喉痹一症，在古方书虽有十八证之辨，古人悉指为相火。然此症虽多由火，而复有非火
证，
不可不详察也。盖火有真假，凡实火可清者，即真火证也。虚火不宜清者，即水亏证也。且
复有阴盛格阳者，即真阴证也。故《内经》曰∶太阳在泉，寒淫所胜，民病嗌病颔肿，其义
即此，何后人之弗究也？
一、喉痹所属诸经，凡少阳、少阴、阳明、厥阴，皆有此症，具列于后。但其中虚实，
各有
不同，盖少阳、厥阴为木火之脏，固多热症。阳明为水谷之海，胃气直透咽喉，故又言阳明
之火为最盛。欲辨此者，但察其情志郁怒而起者，多属少阳、厥阴。因口腹过嗜肥甘辛热而
起者，多属阳明。凡患此者，多宜以实火论治，至若少阴之疾，则非此之比，盖少阴之脉始
于横骨，终于会厌，系于舌本。凡阴火遂冲于上，多为喉痹。但少阴之火有虚有实，不得类
从火断。若果因实火，自有火症火脉现出，亦易知也。若因酒色过度，以致真水亏损者，此
肾中之虚火证也，非壮水不可。又有火虚于下，而格阳于上，此无根之火，即肾中之真寒证
也，非温补命门不可。凡此诸经不同，而虚实大异，皆后人所罕知，独褚氏遗之，有上病察
下之说，诚见道之言也。
一、喉痹症总治之火，则名目虽多，似有不必尽辨者。然亦有不可不辨者，即如单双乳
鹅及
单双缠喉症之有不同也。盖肿于咽之两旁者为双鹅，肿于一边者为单鹅，此其形必圆突如珠
，乃痈疖之类，结于喉间，故多至出毒，或宜刺出血而愈者。若缠喉风，则满喉红肿，多不
成脓，亦不必出血，但使火降，其肿自消。此其所以有异，而治之亦当有法也。
喉痹这一病症，在古代医书中虽然有十八种证型的辨析，但古人全都将其归结为相火所致。然而此症虽然多由火邪引起，却也有非火邪导致的证型，不可不详细考察。因为火邪有真假之分，凡是实火且可以用清热法治疗的，就是真火证。虚火不宜用清热法治疗的，就是肾水亏损证。并且还有阴寒内盛、格拒阳气于外的情况，这就是真阴（真寒）证。所以《内经》说：“太阳在泉之时，寒气过胜，百姓容易患咽喉病和下巴肿胀”，其中的道理正是如此，为什么后世之人不去深入研究呢？
一、喉痹涉及的各条经络，凡少阳经、少阴经、阳明经、厥阴经，都会出现这种病症，具体列举在后面。但是其中虚实情况，各有不同。大概少阳经、厥阴经属于木火之脏，本来就容易产生热症。阳明经是水谷之海，胃气直接通达咽喉，所以说阳明之火最为旺盛。想要辨别这一点，只需观察是否因情志抑郁愤怒而起，这类多属于少阳经、厥阴经。如果是因口腹过度嗜好肥甘厚味、辛辣温热食物而起，多属于阳明经。凡是患此病的人，大多适宜按实火论治。至于少阴经的疾病，则不属于这种情况，因为少阴经脉起始于横骨，终止于会厌，联系于舌根。凡是阴火顺势冲逆于上，多导致喉痹。但少阴之火有虚有实，不能一概从火邪断论。如果确实是因实火，自然会有火症的症候和脉象显现出来，也容易知晓。如果是因酒色过度，导致真水亏损的，这是肾中的虚火证，必须采用壮水制火的疗法。又有火衰于下，而格拒阳气于上的，这是无根之火，即肾中的真寒证，必须温补命门。以上各经不同，虚实差异巨大，都是后世之人很少知道的，唯独褚氏遗留了“上病察下”的说法，这确实是洞悉医道的言论。
一、喉痹病症总的治疗原则是清火，那么名目虽然多，似乎不必全部辨析。然而也有不可不辨析的，比如单侧或双侧乳蛾以及单侧或双侧缠喉风症状的不同。大概肿胀在咽喉两侧的为双鹅（双乳蛾），肿胀在一边的为单鹅（单乳蛾），这种形态必定圆突如珠，属于痈疖之类，结聚在喉间，所以多能排出毒脓，或者适宜刺破出血而痊愈。若是缠喉风，则是满喉红肿，多不成脓，也不必放血，只要使火气下降，其肿胀自然消退。这就是它们之所以不同的原因，治疗时也就应当有不同的方法。
The syndrome of Hou Bi (Sore Throat/Obstruction), although differentiated into eighteen types in ancient medical texts, was entirely attributed by ancients to Xiang Huo (Ministerial Fire). However, although this syndrome is mostly caused by Fire, there are also non-Fire syndromes; therefore, a detailed examination is indispensable. Fire has true and false distinctions: cases where Excess Fire can be cleared are True Fire syndromes; cases where Deficient Fire should not be cleared are Kidney Water Deficiency syndromes. Furthermore, there are cases of Yin Excess repelling Yang outward, which constitute True Yin (True Cold) syndromes. Thus, the *Nei Jing* states: "When Taiyang governs the interior, if Cold dominates excessively, the people suffer from throat diseases and submandibular swelling." The meaning here is precisely this; why do later generations fail to investigate it?
