张子和曰∶咽与喉，会厌与舌，此四者同在一门，其用各异，喉以候气，咽以咽物。会厌与喉上下，
以司开合，食下则吸而掩，气上则呼而出。是以舌抵上 ，则会厌能蔽其咽矣。四者交相为用，乃气与食出入
之门，最急之处。故《难经》言七冲门，而会厌之下为吸门。及其为病，一言可了，曰火。《内经》曰∶一阴
一阳结，谓之喉痹。一阴者，手少阴君火心主之脉气也。一阳者，手少阳相火三焦之脉气也。二火皆主脉，并
络于喉。气实则内结，结甚则肿胀，肿胀甚则痹，痹甚不通则死矣。推十二经，惟足太阳别项下，其余皆凑于
喉咙，《内经》何独言一阴一阳结为喉痹！盖君相二火，独胜则热结正络，故痛且速也。凡十二经，言嗌干、
嗌痛、咽肿、颔肿、舌本强，皆君火为之。惟喉痹最速，相火之所为也。君火犹人火，相火犹龙火。人火焚
木，其势缓；龙火焚木，其势速。《内经》之言喉痹，则咽与舌在其间矣。以其病同是火，故不分也。后人
立八名，曰单蛾、双蛾、单闭、子舌胀、木舌胀、缠喉风、走马喉痹。生死人特反掌之间。治之无如砭针出血
，血出则病已。然喉痹为龙火，虽用凉剂，而不可使令服，宜以火逐之，
以热行寒，不为热病扦格，乃可以散龙火。凡用针创者，宜捣生姜一块，调以热白汤，时时呷之，则创口易
合。《内经》谓火郁发之，出血者乃发之一端也。若其微者，可以咸软之。大者以辛散之，如薄荷、乌头、
僵蚕、白矾、朴硝、铜绿之类，皆其药也。
方约之曰∶缠喉风、喉痹之症，其人膈间素有痰涎，或因饮食过度，或因忿怒失常，或房室不节而发
作也。何则？饮酒过度，是胃火动也；忿怒失常，是肝火动也；房室不节，是肾火动也。火动痰上而为痰热，
燔灼壅塞于咽嗌之间，所以内外肿痛而水浆不入也。治法∶急则治标，缓则治本。治标用丸散，以吐痰散热
；治本用汤药，以降火补虚。诸方出症，但云风热，未云治痰；但云治脾肝火，
未云降肝肾火。予虽不敏，赘以管见。如挟痰加以栝蒌、半夏，或千缗汤之类∶挟肝火，加以柴胡、黄连，或
小柴胡汤、左金丸之类；挟肾火，加以生地、黄柏，或四物汤加知母，黄柏之类。凡人之五脏六腑皆有火，
不知此三经之火，常更而为病之多也。
赵养葵曰∶喉咽痛，喉与咽不同∶喉，肺脘呼吸之门户，主出而不纳；咽，胃脘水谷之道路，主纳而
不出。经曰∶足少阴所生病者，口渴舌干，咽肿上气，噎干及痛。《素问》云∶邪客于足少阴之络，令人咽
痛不可纳食。又曰∶足少阴之络，循喉咙，通舌本。凡喉痛者，皆少阴之病，但有寒热虚实之分。少阴之火，
直如奔马，逆冲于上。到此咽喉紧锁处，郁结而不得舒。故或肿或痛也。其症必内热口干面赤，痰涎涌上，其
尺脉必数而无力。盖缘肾水枯损，相火无制而然。须用六味地黄，麦冬，五味，大剂作汤服之。又有色欲过度
，元阳亏损，无根之火游行无制，客于咽喉者，须用八味肾气丸大剂，煎成冰冷与饮，便引火归原。如此治
法，正褚氏所谓上病治下也。以上论阴虚咽痛。
张景岳曰∶喉痹一症，有实火虚火之别，凡实火可清；虚火即水亏症也，复有阴盛格阳者，即真寒症
也，皆不宜清。经云∶太阳在泉，寒淫所胜，民病嗌痛颔肿。其义即此。喉痹
所属诸经──少阳、阳明、厥阴、少阴、厥阴、少阳为木火之藏，固多热症，阳明为水谷之海，胃气直透
咽喉，火为尤甚。察其情志郁怒而起者。多属少阳厥阴；肥甘辛热而致者，多属阳明，此实火也。若少阴络
横骨，终于会厌，系于舌本，阴火逆冲于上，多因喉痹。有实火者，自有火症火脉。若因酒色过度，真阴亏
损，此肾中虚火症也，非壮水不可。又有火虚于下，而格阳于上，此无根之火，非温补命门不可。
凡火浮于上，结于头面、咽喉者，最宜清降，切不可升散。盖火得升愈炽，非火郁宜发之义。经曰高
者抑之，正此义也。
阴虚喉痹者，亦多内热，口渴喉干，或唇红颊赤，痰涎壅盛，然必尺脉无神，脉虽数而浮软无力。但
察过于酒色，或素禀阴虚，多倦少力，是水不制火。火甚者滋阴，八味煎。火微而便不坚，小便不热，六味
地黄汤。
格阳喉痹，由火不归原，上热下寒。诊其六脉微弱，全无滑大之意，且下体绝无火证，腹不喜冷，即其
候也。此因色欲伤精，泄泻伤肾所致，八味地黄汤。
阳虚喉痹，非喉痹因于阳虚，乃阳虚因于喉痹也。因喉痹而过于攻击，致伤胃气。凡中气内虚，疼痛
外逼，多致元阳飞越，脉浮而数，或弱而涩，声如曳锯。此肺胃垂绝之候，速宜挽回元气，以独参汤饮之。痰
多者加竹沥、姜汁。若再用寒凉，必致不救。
张子和说：咽和喉，会厌和舌，这四个部位同处于一个门户，但它们的功能各不相同。喉用来候察气息，咽用来吞咽食物。会厌位于喉的上方，负责主管开合，进食时吸气并覆盖住咽部，呼气时则张开让气排出。因此，当舌尖抵住上颚时，会厌就能遮蔽住咽部。这四者相互协作，是气息与食物进出的门户，也是最关键的地方。所以《难经》中提到“七冲门”，而会厌下方称为吸门。等到它们发病时，用一句话就可以概括，那就是“火”。《内经》说：“一阴一阳结，谓之喉痹。”一阴，指的是手少阴君火心主之脉气；一阳，指的是手少阳相火三焦之脉气。这两种火都主要主宰血脉，并联络于咽喉。气实则会内部郁结，郁结严重就会肿胀，肿胀严重就会闭塞不通，闭塞不通至极就会死亡。推究十二经脉，只有足太阳膀胱经别行于项下，其余各经都汇聚于喉咙，《内经》为何唯独说一阴一阳结导致喉痹呢？大概是因为君火和相火独盛，导致热邪结聚在正络，所以疼痛发生得迅速。凡是十二经中提到的嗌干、嗌痛、咽肿、颔肿、舌本强，都是君火引起的。唯独喉痹发病最快，这是相火的作用。