Throat diseaseThroat disease

Character of Throat disease: -- Acute diseases more than chronic diseases -- Heat diseases more than cold diseases -- Excess diseases more than deficient diseases

Organs Related: Lung & Stomach are most related Kidney: kidney Yin def. def. fire attack the throat Kidney Qi def. low voice Heart: Heart in charge of the voice Heart fire sore throat Liver: especially for chronic throat disease Spleen: nourish the Qi & blood

Etiology & PathologyEtiology & Pathology

1. Exterior evil poison (wind-heat or wind-cold) attack throat

2. Spleen & Stomach excess heat or fire

3. Damp-heat attacking throat

4. Fire toxin ( Excess or Def. fire)

5. Lung Yin def. or lung dryness

6. Liver Qi Stag. : Mei He Qi

7. Kidney def. fire

8. Phlegm or blood stasis

9. Over talking or crying

Diagnosis1.1. Inquiring:Inquiring:

<a> pain location; pain time; degree of the pain; character of the pain<b> Chronic or Acute diseases. : <c> with fever or not

<d> Caused by other diseases: <e> swollen condition: <f> voice changing condition: <g> living enviroment <h> medical history

2. Observation: <a> spirit status <b> Face color <c> throat color: <d> swollen: <e> erosion or ulcer

Deep red

Fire Toxin: with white pus spotEpidemic disease: red & purple colorOver eating hot spicy food: red as mirror

Slight red

Deficient disease: slight red or dark redKidney Yin def. : dark red & moisten

Red without swollen

Wind : Wind-cold

Dry Qi & Yin def.

Treating method1.1. Internal medicine:Internal medicine:

<a> Release the exterior pathogen <b> Clear fire toxin <c> transform the phlegm <d> Invigorate the blood <e> Strengthen the Spleen <f> Tonify the deficiency

2. Externally applied Medicine: <a> bloating the powder direct to the throat <b> gargle <c> externally applied: <d> needles

• Common herbs for throat diseases

• 1. Disperse external wind & release exterior herbs

• 2. Clear fire toxin herbs• 3. Clear interior heat drain fire herbs• 4. Nourish Yin clear def. heat herbs• 5. Transform phlegm & clear heat herbs• External applied herbs

Bing Pian; Zhu Sha; Peng Sha; Qing Dai; Bai Fan (6 major herbs used in throat diseases)

• Neurosis disease ( Throat ) Neurosis disease ( Throat ) • Mei He Qi ( Mei He Qi ( 梅核气 ）梅核气 ）

• Neurosis• 1. A psychological or behavioral disorder in which anxiety is

the primary characteristic; defense mechanisms or any phobias are the adjustive techniques that a person learns to cope with this underlying anxiety. In contrast to the psychoses, people with a neurosis do not exhibit gross distortion of reality or gross disorganization of personality but in severe cases, those affected may be as disabled as those with a psychosis.

• 2. A functional nervous disease, or one in which there is no evident lesion.

• 3. A peculiar state of tension or irritability of the nervous system; any form of nervousness.

• Syn: neurotic disorder

• 1. Qi Stag. type1. Qi Stag. type

Main Sym: blocked feeling in the throatMain Sym: blocked feeling in the throat

Concurrent sym: no pain, oppressed feeling in the chest sometime, good appetite, no phlegm, only feel the sym, after hard working or after emotional changing.

Tongue:Tongue: thin white coating thin white coating

Pulse:Pulse: slightly wiry slightly wiry

Treatment principle: Promote the Qi circulationTreatment principle: Promote the Qi circulation

FormulaFormula

Yue Ju Wan ( Cang Zhu, Xiang Fu, Chuan Xiong, Yue Ju Wan ( Cang Zhu, Xiang Fu, Chuan Xiong, Shen Qu, Zhi Zi )Shen Qu, Zhi Zi )

• 2. Qi & stag. With phlegm rebellion2. Qi & stag. With phlegm rebellion

Main SymMain Sym: blocked feeling in the throat, with : blocked feeling in the throat, with phlegmphlegm

