又云∶咽喉痛而唇卷，不治。
又云∶咽喉痛而盗汗出，不治。
又云∶鼻中塞者，不治。
又云∶口中黑者，难治。
又云∶口中干夜间潮热，不得睡卧，时发谵语，举足妄动者，用十味人参散主之。
又云∶若病患手足厥冷，口唇摇动者，宜用小续命汤，姜枣煎，热服。
又云∶凡病传咽喉右畔者，乃余毒未除，急服牛蒡子汤，降气汤加减，治之。
又云∶口中红活吐得血，又有痰涎息而清者，不治。
又云∶手足冷者，不治。
又云∶声音不响，喉中无肿干痛者，不治。
又云∶手足冷，不能自收，颈低不能自举，眼晕暗者，不治。
又云∶虚阳上攻，上下不升降，水火不既济，腰冷不知痛痒，口中痰多唇黑者，不治。
又云∶喉中如雷声或呛食，不治。
又云∶面赤目睛上视，不治。
又云∶心胸紧满吐痰不出，不治。
又云∶面黑头汗出，不治。
又云∶自利不治。
又云∶潮热往来时发谵语，不治。
又云∶自利而喘，不治。
又云∶胸腹胀急，不治。
又云∶手足厥冷，不治。
又云∶心促四肢厥冷不治。
又云∶心中怔忡，胸前红甚，舌卷面
赤，目上视者不治。
又云∶妇人胎前咽喉痛而脉浮者，不治。
又云∶男妇法则，一般惟女人喉中有肿而色红者，此月经不调也。经不能行则
壅塞于上，故咽肿痛也。盖由荣卫不和，但男子以气为主，妇人以血为主，男妇各随
其气血之分调治，宜调荣汤可也。如病势重，其色微白脚者，此虚阳上攻，宜服降
气汤探痰，吹药同前，妇人有孕心头痛者，不治。
又云∶妇人伤寒，身发潮热咽痛者，此经行也。《活人书》云∶妇人伤寒，经水适
来，昼则明明，暮则谵语如见鬼神状，此乃热入血室，无犯胃气及上二焦，不可下
也，小柴胡汤主之。今咽喉痛而潮热往来，面赤唇红者，此热邪上壅也，不用小柴胡
汤，宜用竹叶石膏汤，清上膈，除心烦，所以为妙，次用四物汤。
又云∶喉中有疮，其色带黄，探痰同前。用小刀点疮上，出脓后即吹冰片散，宜
用鼠粘子解毒汤。
窦梦麟曰∶喉肿乃毒起于脾经，因食煎 油腻等物，及饮酒太过而行房事，以
致毒瓦斯不能流行，聚结于喉根，若不速治，溃毒闭急即死。治法先用醋水 汁搅去痰
涎，再吹药。
又曰∶咽喉间生肉，层层相叠，渐渐肿起，有孔出臭气，用臭狗橘叶煎，频服之而愈。
汪省之曰∶虚阳上攻，气不升降，致结患咽嗌，痰涎壅塞，治以苏子降气汤。（《理例》）
澄曰∶咽喉之病，近世最多者有数证∶曰单乳蛾、双乳蛾，曰子舌胀、木舌胀、缠
喉痹、走马喉痹。其热气上行，转于喉之两旁，近外结肿，以其形似是谓乳蛾，一
为单二为双也。其比乳蛾差小者为喉痹；热结于舌下，复生小舌，名曰子舌胀；热结
于舌中，舌为之肿，名曰木舌胀；木舌者，
强硬而不柔和也，热结于咽喉，肿绕于外，且麻且痒；肿而大者，名曰缠喉风痹，暴
发痰涎涌盛，水浆不入。然名虽不同，其证总不外乎手少阴君火手少阳相火为病
也。二脉并络于喉，气热则内结，结甚则肿胀，胀甚则痹，痹甚则不通而死矣。其
危者可以咸软之，而大者以辛散之，如薄荷、乌头、僵蚕、白矾、朴硝之类，用之
自可消除。至于走马喉痹，则非此等所疗，以其生死只在反掌之间耳。急救之法，无
如砭针出血，血出则病已，此上策也。后之患者，万勿畏针以自毙其命；后之君子，
万勿执小方而曰吾药不动脏腑，又妙于不用针砭出血，在小疾幸而获愈，而大疾必
致死亡。特为拈出，以告病者、医者，勿自误以误人也。
又曰∶凡咽喉用针后，有针创者，宜捣姜块和以熟白汤，时时呷之，则创口易合。
