Woodcut from Houke zhizhang (Guide to Laryngology), published in 1757 (22nd year of the Qianlong reign period of the Qing dynasty). It illustrates the condition known as chanhou feng (entwining throat wind). This is described as arising when seasonal malignities affect the lungs, wind and phlegm rise to form an obstruction, Yin and Yang are blocked, and intercourse between inside and outside is interrupted. The symptoms of this condition are a swollen and painful throat, extending to the outside of the throat and giving the appearance of a snake entwined around the neck. There may be symptoms of lockjaw (yaguan jinji) and backward arching of the neck and back. It may be treated, as preferred, with pass-opening powder (kaiguan san) introduced into the nose by insufflation so as to produce sneezing; with moxibustion on the jaws; with an emetic of egg white and alum; by mechanically provoking vomiting with a goose feather dipped in tung oil; or through the external application by insufflation of a phlegm-reducing drug composed of gall and alum, to 'free the passes and open up the orifices'. If vomiting fails to occur, needling and opening (tiaoci) may be carried out at the shaoshang (Lesser Shang), guanchong (Rushing Pass), and shaochong (Lesser Rushing) points, etc., on both hands until blood is drawn. As an internal treatment, six-flavour decoction (liuwei tang) can be given, concocted with fresh rhubarb, ephedra, rhizome of notopterygium (qianghuo), perilla juice or myrobalan (hezi) as preferred.
