经曰∶一阴一阳结，谓之喉痹（厥阴风木，少阳相火）。又曰∶咽喉者，水谷之道路也；喉
咙者，气之所以上下也；会厌者，音声之门户也。足少阴肾，上系于舌，络于横骨，终于会厌。
夫喉痹者，由痰生热，热生风，火主肿胀，故热客上焦，而咽嗌肿痛也。咽喉之于会厌，《内经》
谓之吸门。咽以候气，通肺属金；轻清不容；喉以纳食，通胃属土，无物不受。会厌管乎其中以
司开合，能闭其咽以进食。仓卒误投滴粒，嗽出乃止。咽中惟呼吸行焉，故为人身之 紧关。
卒然浆水不入，语言不出，命悬须臾。喉痹即今之乳蛾，咽喉一十八证，谓单蛾、双蛾、缠喉风
之类。名状不同，其源则一，相火是也。多感于酒腥辛辣浓味，七情痰火。发则通连颈项，头面
肿胀。古书治法，刺破出血。今屡见因刺有伤人者，莫如探吐痰涎，万无一失。脉宜浮洪，忌微
伏。尤有伤寒少阴咽痛及阴证下虚痛，不能分别，先根据主方。
主方 桔梗（四钱） 甘草（三钱） 荆芥（钱半） 玄参（一钱） 水煎服。卧床慢咽
。
详脉证属热，渐加牛蒡、连翘、天粉、僵蚕、射干、山根、薄荷、芩、连、栀、柏、防风、
升麻、生地、当归择用。
大便秘，大黄；小便涩，木通。
清心利嗌汤 咽喉肿痛，痰涎壅盛。
桔梗 黄连 黄芩 薄荷 荆芥 防风 栀子（各钱半） 甘草 玄参 连翘（各一钱）
大黄 芒硝 牛蒡子（各七分）
上作一剂，水煎，食后服。兼用碧雪（方见舌证）
透天水 一切风热喉痹，口舌生疮，头目不清，痰涎壅盛。
黄连 薄荷叶 槟榔 蒲黄 荆芥穗 甘草 黄柏（各末，五分） 冰片（三分） 柿霜（
五钱。无，用白糖）
蜜和丸，不时噙化。
玉雪散 咽喉肿痛，单、双乳蛾一十八证皆效。
僵蚕（坚亮者洗，一钱） 山豆根（广西者，取皮研，五分） 雄黄（飞） 玄明粉（如无，
用焰硝淡者） 硼砂（明亮者。各三分）
研极细，入冰片二分匀，先以箸捺下舌，芦管吹入患处，闭口一时。口噤吹入鼻，加薄荷、
甘、桔，末，蜜丸噙亦佳。
稀涎散 乳蛾喉肿，面浮目闭，口噤食绝。
皂荚（末，猪牙者尤佳） 明矾（研。各一钱）
白汤调灌。牙紧，灌入鼻；未吐，以鹅毛蘸生桐油（或灯窝油），口内搅即吐。一人托额，
一人用指，口内引出痰涎盆许，即刻痛止肿消，声出食进。未痊愈，再吐。
或只白矾，或油亦可发吐。
或土牛膝根（一名鼓槌草，俗名夫娘子。红梗大叶，壮节生子刺衣）。捣汁入白矾灌。
或马蓝头（春苗可食，秋小紫花如菊），捣绞汁，入香油少许灌。
或胆矾五分，汤调得吐，愈。或饮盐汤二碗，吐亦可。
简便方 治喉痹。
真山豆根，水浸透，含咽汁。
急喉痹∶巴豆（去壳），纸打油作燃，点火吹灭，以烟熏入鼻，涎出牙开。
又 皂角（炙，去皮子）。为末，箸头蘸点患处，以米醋调敷项下，自破，血出即安。
又 悉尼捣绞汁饮，效。
走马喉痹∶桔梗（二两），水煎，分二服。
喉痹并毒瓦斯∶生姜汁和蜜共一碗，熬六分，日服三、五次。
缠喉风∶生白矾末（二钱），水调下。或韭菜捣细敷项上；或萝卜汁和皂角末服，吐痰；或硼砂噙化。
《黄帝内经》说：一阴（厥阴）与一阳（少阳）之气郁结，就称为喉痹（即厥阴风木与少阳相火）。又说：咽喉是水谷通行的道路；喉咙是气息上下出入的通道；会厌是声音发出的门户。足少阴肾经，向上联系到舌根，络属于横骨，最终终止于会厌。
所谓喉痹，是由于痰湿产生热邪，热极生风，火性主肿胀，所以热邪客居上焦，导致咽喉肿痛。咽喉与会厌的关系，《内经》称之为“吸门”。咽部主要用来候气，通应于肺，属金，性质轻清不容异物；喉部主要用来纳食，通应于胃，属土，无物不受。会厌位于中间主管开合，能够关闭咽部以进食。如果匆忙误吞微小颗粒，咳嗽排出后才停止。咽中只有呼吸通过，因此是人身的紧要关口。突然之间浆水不能入口，语言不能发出，生命危在旦夕。喉痹就是现在的乳蛾病，咽喉共有十八种证候，包括单蛾、双蛾、缠喉风等。名称和形态不同，但根源相同，都是相火为患。多因感受酒肉腥膻、辛辣浓味，以及七情内伤、痰火所致。发作时疼痛连及颈项，头面肿胀。古书中的治疗方法是刺破出血。如今屡见因针刺而伤人的案例，不如探吐痰涎，万无一失。脉象宜见浮洪，忌见微伏。还有伤寒少阴咽痛及阴证下虚引起的疼痛，如果不能分辨，先按照主方治疗。