王奎光曰∶咽喉为人身饮食门户，呼吸关隘，方寸之地，受病危险，其证甚繁，
大约总归于火。盖少阴少阳君相二火，其脉皆络于咽喉，故往往为火证之所结聚。君
火势缓，则结而为疼为肿；相火势速，则肿甚不仁而为痹，痹甚不通而痰塞以死。经
云∶一阴一阳结谓之喉痹。火者痰之本，痰者火之标，火有虚实，实火因过食煎炒炙
，蕴结积毒，其证口渴，二便秘塞，风痰上壅，将发喉痹，必先胸膈不利，脉弦
而数。治宜先去风痰，后解热毒虚火；或因饮酒太过，或因忿怒，或因色欲，火炎
上攻咽喉干燥，必二便如常，少阴脉微，治宜补虚泻火。凡用药不宜纯用寒凉，取效
目前，上热未除，中寒复起，毒瓦斯乘虚入腹，胸前高肿，上喘下泻，手足指甲青黑，
七日以后全不进食，口如鱼口者死。且治咽喉，最忌发汗，针砭出血已寓出汗之意，
何堪更发其汗。凡伤寒于肾及帝中（喉名）肿者，断不宜针。至如内伤虚损，咽喉失音，无法可治。
又曰∶喉证初起，一日寒战即生发者，发后身凉口不碎，又无重舌，或二便俱利，
不可认作热证。皆因阴气虚寒而发，其痰不可吊尽，此痰即身内之津液所化，与热
证乳蛾HT 舌之痰壅一处，以流尽则毒愈者不同，若亦流尽，则精神竭而必毙。先宜
药吹或用水换之法，使喉一通，即便服药，初剂发散和解，第二剂即施温补滋养之药。
设三四日再发寒战，或心疼、骨痛、胁疼等证，皆属难治。
又曰∶发时牙关紧闭，舌喉俱肿，口碎而臭，或有重舌，及舌上有黄屑者，发
后下午再发寒热，二便闭塞者，即作热证。用石膏败毒散主之，然亦易愈之证。如渐
起三四日后而寒热者，虽极凶亦不为害。惟有证未减而牙关反不紧闭，唇口不肿，纹
如好人者不治。舌肿满口者不治。色如胡桃，如茄子，如砂纸者不治。或连重舌发
寒热者，犹可治也。舌以箸按之若色雪白，起箸即紫红色者，此身内血已死，然口若
臭犹或可生；尤忌口渴气急，痰多而稠如桃胶者，死期已速。
又曰∶一颈俱红肿者，亦极危也。面带红紫，面青带白，神气少者俱无救。不
语者死。略能语者尚有可生之机。面色少神，喜坐低处者，亦难治。帝中（喉也）乃性命
攸关，舌系下通于肾，白肿不治，伤之者死。
又曰∶凡喉证至五日即重。三日前证虽重，尚未成脓，药能清散。若至五六日，
患处多成脓，随便穿破后烂成窝，为难愈。如烂用口疳药多加龙骨、珍珠。
又曰∶凡喉非急证者，一二日未必发热，病尚轻缓；若至三日发热证必加重。须
问其大小便通利与否，如二便利，证候虽加，不过浮火上攻，服解毒消风消火之药
即愈；若二便不通利，必内有实火，非用降火解毒重剂及通利二便之药，火何从而
出？病何从而解？亦须问其头痛与否，如头痛即兼伤寒，难治。凡喉证必俟大便去
后，方可望痊；若大便秘结，未可轻许。
又曰∶凡喉证初起，大便秘结，宜大黄、玄明粉通之，则大便降而易痊。若至
五六日，久而不食，大便结，用之立毙。盖病久元气已虚，岂宜再用硝、黄？当有善法以处之。
又曰∶凡患喉证者，无痰不治。
又曰∶凡喉证先碎者，先吹长肉药，后吹碧丹。
又曰∶凡吹喉证，须吹药四五管，方得痰出，三次可以痊愈。其出痰初吹宜多
用金丹，必直对帝中，重吹之，急提出管，恐痰即呕出也。
又曰∶妇人喉证肿痛，有因经闭致火上攻而成者，宜内服通经药，月事通则愈。
又曰∶凡喉中无形红肿者，当用灯心。
又曰∶凡喉证凶者，面发肿，白亮无光彩，脉微沉无力，是神气外泄，无阳之
证，断不治。若面发红肿，脉来洪大有力，证虽极重，是有元气，火气盛，治之易痊。