1. The meridians involved in Hou Bi include Shaoyang, Shaoyin, Yangming, and Jueyin, all of which present with this syndrome, listed below. However, the deficiency and excess conditions vary among them. Generally, Shaoyang and Jueyin belong to the Wood and Fire viscera, so they naturally tend toward Heat syndromes. Yangming is the Sea of Water and Grain, and Stomach Qi penetrates directly to the throat; thus, it is said that Fire in Yangming is the most vigorous. To distinguish these, one should observe whether the onset arises from emotional depression or anger; such cases mostly belong to Shaoyang and Jueyin. If the onset arises from excessive indulgence in rich, sweet, fatty, pungent, or hot foods, it mostly belongs to Yangming. Most patients suffering from this condition are suitable for treatment based on Excess Fire. As for diseases of Shaoyin, they do not fall into this category, because the Shaoyin meridian begins at Henggu (KI-11) and ends at Huiyan, connecting to the root of the tongue. Whenever Yin Fire rushes upward, it often causes Hou Bi. However, Fire in Shaoyin can be either deficient or excess, and cannot be uniformly judged as Fire. If it is indeed due to Excess Fire, Fire symptoms and pulses will naturally manifest, making it easy to identify. If it results from excessive alcohol and sexual activity leading to the depletion of True Water, this is a Deficient Fire syndrome within the Kidney, requiring the method of Strengthening Water (to control Fire). In cases where Fire is deficient at the lower jiao while repelling Yang to the upper jiao, this is Rootless Fire, constituting a True Cold syndrome within the Kidney, requiring warming and tonification of Mingmen (Gate of Vitality). These various meridians differ significantly in terms of deficiency and excess, a knowledge rarely possessed by later generations. Only Chu Shi left behind the theory of "investigating the lower body for diseases in the upper body," which is truly a statement revealing the Dao of medicine.
1. The general treatment principle for Hou Bi is clearing Fire. Although there are many names, it might seem unnecessary to differentiate all of them. However, differentiation is indispensable in certain cases, such as the differences between unilateral/bilateral Ru E (Tonsillar Hypertrophy/Pear-like Swellings) and Dan Shuang Chan Hou Feng (Unilateral/Bilateral Winding Throat Wind). Swelling on both sides of the pharynx is called Double E (Bilateral Pear-like Swelling); swelling on one side is Single E (Unilateral Pear-like Swelling). These forms are typically round and protruding like pearls, belonging to the category of abscesses and boils, accumulating in the throat. Consequently, they often discharge toxic pus, or may be cured by pricking to release blood. In contrast, Chan Hou Feng presents with diffuse redness and swelling throughout the throat, rarely forming pus, and does not require bleeding. It suffices to reduce the Fire, after which the swelling subsides spontaneously. This is why they differ, and their treatments must follow distinct methods.