主方：桔梗（四钱）、甘草（三钱）、荆芥（钱半）、玄参（一钱），水煎服。卧床慢慢咽下。
详细诊察脉证若属热证，逐渐加入牛蒡子、连翘、天花粉、僵蚕、射干、山豆根、薄荷、黄芩、黄连、栀子、黄柏、防风、升麻、生地、当归，酌情选用。
清心利嗌汤：主治咽喉肿痛，痰涎壅盛。
组成：桔梗、黄连、黄芩、薄荷、荆芥、防风、栀子（各钱半），甘草、玄参、连翘（各一钱），大黄、芒硝、牛蒡子（各七分）。
以上为一剂，水煎，饭后服用。兼用碧雪（方剂见舌证章节）。
透天水：主治一切风热喉痹，口舌生疮，头目不清爽，痰涎壅盛。
组成：黄连、薄荷叶、槟榔、蒲黄、荆芥穗、甘草、黄柏（各研为末，五分），冰片（三分），柿霜（五钱。若无，可用白糖代替）。
用蜂蜜调和制成丸药，随时含化。
玉雪散：主治咽喉肿痛，对单乳蛾、双乳蛾等十八种证候均有效。
组成：僵蚕（质地坚亮者洗净，一钱）、山豆根（广西产者，取皮研细，五分）、雄黄（飞制）、玄明粉（如无，可用焰硝淡者代替）、硼砂（明亮者，各三分）。
研磨成极细粉末，加入冰片二分混合均匀。先用筷子压下舌头，用芦管将药粉吹入患处，闭口片刻。若牙关紧闭，可将药粉吹入鼻中，或加入薄荷、甘草、桔梗研末，用蜜丸含化也很好。
稀涎散：主治乳蛾喉肿，面部浮肿眼睛闭合，牙关紧闭饮食断绝。
组成：皂荚（研末，猪牙皂尤佳）、明矾（研细，各一钱）。
用白开水调匀灌服。若牙关紧闭，从鼻灌入；若未吐出，用鹅毛蘸取生桐油（或灯窝油），在口内搅动即可催吐。一人托住患者额头，一人用手指伸入口内引出约一盆的痰涎，即刻疼痛停止、肿胀消退，声音发出并能进食。若未痊愈，再次催吐。
或者只用白矾，或者只用油也可以催吐。
或者使用土牛膝根（一名鼓槌草，俗名夫娘子。红梗大叶，节壮生子带刺衣），捣汁加入白矾灌服。
或者使用马蓝头（春苗可食用，秋开小紫花如菊花），捣烂绞汁，加入少许香油灌服。
或者使用胆矾五分，开水调匀催吐，病愈。或者饮用两碗盐汤，催吐也可。
急喉痹：巴豆（去壳），用纸榨油做成蜡捻，点燃后吹灭，用烟熏入鼻孔，流出涎液、牙关张开。
又法：皂角（炙烤，去皮去子），研为细末，用筷子头蘸取点涂患处，用米醋调敷颈部下方，自会破溃，血出则平安。
又法：用悉尼（植物名）捣烂绞汁饮用，有效。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The binding of one Yin (Jueyin) and one Yang (Shaoyang) qi is called Hou Bi (Throat Bi syndrome, involving Jueyin Wind-Wood and Shaoyang Minister-Fire). It further states: The pharynx (Yan) is the pathway for food and drink; the larynx (Hou) is the channel through which Qi ascends and descends; the epiglottis (Huiyan) is the gatehouse for voice production. The Foot-Shaoyin Kidney meridian connects upward to the root of the tongue, links to the transverse bone, and terminates at the epiglottis.