又曰∶凡吹喉咙药，医家吹时，气须和平，用管周遍为妙。
又曰∶凡初起吹药，须令患者低头，流出涎痰。
又曰∶凡吹喉证，欲出痰涎，药中用皂荚末少许。
《伤寒论》曰∶咽中闭塞，不可发汗，发汗则吐血，气欲绝。
又曰∶咽喉干燥者，不可发汗。
又说：咽喉疼痛且嘴唇卷缩的，属于不治之症。
又说：咽喉疼痛且夜间盗汗的，属于不治之症。
又说：鼻塞不通的，属于不治之症。
又说：口中发黑的，难以治疗。
又说：口中干燥、夜间潮热、无法安睡、时常说胡话、手脚乱动无意识的，用十味人参散主治。
又说：如果病人手足冰冷、口唇颤动的，适宜用小续命汤，加生姜、大枣煎煮，热服。
又说：凡是病邪传至咽喉右侧的，这是余毒未清，应紧急服用牛蒡子汤，并根据情况加减降气汤来治疗。
又说：口中红润鲜活并能吐出血液，且痰涎气息清稀的，属于不治之症。
又说：手足冰冷的，属于不治之症。
又说：声音不响亮，喉中无肿胀但干痛的，属于不治之症。
又说：手足冰冷，不能自主收缩，颈部低垂不能自主抬起，眼睛昏花昏暗的，属于不治之症。
又说：虚阳上攻，上下气机不升降，水火不能既济，腰部寒冷不知痛痒，口中痰多且嘴唇发黑的，属于不治之症。
又说：喉中有如雷声或呛食的情况，属于不治之症。
又说：面色红赤、眼球上视的，属于不治之症。
又说：心胸紧闷胀满、想吐痰却吐不出的，属于不治之症。
又说：面色发黑、头部出汗的，属于不治之症。
又说：自发性腹泻的，属于不治之症。
又说：潮热往来、时常说胡话的，属于不治之症。
又说：自发性腹泻兼有喘息的，属于不治之症。
又说：胸腹胀急的，属于不治之症。
又说：手足厥冷的，属于不治之症。
又说：心气急促、四肢厥冷的，属于不治之症。
又说：心中惊悸不安，胸前皮肤红甚，舌头卷曲、面色红赤、眼球上视的，属于不治之症。
又说：妇女怀孕期间咽喉疼痛且脉象浮的，属于不治之症。
又说：男女患病法则大体相同，唯独女性喉中有肿胀且颜色红的，这是月经不调所致。经血不能下行则壅塞于上部，所以导致咽喉肿痛。这大概是由于营卫不和造成的。大抵男子以气为主，女子以血为主，男女各自根据气血的不同情况进行调治，适宜使用调荣汤。如果病势严重，患处颜色微白带脚色的，这是虚阳上攻，适宜服用降气汤以探吐痰涎，外用吹药同前所述。妇女怀孕时若出现心头痛的，属于不治之症。
又说：妇女患伤寒，身体出现潮热且咽喉痛的，这是月经来潮的表现。《活人书》说：妇女患伤寒，月经适逢来潮，白天神志清醒，傍晚则说胡话如见鬼神状，这是热入血室，不可侵犯胃气及上二焦，不可使用泻下法，用小柴胡汤主治。如今咽喉痛且潮热往来、面赤唇红的，这是热邪上壅，不用小柴胡汤，适宜用竹叶石膏汤，清上膈热，除心烦，这样才为妙，随后再用四物汤调理。
又说：喉中有疮，颜色带黄的，探吐痰涎方法同前。用小刀刺破疮口，脓出后立即吹冰片散，适宜用鼠粘子解毒汤。
窦梦麟说：喉肿是毒气起于脾经，因食用煎炸油腻等食物，以及饮酒过量而行房事，导致毒瓦斯不能流通，聚结于喉根，若不迅速治疗，溃烂毒盛闭塞气道即会死亡。治疗方法先用醋水搅去痰涎，再吹药。
又说：咽喉间长出肉赘，层层相叠，渐渐肿起，有孔洞散发臭气，用臭狗橘叶煎煮，频繁服用即可痊愈。
汪省之说：虚阳上攻，气机不升降，致使结患咽部，痰涎壅塞，用苏子降气汤治疗。（出自《理例》）