Concurrent symConcurrent sym: first feel the uncomfortable in the : first feel the uncomfortable in the throat, after coughing out the phlegm, patient feel throat, after coughing out the phlegm, patient feel comfortable. Oppressed feeling in the chest, coughing or comfortable. Oppressed feeling in the chest, coughing or vomiting phlegm in severe casevomiting phlegm in severe case

tonguetongue: thick greasy white coating : thick greasy white coating

Pulse: wiry & slipperyPulse: wiry & slippery

Treatment: moving qi & resolve phlegmTreatment: moving qi & resolve phlegm

Formular:Formular: Ban Xia Hou Pu Tang + Chai Hu Shu Ban Xia Hou Pu Tang + Chai Hu Shu Gan SanGan San

• 3. Liver Qi Stag.3. Liver Qi Stag.

Main SymMain Sym: blocked feeling in the throat, with : blocked feeling in the throat, with emotional changing historyemotional changing history

Concurrent symConcurrent sym: easy to lose temper, rib sides : easy to lose temper, rib sides distention, prefer sighing all the time, tireness, bad distention, prefer sighing all the time, tireness, bad appetite, headache, dizzinessappetite, headache, dizziness

tonguetongue: white coating : white coating

Pulse: wiryPulse: wiry

Treatment: smooth the liver QiTreatment: smooth the liver Qi

Formular:Formular: Xiao Yao San Xiao Yao San

or Dan Zhi Xiao Yao Sanor Dan Zhi Xiao Yao San

• 4. Yin def. fever4. Yin def. fever

Main SymMain Sym: blocked feeling in the throat: blocked feeling in the throat

Concurrent symConcurrent sym: irritability, insomnia, dizziness, : irritability, insomnia, dizziness, sore lower back, weak knee, dry throat, uncomfortable sore lower back, weak knee, dry throat, uncomfortable feeling in rib area feeling in rib area

tonguetongue: red body with less coating : red body with less coating

Pulse: wiry & finePulse: wiry & fine

Treatment: Nourish YinTreatment: Nourish Yin

Formular:Formular: Yi Guan Jian + Xiao Yao San Yi Guan Jian + Xiao Yao San

pharyngitis 喉痹咽炎

Chronic pharyngitis, a chronic inflammation of the pharyngeal mucous membrane and submucous lymphoid tissues, is often caused by unsatisfactory treatment of acute pharyngitis or repeated occurrences of upper respiratory tract infection and it is related to high-dust environment.

Clinically it manifests itself as

--Itching

--dryness

--soreness of the throat

--cough

--a feeling of foreign body or obstruction in the throat.

In TCM it belongs to the category of "hou bi," or inflammation of throat.

• 1. 1. Dryness of the Lung due to Yin-DeficiencyDryness of the Lung due to Yin-Deficiency

Main Sym: dryness, slight pain or a sensation of Main Sym: dryness, slight pain or a sensation of burning heat or foreign body in the throatburning heat or foreign body in the throat

Concurrent sym: Congestion, diffuse dark Concurrent sym: Congestion, diffuse dark redness and dilatation of micrangium of the pharyngeal redness and dilatation of micrangium of the pharyngeal mucous membranes and thickening of the lateral mucous membranes and thickening of the lateral pharyngeal bands may be present, accompanied with pharyngeal bands may be present, accompanied with itching of the throat, cough with little sputum, fidgets due itching of the throat, cough with little sputum, fidgets due to deficiency and dreaminess. to deficiency and dreaminess.

Tongue: red body with less coatingTongue: red body with less coating

Pulse: thready & rapid Pulse: thready & rapid

Treatment principle: Nourishing yin, moistening Treatment principle: Nourishing yin, moistening dryness and purging pathogenic fire to relieve sore throat. dryness and purging pathogenic fire to relieve sore throat.