Hou Bi arises from phlegm generating heat, heat generating wind, and fire causing swelling. Thus, when heat pathogens lodge in the Upper Jiao, it results in soreness and swelling of the throat and pharynx. Regarding the relationship between the pharynx/larynx and the epiglottis, the *Neijing* refers to them as the Xi Men (Suction Gate). The pharynx primarily governs Qi reception, corresponds to the Lung, belongs to Metal, and is light and clear, not allowing foreign objects; the larynx primarily receives food, corresponds to the Stomach, belongs to Earth, and accepts all things. The epiglottis sits in the middle, controlling opening and closing, capable of closing the pharynx during eating. If small particles are accidentally swallowed in haste, coughing expels them before stopping. Only respiration passes through the pharynx, making it a critical passageway of the human body. Suddenly, if fluids cannot enter the mouth and speech is lost, life hangs in the balance. Hou Bi is equivalent to modern Ru E (Tonsillitis/Angina). There are eighteen types of throat syndromes, such as Dan E (Unilateral Tonsillitis), Shuang E (Bilateral Tonsillitis), and Chan Hou Feng (Wind-Entangling Throat). Although names and manifestations differ, their source is identical: Minister-Fire. These are often caused by dietary factors like alcohol, fishy/meaty foods, spicy and rich flavors, as well as emotional disturbances, phlegm, and fire. Upon onset, pain extends to the neck and temples, with swelling of the head and face. Ancient texts recommend pricking to bleed. However, cases of injury from pricking are now common; therefore, inducing vomiting to expel phlegm and saliva is safer and infallible. The pulse should be Floating and Surging; a Fine and Hidden pulse is contraindicated. Additionally, one must distinguish Shaoyin Sore Throat from Cold Damage and pain due to Lower Deficiency in Yin Syndromes. If differentiation is difficult, treat initially according to the Main Formula.
Main Formula: Jiegeng (Platycodonis Radix, 4 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian), Jingjie (Schizonepetae Herba, 1.5 qian), Xuanshen (Scrophulariae Radix, 1 qian). Decoct in water and take orally. Swallow slowly while lying in bed.
If detailed pulse and syndrome analysis indicates Heat, gradually add Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Tianfenn (Puerariae Radix), Jiangcan (Bombyx Batryticatus), Shegan (Belamcandae Rhizoma), Shandougen (Sophorae Tonkinensis Radix), Bohe (Menthae Haplocalycis Herba), Huangqin (Scutellariae Radix), Lianlian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), Huangbai (Phellodendri Cortex), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), Shengdi (Rehmanniae Radix), and Danggui (Angelicae Sinensis Radix), selecting as appropriate.
For constipation, add Dahuang (Rhei Radix et Rhizoma); for dysuria, add Mutong (Akebiae Caulis).
Qingxin Liyi Tang (Clear Heart and Benefit Throat Decoction): Treats soreness and swelling of the throat with abundant phlegm and saliva.
Ingredients: Jiegeng, Huanglian (Coptidis Rhizoma), Huangqin, Bohe, Jingjie, Fangfeng, Zhizi (each 1.5 qian); Gancao, Xuanshen, Lianqiao (each 1 qian); Dahuang, Mangxiao (Natrii Sulfas), Niubangzi (each 0.7 qian).