顾世澄说：咽喉的疾病，近代最多见的有几类证候：叫单乳蛾、双乳蛾，叫子舌胀、木舌胀、缠喉痹、走马喉痹。热气上行，转至喉部两旁，靠近外侧结肿，因其形状相似称为乳蛾，一为单侧，二为双侧。比乳蛾稍小的称为喉痹；热结于舌下，又生小舌，名叫子舌胀；热结于舌中，舌头为之肿胀，名叫木舌胀；木舌是指舌头强硬而不柔和；热结于咽喉，肿胀环绕外部，且麻且痒；肿胀较大的，名叫缠喉风痹，突发痰涎涌盛，水浆难进。虽然名称不同，但其证候总不外乎手少阴君火和手少阳相火致病。这两条经脉都联络于喉，气热则内结，结甚则肿胀，胀甚则痹阻，痹阻甚则不通而死。危重的可以用咸味药物软坚散结，大的用辛味药物发散，如薄荷、乌头、僵蚕、白矾、朴硝之类，使用它们自然可以消除。至于走马喉痹，则不是这些药物所能治疗的，因为它的生死只在眨眼之间。急救的方法，没有比砭针刺出血更好的了，血出则病愈，这是上策。后来的患者，千万不要畏惧针砭而自取灭亡；后来的医者，千万不要拘泥于小方剂说我的药不动脏腑，又巧妙于不用针砭出血，在小病上侥幸治愈，而大病必定导致死亡。特意提出这一点，以告诫病患者和医者，不要自己误诊而误人。
又说：凡是咽喉用针后，有针创口的，适宜捣碎姜块混合熟白开水，时时含漱，则创口容易愈合。
王奎光说：咽喉是人身的饮食门户、呼吸关隘，方寸之地，受病危险，其证候非常繁杂，大约总归于火。盖少阴、少阳君相二火，其经脉都络于咽喉，所以往往成为火证结聚之处。君火势缓，则结而为疼为肿；相火势速，则肿甚麻木不仁而为痹，痹甚不通而痰塞致死。经文说：一阴一阳结谓之喉痹。火是痰的根本，痰是火的表现，火有虚实之分，实火因过食煎炒炙烤之物，蕴结积毒，其证口渴，大小便闭塞，风痰上壅，将要发喉痹，必先胸膈不利，脉弦而数。治疗宜先去风痰，后解热毒虚火；或因饮酒过量，或因愤怒，或因色欲，火炎上攻咽喉干燥，必大小便如常，少阴脉微，治疗宜补虚泻火。凡用药不宜纯用寒凉，虽取效目前，但上热未除，中寒复起，毒瓦斯乘虚入腹，胸前高肿，上喘下泻，手足指甲青黑，七日以后完全不能进食，口如鱼口张开的则死。而且治疗咽喉，最忌发汗，针砭出血已寓含出汗之意，怎能再发其汗。凡是伤寒导致肾及帝中（喉名）肿的，断然不宜用针。至于内伤虚损导致的咽喉失音，无法治疗。
又说：喉证初起，一日寒战随即发作的，发后身凉口不碎，又没有重舌，或大小便均通利，不可认作热证。皆因阴气虚寒而发，其痰不可吊尽，此痰即体内津液所化，与热证乳蛾、木舌之痰壅塞一处，以流尽则毒愈者不同，若也流尽，则精神竭绝而必死。先宜用药吹或用水换之法，使喉部通畅，即便服药，初剂发散和解，第二剂即施温补滋养之药。假如三四日再发寒战，或心疼、骨痛、胁疼等证，都属于难治。
又说：发作时牙关紧闭，舌喉俱肿，口碎而臭，或有重舌，及舌上有黄屑的，发后下午再发寒热，大小便闭塞的，即作热证论治。用石膏败毒散主治，然而这也是容易痊愈的证候。如果是渐起三四日后而寒热的，虽然极凶险也不致危害生命。惟有证候未减而牙关反不紧闭，唇口不肿，纹路如好人的，属于不治。舌肿满口的，属于不治。颜色如胡桃、如茄子、如砂纸的，属于不治。或连重舌发寒热的，还可以治疗。舌头以筷子按压若颜色雪白，提起筷子即呈紫红色的，这是体内血已死，然而口若臭犹或可生；尤其忌讳口渴气急，痰多而稠如桃胶的，死期已近。
又说：整个颈部都红肿的，也是极危重的。面带红紫、面青带白、神气不足的都没有救。不能说话的会死。略能说话的尚有生机。面色少神、喜坐低处的，也难治。帝中（喉也）乃性命攸关，舌系下通于肾，白色肿胀的不治，损伤者死。