君火就像人的火，相火就像龙火。人火烧木头，火势缓慢；龙火烧木头，火势迅猛。《内经》所说的喉痹，咽和舌都在其中了。因为它们的病机都是火，所以不加以区分。后人确立了八种名称，叫作单蛾、双蛾、单闭、子舌胀、木舌胀、缠喉风、走马喉痹。生死往往就在转掌之间。治疗没有比砭针刺血更好的方法，血出来病就好了。然而喉痹属于龙火，虽然使用凉剂，但不能命令患者服用，适宜用火法来驱逐它，以热行寒，不被热病所格拒，这样才能疏散龙火。凡是用针造成创口的，应该捣碎一块生姜，用热开水调匀，不时地呷服，这样创口容易愈合。《内经》说火郁发之，刺血出血就是“发”的一种手段。如果病情轻微的，可以用咸味药物软坚散结。病情严重的，用辛味药物发散，如薄荷、乌头、僵蚕、白矾、朴硝、铜绿之类，都是适用的药物。
方约之说：缠喉风、喉痹的症状，这类病人膈间素有痰涎，或者因为饮食过度，或者因为愤怒失常，或者因为房事不节制而发作。为什么呢？饮酒过度，是胃火动；愤怒失常，是肝火动；房事不节，是肾火动。火动带动痰上逆形成痰热，燔灼壅塞在咽喉之间，所以内外肿痛且水浆不能入口。治疗方法：急则治标，缓则治本。治标用丸散，通过吐痰散热；治本用汤药，以降火补虚。各种方剂论述病症时，只说风热，没说治痰；只说治脾肝火，没说降肝肾火。我虽然不才，补充一点个人见解。如果挟带痰邪，加上栝蒌、半夏，或者千缗汤之类；挟带肝火，加上柴胡、黄连，或者小柴胡汤、左金丸之类；挟带肾火，加上生地、黄柏，或者四物汤加知母、黄柏之类。大凡人的五脏六腑都有火，不知道这三经之火，常常交替致病最多。
赵养葵说：喉咽痛，喉和咽不同：喉，是肺脘呼吸的门户，主出而不纳；咽，是胃脘水谷的道路，主纳而不出。经文说：足少阴肾经所生的病，有口渴舌干、咽肿上气、噎干及痛。《素问》说：邪气客居足少阴之络，使人咽痛不能进食。又说：足少阴之络，循行喉咙，连通舌本。凡是喉痛，都是少阴的病，只是有寒热虚实的区别。少阴之火，直如奔马，逆冲于上。到达咽喉这个紧锁之处，郁结而不能舒展。所以或肿或痛。其症状必定内热口干面赤，痰涎涌上，尺脉必然数而无力。这是因为肾水枯损，相火无制所致。必须用六味地黄丸、麦冬、五味子，大剂量煎汤服用。又有因色欲过度，元阳亏损，无根之火游行无制，客居于咽喉的，必须用八味肾气丸大剂量煎成，放冷后饮用，以便引火归原。这样的治法，正是褚氏所说的上病治下。以上论述的是阴虚咽痛。
张景岳说：喉痹这一症，有实火和虚火的区别。凡是实火可以清泻；虚火即是水亏症，还有阴盛格阳者，即真寒症，都不宜清泻。经文说：太阳在泉，寒淫所胜，百姓患病嗌痛颔肿。其中的道理就是这个。喉痹所属的各经——少阳、阳明、厥阴、少阴、厥阴、少阳为木火之脏，固多热症，阳明为水谷之海，胃气直透咽喉，火邪尤为严重。观察那些由情志郁怒引起的，多属少阳厥阴；由肥甘辛热饮食导致的，多属阳明，这是实火。若少阴络横骨，终于会厌，系于舌本，阴火逆冲于上，多因喉痹。有实火的，自然有火症火脉。若因酒色过度，真阴亏损，这是肾中虚火症，非壮水（滋阴）不可。又有火虚于下，而格阳于上，这是无根之火，非温补命门不可。
凡火浮于上，结于头面、咽喉的，最宜清降，切不可升散。因为火得升散会更炽烈，不符合火郁宜发的道理。经文说高者抑之，正是这个意思。
阴虚喉痹的，也多内热，口渴喉干，或唇红颊赤，痰涎壅盛，但尺脉一定无神，脉虽数但浮软无力。只要观察是否过于酒色，或素禀阴虚，多倦少力，这是水不制火。火盛的用滋阴法，八味煎。火微且大便不坚，小便不热的，用六味地黄汤。
格阳喉痹，由火不归原，上热下寒。诊察六脉微弱，全无滑大之意，且下体绝无火证，腹部不喜欢冷，就是它的征候。这因色欲伤精，泄泻伤肾所致，用八味地黄汤。
阳虚喉痹，不是喉痹因于阳虚，而是阳虚因于喉痹。因患喉痹而过度攻伐，导致损伤胃气。凡中气内虚，疼痛外逼，多导致元阳飞越，脉浮而数，或弱而涩，声音像拖锯一样。这是肺胃垂绝的征候，速宜挽回元气，用独参汤饮用。痰多的加竹沥、姜汁。如果再使用寒凉药物，必定导致无法救治。
Zi Hezi stated: The pharynx (Yan) and larynx (Hou), the epiglottis (Huiyan) and tongue (She), these four structures share the same gate but have distinct functions. The larynx is for monitoring qi, while the pharynx is for swallowing food. The epiglottis is located above and below the larynx, controlling opening and closing; when eating, it inhales and covers the pharynx, and when exhaling, it opens to let air out. Therefore, when the tongue touches the upper palate, the epiglottis can cover the pharynx. These four interact with each other, serving as the