use a common household needle to prick until blood flows for immediate effect. In critical cases, pricking both thumbs multiple times is excellent. (*Yijian Zhi*)

Back-picking method: In a dark room, light a red paper strip and shine it on the back. Faint red spots will appear. Pick these spots with a needle. Patients near death from throat Bi will revive once all spots are picked.

Vice Minister Yuan Zhang narrated that a scholar from De Prefecture brought his servant to the capital. The servant suffered from throat closure with distension, wheezing, and blockage, facing imminent death. Locals advised seeking treatment from Master Li at Shanshui Street. Master Li exclaimed, "This condition is critical; fortunately, you came here, otherwise he would have died." He took a paper twist from a box, lit half of it, blew out the flame when smoke rose, had the servant open his mouth, and pierced the throat. Soon, half a ge of purple blood was expelled. Breath immediately eased, speech returned, and after eating porridge and applying medication, he healed instantly. The scholar marveled at the skill. Later, a village doctor learned this method, stating: "Throat diseases originating in the Six Fu organs are accessible to hand manipulation; piercing stasis cures them. Those originating in the Five Zang organs involve deep toxin penetration where manual and medicinal force is insufficient; only paper twists are effective." However, the reason was not explained. Someone found a discarded twist and discovered it was pre-coated with croton oil, igniting easily to deliver toxic vapors directly to the lesion to break the toxicity. For trismus (lockjaw), smoke is insufflated into the nose, causing salivation and opening the jaw. (*Yi Shuo*)

Zhou Mi's *Qidong Yeyu* records: Passing Nanpu, an old physician taught me a formula for dying throat Bi. Use real duck-bill alum (Danfan) powdered, mixed with vinegar and灌ed. Profuse vomiting of gelatinous phlegm for several sheng results in cure. A veteran's wife in Linting suffered from this, abstaining from food and water for three days. Using this method cured her. It proved effective repeatedly, a divine prescription. *Jisheng Fang* uses 2.5 qian of Danfan and 5 qian of stir-fried White Silkworm (Bai Jiangcan), ground fine. Insufflate a small amount to induce salivary vomiting, named Ge Sheng San.

Sun Zhao treated Pan Yuancun's acute throat Bi by insufflating half a qian of medicine into the throat. Moments later, pus and blood were vomited, and he recovered instantly. Pan thanked him, offering 100 taels of gold for the formula. Sun Zhao replied, "It is merely equal parts of Pig Tooth Soapberry (Zhuya Zaorou), Alum (Baifan), and Coptis (Huanglian), roasted on tile and ground." He gave the formula but refused the gift.

Jiedu Xionghuang Wan (Detoxifying Realgar Pill): Realgar (Xionghuang) and Curcuma (Yujin) (1 fen each), Croton Seed (Badou) (peeled, oil removed, 14 seeds). Grind to fine powder, make pills with vinegar paste size of mung beans. Take 7 pills with clear tea broth to expel stubborn phlegm and restore consciousness. If unable to swallow liquids, grind medicine with vinegar and灌 into throat to induce vomiting; repeat if no vomiting occurs. Danxi stated: Ginger juice mixed with Silkworm powder is miraculous for sore throat and Bi.

Throat Bi Insufflation Powder: 1 qian Alum (Baifan) powder stir-fried with 1 Croton seed; discard Croton, grind Alum fine and insufflate to expel turbid phlegm, named Biyun San. Add a little Calomel (Qingfen) and Musk (Shexiang), named Fenxiang San. Effective for tonsillar abscess (Ru'e).

Yusuo Chi (Jade Lock Key): Saltpeter (Yanxiao) (7.5 qian), Borax (Pengsha) (2.5 qian), White Silkworm (Bai Jiangcan) (1.25 qian), Borneol (Longnao) (1 zi). Grind to powder. Insufflate 0.5 fen via bamboo tube into throat for miraculous effect. (*Zhizhi Fang*)

Chubi Touguan San (Nasal Insufflation to Open Orifices Powder): Realgar (Xionghuang) (ground), Honey-roasted Pig Tooth Soapberry (Zhuya Zaorou) (peeled), Veratrum (Lilu) (1 fen each). Grind to powder. Use one spoonful, flick into both nostrils. Once orifices open, cure follows.