又说：凡是喉证到了第五天就加重。前三天证候虽重，尚未成脓，药物能清散。若到五六天，患处多成脓，随便穿破后烂成窝，为难愈。如溃烂用口疳药多加龙骨、珍珠。
又说：凡是喉非急证的，一二日未必发热，病尚轻缓；若到三日发热证必加重。须问其大小便通利与否，如二便利，证候虽加，不过浮火上攻，服解毒消风消火之药即愈；若二便不通利，必内有实火，非用降火解毒重剂及通利二便之药，火何从而出？病何从而解？亦须问其头痛与否，如头痛即兼伤寒，难治。凡是喉证必须等到大便通畅后，方可望痊愈；若大便秘结，不可轻易许诺治愈。
又说：凡是喉证初起，大便秘结，宜用大黄、玄明粉通下，则大便降而易痊。若到五六天，久而不食，大便结，用之立毙。盖病久元气已虚，岂宜再用硝、黄？当有善法以处之。
又说：凡是患喉证者，无痰不治。
又说：凡是喉证先出现口碎的，先吹长肉药，后吹碧丹。
又说：凡是吹喉证，须吹药四五管，方能出痰，三次可以痊愈。其出痰初吹宜多用金丹，必须直对帝中，重吹之，急提出管，恐痰即呕出也。
又说：妇人喉证肿痛，有因经闭致火上攻而成的，宜内服通经药，月事通则愈。
又说：凡是喉中无形红肿的，当用灯心草。
又说：凡是喉证凶险的，面部浮肿，白亮无光彩，脉微沉无力，是神气外泄，无阳之证，断然不治。若面部红肿，脉来洪大有力，证虽极重，是有元气，火气盛，治疗易愈。
又说：凡是吹喉咙药，医家吹时，气须和平，用管周遍为妙。
又说：凡是初起吹药，须令患者低头，流出涎痰。
又说：凡是吹喉证，欲出痰涎，药中用皂荚末少许。
《伤寒论》说：咽中闭塞，不可发汗，发汗则吐血，气欲绝。
又说：咽喉干燥者，不可发汗。
It is also said: Throat pain accompanied by curled lips indicates an untreatable condition.
It is also said: Throat pain accompanied by night sweats indicates an untreatable condition.
It is also said: Nasal congestion indicates an untreatable condition.
It is also said: A black mouth is difficult to treat.
It is also said: A dry mouth, tidal fever at night, inability to sleep, occasional delirium, and involuntary movements of the limbs should be treated with Shiwu Renshen San (Ten-Ingredient Ginseng Powder).
It is also said: If the patient has cold hands and feet and trembling lips, Xiaoxuming Tang (Minor Continuation Life Decoction) decocted with ginger and jujube should be taken hot.