gateway for qi and food entry and exit, which is the most critical area. Thus, the *Nan Jing* mentions the "Seven Rushing Gates," and the area below the epiglottis is called the Gate of Inhalation (Ximen). When disease occurs in these areas, it can be summarized in one word: Fire (Huo). The *Nei Jing* states: "When one Yin and one Yang knot together, it is called throat obstruction (Houbi)." One Yin refers to the meridian qi of the Hand Shaoyin Jueyin Heart Pericardium (Shou Shao Yin Jun Huo Xin Zhu); One Yang refers to the meridian qi of the Hand Shaoyang Sanjiao (Shou Shao Yang Xiang Huo). Both fires primarily govern the vessels and connect to the throat. Excess qi leads to internal knotting; severe knotting causes swelling; severe swelling causes obstruction; severe obstruction leads to death. Investigating the twelve meridians, only the Foot Taiyang Bladder Meridian branches down the neck, while all others converge at the throat. Why does the *Nei Jing* specifically state that the knotting of one Yin and one Yang causes Houbi? It is likely because the Jueyin and Shaoyang fires prevail exclusively, causing heat to knot in the main collaterals, resulting in rapid pain. All mentions in the twelve meridians regarding dryness of the pharynx (Yigan), pain in the pharynx (Yatong), swelling of the pharynx (Yanzhong), swelling of the jaw (Hanzhong), and stiffness of the tongue root (Sheben) are caused by Jueyin Fire. Only Houbi occurs most rapidly, which is the action of Shaoyang Fire. Jueyin Fire is like human fire, while Shaoyang Fire is like dragon fire. Human fire burning wood has a slow momentum; dragon fire burning wood has a fast momentum. In the *Nei Jing*'s discussion of Houbi, the pharynx and tongue are included. Because their pathology is both Fire, they are not distinguished. Later generations established eight names: Dan'e (Single Tonsil), Shuang'e (Double Tonsils), Danbi (Single Closure), Zishe Zhang (Child Tongue Swelling), Musheshe Zhang (Wooden Tongue Swelling), Chanhou Feng (Entangling Throat Wind), and Zouma Houbi (Running Horse Throat Obstruction). Life and death can turn in an instant. Treatment is best achieved by bloodletting with a bi needle; once blood flows, the disease