Prepare as one dose, decoct in water, and take after meals. Also use Bixue (see Tongue Syndromes chapter).
Toushui Tian (Penetrating Water Heaven Pill): Treats all types of Wind-Heat Hou Bi, sores on the mouth and tongue, unclear head and eyes, and abundant phlegm and saliva.
Ingredients: Huanglian, Boheye (Menthae Folium), Binglang (Arecae Semen), Puhuang (Typhae Pollen), Jingjiesui (Schizonepetae Spica), Gancao, Huangbai (each powdered, 5 fen); Bingpian (Borneolum Syntheticum, 3 fen); Shishuang (Diospyros Fructus Frost, 5 qian. If unavailable, use white sugar).
Mix with honey to form pills, and hold in the mouth for dissolution as needed.
Yuxue San (Jade Snow Powder): Treats soreness and swelling of the throat; effective for all eighteen syndromes including unilateral and bilateral tonsillitis.
Ingredients: Jiangcan (washed, those that are firm and bright, 1 qian); Shandougen (from Guangxi, peel powdered, 5 fen); Xionghuang (Realgar, purified); Xuanmingfen (Mirabilite, or substitute with mild Yanxiao/Niter); Pengsha (Borax, bright ones, each 3 fen).
Grind into an extremely fine powder, mix evenly with 2 fen of Bingpian. First press down the tongue with chopsticks, then blow the powder into the affected area using a reed tube. Keep the mouth closed for a moment. If the jaw is locked, blow the powder into the nose. Alternatively, add Bohe, Gancao, and Jiegeng, grind into powder, make into honey pills, and hold in the mouth.
Xixian San (Thin Saliva Powder): Treats tonsillitis and throat swelling, facial edema with closed eyes, locked jaw, and inability to eat.
Ingredients: Zaojiao (Gleditsiae Sinensis Fructus, powdered, Zhu Ya variety is best); Mingfan (Alumen, ground, each 1 qian).
Mix with warm water and administer forcibly. If the jaw is locked, administer via the nose. If vomiting does not occur, dip a goose feather in raw Tung oil (or lamp wick oil) and stir inside the mouth to induce vomiting. One person supports the patient's forehead, another inserts a finger to draw out approximately a basin of phlegm and saliva. Pain stops and swelling subsides immediately, voice returns, and eating resumes. If not fully recovered, induce vomiting again.
Alternatively, using only Alumen or only oil can also induce vomiting.
Or use Tubinxigen (Radix Achyranthis Bidentatae, also known as Guchui Cao or Funiangzi; red stem, large leaves, thick nodes bearing spiny fruit), crush and extract juice, mix with Alumen, and administer.
Or use Malantou (Indigofera tinctoria, spring shoots edible, autumn flowers small and purple like chrysanthemum), crush and extract juice, mix with a little Sesame Oil, and administer.
Or use Danfan (Chalcanthite, 5 fen), mix with water to induce vomiting, leading to recovery. Or drink two bowls of salt water to induce vomiting.
Simple Prescription: Treats Hou Bi.
True Shandougen, soak thoroughly in water, hold in the mouth and swallow the juice.
Acute Hou Bi: Badou (Crotonis Fructus, shelled), press between paper to remove oil, make into a wax taper, ignite, blow out, and smoke into the nostrils. Saliva flows, and the jaw opens.
Another method: Zaojiao (roasted, skin and seeds removed), powder. Dip the tip of a chopstick into the powder and apply to the lesion. Mix with rice vinegar and apply to the lower neck. It will spontaneously ulcerate; bleeding brings relief.
Another method: Crush Sydney (plant name) and drink the juice; effective.
Zouma Hou Bi (Running Horse Throat Bi): Jiegeng (2 liang), decoct in water, divide into two doses.
Hou Bi with Toxic Gas: Mix fresh Ginger Juice and Honey in a ratio of one bowl total. Simmer until reduced to six-tenths. Take three to five times daily.
Chan Hou Feng (Wind-Entangling Throat): Raw Baifan (Alumen, 2 qian), take with water. Or crush Chive and apply to the upper neck; or drink Radish Juice mixed with Zaojiao powder to induce vomiting of phlegm; or hold Pengsha in the mouth for dissolution.