It is also said: When the disease transmits to the right side of the throat, it is due to residual toxins not yet cleared; Niubangzi Tang (Arctii Fructus Decoction) and Jiangqi Tang (Qi-Descending Decoction) with modifications should be administered urgently.
It is also said: A red and vibrant mouth with blood expectoration and clear, thin saliva indicates an untreatable condition.
It is also said: Cold hands and feet indicate an untreatable condition.
It is also said: Hoarseness without swelling but with dry pain in the throat indicates an untreatable condition.
It is also said: Cold hands and feet, inability to move them voluntarily, a drooping neck unable to lift itself, and dim vision indicate an untreatable condition.
It is also said: Deficient Yang attacking upward, failure of Qi to ascend and descend, failure of Water and Fire to interact, coldness in the waist with loss of sensation, excessive phlegm in the mouth, and black lips indicate an untreatable condition.
It is also said: Thunder-like sounds in the throat or choking on food indicates an untreatable condition.
It is also said: Red face and upward-gazing eyes indicate an untreatable condition.
It is also said: Tightness and fullness in the chest and heart with inability to expectorate phlegm indicates an untreatable condition.
It is also said: Black face and sweating on the head indicate an untreatable condition.
It is also said: Spontaneous diarrhea indicates an untreatable condition.
It is also said: Tidal fever with alternating chills and occasional delirium indicates an untreatable condition.
It is also said: Spontaneous diarrhea with panting indicates an untreatable condition.
It is also said: Chest and abdominal distension and urgency indicate an untreatable condition.
It is also said: Cold extremities indicate an untreatable condition.
It is also said: Rapid heartbeat with cold extremities indicates an untreatable condition.
It is also said: Palpitations, intense redness on the chest, curled tongue, red face, and upward-gazing eyes indicate an untreatable condition.
It is also said: Throat pain during pregnancy with a floating pulse indicates an untreatable condition.
It is also said: The principles for men and women are generally the same, except when a woman has a red, swollen throat, which is caused by irregular menstruation. When menstrual blood cannot flow downward, it stagnates upward, causing throat swelling and pain. This is likely due to disharmony between Ying (Nutritive) and Wei (Defensive) Qi. Generally, men prioritize Qi, while women prioritize Blood; treatment should adjust according to their respective Qi and Blood conditions, using Tiaorong Tang (Regulate Nutritive Decoction). If the condition is severe and the area is slightly white with edema, it is deficient Yang attacking upward; Jiangqi Tang (Qi-Descending Decoction) should be taken to induce vomiting of phlegm, and topical powders applied as previously described. Heartache during pregnancy in women indicates an untreatable condition.
It is also said: In women with Shanghan (Cold Damage), tidal fever and throat pain indicate menstruation. The *Huoren Shu* states: When a woman with Shanghan has her period, she is lucid during the day but delirious at night as if seeing ghosts; this is Heat entering the Blood Chamber. One must not violate Stomach Qi or the Upper and Middle Jiao, nor use purgatives; Xiao Chaihu Tang (Minor Bupleurum Decoction) should be used. However, when there is throat pain with tidal fever, red face, and red lips, it is Heat pathogen stagnating upward; Xiao Chaihu Tang should not be used. Instead, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) should be used to clear Upper Jiao heat and relieve irritability, followed by Siwu Tang (Four Substance Decoction).
It is also said: Ulcers in the throat with a yellowish color should have phlegm induced as before. The ulcer should be pricked with a small knife; after pus drains, Bingpian San (Borneol Powder) should be blown into the wound, and Shuniuzi Jiedu Tang (Arctii Fructus Detoxification Decoction) should be used.
Dou Menglin said: Throat swelling originates from toxins in the Spleen Meridian, caused by consuming fried, greasy foods, excessive alcohol consumption, and sexual activity, leading to toxic vapors failing to circulate and accumulating at the root of the throat. If not treated promptly, ulceration and toxic blockage will cause death. The treatment first involves stirring vinegar water to remove phlegm and saliva, then blowing powder into the throat.
He also said: Flesh growths in the throat that stack upon each other, gradually swelling with foul-smelling holes, can be cured by frequently drinking decoctions made from the leaves of the bitter orange tree associated with "stinky dogs" (a specific local plant reference).