Formula :Formula :

Formula:

Modifications:dry throat

-- Shi Hu; Bai He sore lower back, insomnia

-- Yi Zhi Ren; Gou Ji; Wu Wei Zi, Huai Xiao Mai sticky white secretion on the wall of the throat

-- Tian Hua Feng, Lu Gen, Gou Qi Zicough

-- Qian Hu; Pi Pa Ye; Xin Ren; Xuan Shen Dry stools

-- Huo Ma Ren; Quan Gua Lou

Bai He Gu Jin Tang; Yang Yin Qin Fei Tang; Zhi Bai Di Huang Wan, Yi Guan Jian

Sha Shen 12 Mai Dong 12 Shen Di 20 Dan Pi 10,

Chuan Bei Mu 9

Bai Shao 10

Bo He 6 Lu E Mei 6 Gan Cao 6

• 2. Stasis of Qi and Stagnation of Phlegm2. Stasis of Qi and Stagnation of Phlegm

Main Sym: a sensation of obstruction or foreign Main Sym: a sensation of obstruction or foreign body in the throat, often wants to "hang ka" (make a body in the throat, often wants to "hang ka" (make a "hang ka" sound of cough) and feels nausea when getting "hang ka" sound of cough) and feels nausea when getting up in the morning.up in the morning.

Concurrent sym: He may have hyperplasis of Concurrent sym: He may have hyperplasis of lymphoid follicles in the retropharyngeal wall and lymphoid follicles in the retropharyngeal wall and thickening of the lateral pharyngeal bands, accompanied thickening of the lateral pharyngeal bands, accompanied with chest distress. with chest distress.

Tongue: dark red with yellow fur Tongue: dark red with yellow fur

Pulse: thready and slipperyPulse: thready and slippery

Treatment principle: Promoting circulation of qi, Treatment principle: Promoting circulation of qi, alleviating mental distress and reducing phlegm to resolve alleviating mental distress and reducing phlegm to resolve masses.masses.

Formula:

Modifications:cough with profuse sputum

-- Zi Wan, Zhe Bei Mu; Gua Lou Pirib area pain or distention

-- Dang Gui; Tao Ren; Dan Shen; Yu Jin reddish & sore throat

-- Chi Shao; Niu Xifood stag.

-- shen qu; ji nei jin Other formula: Chai Hu Shu Gan San; Xiao Yao San; Si Ni San; Ban Xia Hou

Pu Tang;

Chai hu 9 Zhi Ke 9 Lu E Mei 6 Bai shao 9

Bo he 6 Jie Gen 4.5

She Gan 4.5 Gan Cao 6 Gan Song 9

• 3. Blood Stasis3. Blood Stasis

Main Sym: dry & sore throat with burning Main Sym: dry & sore throat with burning sensation or blocked feeling but with no difficult to sensation or blocked feeling but with no difficult to swollen swollen

Concurrent sym: He may have hyperplasis of He may have hyperplasis of lymphoid follicles in the retropharyngeal wall and lymphoid follicles in the retropharyngeal wall and thickening of the lateral pharyngeal bands, dark red colorthickening of the lateral pharyngeal bands, dark red color

Tongue: purple body color with spotsTongue: purple body color with spots

Pulse: deep & acerbityPulse: deep & acerbity

Treatment principle: Treatment principle:

Formula : moving blood & resolveing blood stasis & Formula : moving blood & resolveing blood stasis & benefit throatbenefit throat

Formula:

Modifications:headache or dizziness

-- Shi Jue Ming; Zhen Zhu Musore throat

-- jin yin hua; Xuan Shen constipation

-- da Huang; Quan Gua Lousore & reddish throat

-- Sang Lin, E Zhudry throat

-- Bai Mao Gen; Lu Gen; Xuan Shen Other formula:

Xue Fu Zhu Yu Tang; Tao Hong Si Wu Tang; Bu Yang Huan Wu Tang;

Dang gui 12 Shen di 12 Tao ren 15 Chuan shan jia 9

Chi shao 12 Dan pi 10

Jiang chan 9 Chuan xiong 10

Jie gen 6 Chai hu 6

tonsillitis 乳蛾扁桃腺炎

Tonsillitis is an infection of the tonsils and will often, but not necessarily, cause a sore throat and fever.