When suffering from throat closure or winding throat wind, after medicine opens the throat allowing liquid intake, urgently drink half or one bowl of thin porridge to suppress residual heat; otherwise, the disease may return. This must be known. If throat opens but fever and headache persist, it indicates external pathogen invasion. Examine pulse and urination/defecation. If exterior syndrome exists, disperse; if interior syndrome exists, mildly purge. Both lead to cure. Post-recovery, if panting is empty and body is not hot, it is due to excessive cooling medicines causing deficiency below. Administer one dose of sedating and warming medicine, such as Heixi Dan or Zhengyuan San, suppressed with porridge.

Bingmei Wan (Ice Plum Pill): Treats throat wind swelling and pain miraculously. Arisaema (Tian Nanxing) (30 pieces), Pinellia (Ban Xia), Alum (Baifan), Salt (Bai Yan), Saposhnikovia (Fangfeng), Mirabilite (Puxiao) (4 liang each), Platycodon (Jiegeng) (2 liang), Licorice (Gancao) (1 liang), Large Plums (Meizi) (100 pieces, 70% ripe). Soak in nitrate-salt water for one day and night. Grind herbs, mix with water. Place plums in water, covering by three fingers' width. Soak for seven days, sun-dry, soak again, dry again until liquid evaporates. Seal plums in ceramic jar. Frost-like white coating is ideal. Wrap in silk, hold in mouth, slowly swallow juice. Phlegm expulsion brings cure.

For epidemic sore throat, use Puji Xiaodu Yinzi.

Shenxiao San: Treats throat Bi with loss of voice. Grind Soapberry (Zaorou) and frost-plum into powder, hold in mouth. For acute throat Bi with snoring sound, resembling phlegm rattling in throat, this indicates Lung exhaustion. Rescue with Ginseng Paste (Renshen Gao). Use Bamboo Juice (Zhuli) and Ginger Juice (Jiangzhi) to open orifices, administer frequently. If Ginseng Paste unavailable, Single Ginseng Decoction works. Early treatment yields 70-80% cure; moderate yields 40%; late yields less than 10%.

Lanhou Sha Formula (Transmitted by friend Zhang Ruifu): Buffalo Realgar (Xi Niu Huang) (5 li), Borneol (Bingpian) (3 li), Pearl (Zhenzhu) (3 fen), Human Nail (Ren Zhijia) (5 li, female nail for male patient, male for female), Ivory Dust (Xiangya Xie) (3 fen, roasted), Spider Web Sac (Bi Qian) (20 sacs, roasted, from earth walls/bricks, not wood), Indigo (Qingdai) (6 fen, purified). Grind to ultra-fine powder. Insufflate onto affected area for efficacy.

My pen friend Zhang Ruifu, from Huzhou Prefecture, I have known for twenty years. He was honest and peaceful, over fifty, childless despite having a concubine. One day, physiognomist Li congratulated him, saying, "You will have a son." Li was a fellow townsman. Zhang was bewildered, "I have never sired children, why joke?" Li said, "I read your face before, predicting no sons. Now your merit lines cover your face; how could you remain childless?" It came true. I asked Zhang how he did good deeds. Zhang said, "None, except two duties. My younger brother died early, leaving a son whom I raised. I managed his business clients for twenty years. When the nephew grew up, I urged him to leave, but he refused. I said, 'You benefit me greatly here. But staying makes you a mere clerk forever, which I cannot bear. Take my seal/stamp, visit all clients, say: This is my brother's son, now grown, continue using his credentials. He apprenticed here since childhood; his stamp is mine.' Also, this formula is effective; I do not hide it, nor seek profit." I said, "This is truly good. Raising an orphan nephew to succeed his father's trade; sharing a life-saving formula publicly—no greater good." I obtained this formula and recorded its origin. (He Nian.)