resolves. However, Houbi belongs to Dragon Fire. Although cooling agents are used, patients should not be commanded to ingest them. It is appropriate to use fire methods to drive it out, using heat to move cold, avoiding rejection by the heat pathogen, thereby dispersing the Dragon Fire. For any wound created by needling, crush a piece of ginger, mix with hot water, and sip occasionally to facilitate healing. The *Nei Jing* says "disperse fire stagnation"; bloodletting is one aspect of dispersion. For mild cases, salty substances can soften hardness. For severe cases, pungent substances can disperse, such as Bohe (Menthae Haplocalycis Herba), Wutou (Aconiti Radix), Jiangcan (Bombyx Batryticatus), Baifan (Alumen), Puxiao (Natrii Sulfas), and Tonglv (Chalcanthitum).
Fang Yuezhi stated: The symptoms of Chanhou Feng and Houbi involve patients who have phlegm-fluids (Tanyan) in the diaphragm region. These may arise from overeating, emotional anger, or sexual indiscretion. Why? Excessive drinking moves Stomach Fire; emotional anger moves Liver Fire; sexual indiscretion moves Kidney Fire. Fire movement carries phlegm upward, forming Phlegm-Heat, which burns and obstructs the throat, causing internal and external swelling and pain, preventing the intake of fluids. Treatment principle: Treat the branch in acute stages, treat the root in chronic stages. To treat the branch, use pills and powders to induce vomiting and dissipate heat-phlegm; to treat the root, use decoctions to descend fire and tonify deficiency. Previous formulas mention wind-heat without addressing phlegm; they mention treating Spleen and Liver fire but do not mention descending Kidney and Liver fire. I add my humble opinion: If accompanied by phlegm, add Gualou (Trichosanthis Fructus), Banxia (Pinelliae Rhizoma), or Qianmin Tang; if accompanied by Liver fire, add Chaihu (Bupleuri Radix), Huanglian (Coptidis Rhizoma), or Xiaochaihu Tang, Zuojin Wan; if accompanied by Kidney fire, add Shengdi (Rehmanniae Radix), Huangbai (Phellodendri Cortex), or Siwu Tang plus Zhimu (Anemarrhenae Rhizoma) and Huangbai. The five zang and six fu organs all contain fire, but the fire of these three meridians often alternates to cause the most diseases.