Wang Shengzhi said: Deficient Yang attacking upward, with failure of Qi to ascend and descend, leads to throat obstruction and phlegm accumulation; Suzi Jiangqi Tang (Pericarpium Fructus Sojae Preparatum and Qi-Descending Decoction) should be used (from *Li Li*).
Gu Shicheng said: Among modern throat diseases, the most common types include Dan Ru E (Single Tonsillar Hypertrophy), Shuang Ru E (Double Tonsillar Hypertrophy), Zi She Zhang (Child Tongue Swelling), Mu She Zhang (Wooden Tongue Swelling), Chan Hou Bi (Entangling Throat Obstruction), and Zouma Hou Bi (Running Horse Throat Obstruction). Heat Qi ascends and accumulates on both sides of the throat near the exterior, forming swellings resembling tonsils, hence the name Ru E (Tonsil); one is single, the other double. Those smaller than Ru E are called Hou Bi (Throat Obstruction); Heat binding under the tongue creates a secondary small tongue, named Zi She Zhang; Heat binding in the middle of the tongue causes swelling, named Mu She Zhang; "Mu" means stiff and inflexible. Heat binding in the throat causes external swelling with numbness and itching; large swellings are called Chan Hou Feng Bi (Entangling Throat Wind Obstruction), characterized by sudden surging of phlegm and inability to swallow fluids. Although names differ, these conditions all stem from disorders of the Hand-Shaoyin Ministerial Fire and Hand-Shaoyang Ministerial Fire. These two meridians connect to the throat; Qi heat causes internal binding, binding causes swelling, swelling causes obstruction, and severe obstruction leads to death. Critical cases can be softened with salty substances, and large swellings dispersed with pungent herbs such as Bohe (Mint), Wutou (Aconite Root), Jiangcan (Bombyx Batryticatus), Baifan (Alumen), and Puxiao (Mirabilite). However, Zouma Hou Bi cannot be treated with these methods, as life hangs in the balance. The best emergency method is Bianzhen (pricking to bleed); bleeding cures the disease. Later patients must not fear needles and kill themselves; later physicians must not cling to minor prescriptions claiming they do not affect organs and prefer avoiding needle bleeding, which may cure minor ailments but kills those with major ones. I highlight this to warn patients and physicians against self-deception and harming others.
He also said: After needling the throat, if there is a wound, crushed ginger mixed with warm boiled water should be sipped frequently to promote healing.
Wang Kuiguang said: The throat is the gateway for food and drink and the passageway for respiration. It is a small area where disease is dangerous, and its symptoms are numerous, generally归结 to Fire. The Shaoyin and Shaoyang Ministerial and Directorial Fires both connect to the throat, making it prone to Fire accumulation. Directorial Fire acts slowly, causing pain and swelling; Ministerial Fire acts quickly, causing severe swelling, insensitivity, and obstruction leading to death by phlegm blockage. The Classic states: Binding of Yin and Yang is called Throat Obstruction. Fire is the root of Phlegm; Phlegm is the branch of Fire. Fire has deficiency and excess types. Excess Fire results from overeating fried foods, accumulating toxins, causing thirst and constipation. Wind-Phlegm obstructing upward precedes Throat Obstruction, initially causing chest discomfort and a wiry, rapid pulse. Treatment should first dispel wind-phlegm, then resolve heat-toxin and deficient fire. Alternatively, excessive drinking, anger, or sexual indulgence can cause Fire to flare upward, drying the throat with normal bowel/bladder function and a faint Shaoyin pulse; treatment should tonify deficiency and drain fire. Medicines should not be purely cold/cool, as this may clear upper heat temporarily but create middle cold, allowing toxins to enter the abdomen, causing chest swelling, panting, diarrhea, cyanosis of nails, and eventual death if eating stops after seven days. Treating throat diseases strictly forbids diaphoresis (sweating); needle bleeding already induces sweating, so further sweating is contraindicated. For Shanghan causing kidney or Di Zhong (throat) swelling, needling is absolutely contraindicated. Internal injury and deficiency causing voice loss are untreatable.