Zhao Yangkui stated: Throat and pharynx pain differ. The larynx is the portal for lung respiration, governing exhalation but not ingestion; the pharynx is the pathway for stomach digestion, governing ingestion but not exhalation. The classics state: Diseases of the Foot Shaoyin Kidney Meridian include thirst, dry tongue, swollen pharynx, rising qi, dysphagia, and pain. The *Su Wen* says: Pathogens invading the Foot Shaoyin collateral cause throat pain and inability to eat. It also states: The Foot Shaoyin collateral runs along the throat and connects to the tongue root. All throat pains are diseases of Shaoyin, differing in cold, heat, excess, and deficiency. Shaoyin Fire rushes like a galloping horse, counterflowing upward. Reaching the tight lock of the throat, it knots and cannot relax, causing swelling or pain. Symptoms must include internal heat, dry mouth, red face, surging phlegm-fluids, and a chi pulse that is rapid yet forceless. This is due to dried-up Kidney Water failing to control Shaoyang Fire. One must use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus) in large doses as a decoction. For those with excessive sexual activity leading to Yuan Yang deficiency and uncontrolled rootless fire lodging in the throat, use Bawei Shenqi Wan (Eight-Ingredient Kidney Qi Pill) in large doses, cooled before drinking, to guide fire back to its source. This treatment aligns with Chu Shi's principle of "treating lower body disorders for upper body symptoms." The above discusses Yin-deficiency throat pain.
Zhang Jingyue stated: Houbi differs between Excess Fire and Deficiency Fire. Excess Fire can be cleared; Deficiency Fire indicates Water Deficiency. There is also True Cold due to Yin Excess repelling Yang, which should not be cleared. The classics say: When Taiyang is in the interior, excessive cold causes people to suffer from throat pain and jaw swelling. This explains the meaning. Regarding meridians involved in Houbi—Shaoyang, Yangming, Jueyin, Shaoyin—these are Wood-Fire organs and thus prone to heat syndromes. Yangming is the sea of water and grain, with Stomach Qi penetrating directly to the throat, making Fire particularly severe. Cases arising from emotional depression and anger mostly belong to Shaoyang and Jueyin; those caused by rich, sweet, pungent, and hot foods mostly belong to Yangming; this is Excess Fire. If the Shaoyin collateral from Henggu ends at the epiglottis and ties to the tongue root, with Yin Fire counterflowing upward, it often causes Houbi. Excess Fire presents with typical Fire symptoms and pulses. If caused by excessive wine and sex leading to True Yin deficiency, it is Kidney Deficiency Fire, requiring nourishment of Water. If Fire is deficient below and repels Yang above, it is rootless Fire, requiring warming and tonification of the Mingmen (Gate of Life).
Fire floating upward and knotting in the head, face, and throat requires clearing and descending; ascending and dispersing must be avoided. Ascending makes Fire more intense, contradicting the principle of dispersing Fire stagnation. The classics say "suppress what is high," which applies here.
Yin-deficiency Houbi often involves internal heat, thirst, dry throat, red lips and cheeks, and abundant phlegm, but the chi pulse lacks spirit, being rapid yet floating, soft, and forceless. If caused by excessive wine/sex or innate Yin deficiency with fatigue, it is Water failing to control Fire. For severe Fire, use nourishing Yin methods, Bawei Jian. For mild Fire with hard stools and hot urine, use Liuwei Dihuang Tang.
Ge-Yang Houbi results from Fire not returning to its source, presenting with upper heat and lower cold. The six pulses are weak and faint, lacking slippery or large qualities, with no heat signs in the lower body and abdominal preference for warmth. This is caused by sexual injury to essence and diarrhea injuring the Kidney; use Bawei Dihuang Tang.
Yang-deficiency Houbi: It is not that Houbi causes Yang deficiency, but that Yang deficiency results from Houbi treatment. Over-aggressive treatment of Houbi damages Stomach Qi. Internal Middle Qi deficiency with external pressing pain often leads to flying away of Yuan Yang, presenting with floating-rapid or weak-choppy pulses and a voice like sawing wood. This is a sign of impending Lung and Stomach collapse; urgently restore Yuan Qi with Dushen Tang. Add Zhuli (Bambusa Textilis Caulis Juice) and Jiangzhi (Zingiberis Recens Juice) for profuse phlegm. Using cold-cooling agents again will lead to untreatable conditions.