He also said: If throat disease begins with chills on the first day, followed by cooling and no oral ulcers or heavy tongue, and normal bowels/bladders, it should not be diagnosed as Heat. It is caused by Yin deficiency and cold; phlegm should not be fully drained as it is transformed from body fluids. Draining it completely would exhaust spirit and cause death. Initially, use powder blowing or water-changing methods to open the throat, then administer medicine. The first dose disperses and harmonizes; the second dose warms, tonifies, and nourishes. If chills recur on days 3-4, or if there is heart, bone, or rib pain, it is difficult to treat.
He also said: If teeth are clenched, tongue and throat are swollen, mouth is sore and foul, with heavy tongue or yellow scales, and afternoon chills/fever with constipation, it is a Heat syndrome treated with Shigao Baidu San (Gypsum Detoxification Powder), which is easily curable. If chills/fever start gradually on days 3-4, it is less dangerous. If symptoms persist but teeth are not clenched, lips not swollen, and skin texture normal, it is untreatable. Tongue filling the mouth is untreatable. Colors like walnut, eggplant, or sandpaper are untreatable. Heavy tongue with chills/fever is treatable. If tongue pressed with chopsticks is snow-white but turns purple-red upon removal, internal blood is dead; if mouth smells, survival is possible. Thirst, shortness of breath, and thick phlegm like peach gum indicate imminent death.
He also said: General neck redness and swelling are critical. Red-purple face, blue-white face, and lack of spirit are incurable. Inability to speak indicates death; slight ability to speak indicates potential survival. Lack of spirit and preference for sitting low are difficult to treat. Di Zhong (throat) is vital; the tongue tie connects to the Kidney; white swelling is untreatable, and injury causes death.
He also said: Throat disease worsens on the fifth day. Before day three, although severe, pus has not formed, and medicine can clear/disperse. By days 5-6, pus forms, breaks spontaneously, leaving ulcers that are hard to heal. Use mouth ulcer medicines with added Longgu (Fossilized Bones) and Zhenzhu (Pearl).
He also said: Non-emergency throat diseases may not have fever in 1-2 days and are mild; by day three, fever increases. Check bowel/bladder function. If free, it is floating fire attacking upward; detoxifying and wind-dispersing medicines will cure it. If blocked, there is internal excess fire requiring strong fire-draining, detoxifying, and laxative medicines. Check for headache; if present, it complicates with Shanghan and is difficult to treat. Recovery depends on bowel movement; constipation makes cure uncertain.
He also said: Early throat disease with constipation should be treated with Dahuang (Rhubarb Root) and Xuanmingfen (Natrii Sulfas) to facilitate bowel movement and recovery. By days 5-6, if prolonged fasting and constipation occur, using these will cause immediate death due to depleted Yuan Qi; alternative gentle methods are needed.
He also said: Throat diseases without phlegm are untreatable.
He also said: For throat diseases starting with oral ulcers, apply flesh-growing powder first, then Bidan.
He also said: Blowing powder requires 4-5 tubes to expel phlegm; three treatments can cure. Initially, use more Jin Dan (Golden Pill), aiming directly at Di Zhong, blowing heavily, and withdrawing the tube quickly to prevent vomiting.
He also said: Women with throat swelling/pain due to amenorrhea and fire attack should take blood-invigorating medicines; recovery occurs when menstruation resumes.
He also said: Formless red swelling in the throat should be treated with Dengxincao (Juncus Effusus).
He also said: Severe throat disease with facial edema, pale/lusterless complexion, and weak/deep pulse indicates leaking spirit and Yang deficiency; it is untreatable. Facial redness/swelling with forceful, large pulse indicates sufficient Yuan Qi and vigorous Fire; it is easy to cure.
He also said: When blowing throat medicine, the physician's breath should be calm, and the tube should cover the area evenly.
He also said: For initial powder blowing, the patient should lower their head to allow saliva/phlegm to drain.
He also said: To expel phlegm/saliva during blowing, add a small amount of Zaofeng (Gleditsia Sinensis Fruit) powder to the medicine.
The *Shanghan Lun* states: Closure in the throat contraindicates diaphoresis; sweating causes hematemesis and Qi exhaustion.
It also states: Dry throat contraindicates diaphoresis.