–There are 3 main types of tonsillitis: acute, subacute and chronic. Acute tonsillitis can either be bacterial or viral in origin. Subacute tonsillitis is caused by the bacterium Actinomyces. Chronic tonsillitis, which can last for long periods if not treated, is mostly caused by bacterial infection.

Acute type

Pathogenesis:

1.External pathogenic factors attacking

2.Lung or Stomach heat

3.Liver Qi stagnation

4.Phlegm-dampness

5.Weak body constitution

Diagnosis:

Seasons: frequent occurred in Spring & winter

Ages: 10-40 years

• 1. Wind-heat type

Main Sym: swollen tonsils on one or both sides;

Concurrent sym: hot sensation; swollen difficulty; with high fever; slightly aversion to cold or not; cough with phlegm; headache; whole body ache;

Tongue: red body with thin yellow coating

Pulse: floating & rapid

Treatment principle:

--release the exterior wind heat

-- Clear fire toxin & benefit the throat

Formula:

Modifications:

With excessive heat toxin

-- Da Qing Ye; Ban Lan Gen

with excessive Lung & stomach heat

-- Huang Qin; Sang Bai Pi

Dry mouth:

-- Flesh Lu Gen; Shi Hu

Headache:

-- Ju Hua; bai Zhi

Severe cough

-- qian Hu; xing Ren; Sang Bai Pi

Pyosis:

-- Zao Jiao Ci; Jie Gen

Qing Yan Tou Biao Fang 清咽透表方JingJie 9g Bo He

9g(add later)Lian Qiao

9gJing Yin Hua

15-30gShan Dou

Gen9gZhe Bei Mu 9g

Sheng Shi Gao 15-30g

Niu Pang Zi 9g

Jie Gen 6g Gan Cao 6g Peng Sha 1.5g

• 2. Excessive Lung & Stomach Heat

Main Sym: swollen tonsils on one or both sides;

Concurrent sym: high fever; thirsty; coughing with yellow sticky phlegm; constipation; scanty dark urine; In severe case, could combine with difficult breathing.

tongue: red body with thick yellow coating

Pulse: big & rapid

Treatment principle:

-- Clear fire toxin & benefit the throat

-- promote bowl movement

Formula:

Modifications:

With excessive heat toxin

-- Ling Yang Jiao; tu Niu Xi;

Scanty dark urine

-- Mu Tong; Dan Zhu Ye

Severe cough with yellow sticky phlegm

-- Tian Zhu Huang; Fu Ling

Thirsty

-- Tian Hua Feng; Mai Dong

San Huang Liang Ge San 三黄凉膈散Huang Qin

9gHuang Lian

6gDa Huang

6-15g

Shan Zhi Zi

9-15g

JingYinHua

15-30g

Shi Gao

15-30g

Da Qin Ye

9-15g

Lian Qiao

9g

Xuan Shen

9g

Chuan Bei Mu 9g

Mang Xiao

6-9g

Bo He

6g

Jie Gen 6g Gan Cao6g

Chronic type

Pathogenesis:

1.Remaining fire toxin

2.Liver Qi stagnation

3.Yin def. fire

4.Weak body constitution

Diagnosis:

Seasons: Could occurred in 4 seasons

Ages: Female or adults

Frequent occurred

• 1. Lung Yin def.

Main Sym: frequent occurred uncomfortable throat ;

Concurrent sym: dry or sore throat; slightly pain; dry cough; tidal fever; night sweating; five palms hot sensation; fatigue; dry mouth; bad mouth smelling

tongue: red body with less coating

Pulse: fine & rapid

Treatment principle:

-- Nourish lung Yin & clear def. heat

-- Generate the fluids & benefit throat

For

mula:

Modifications:

With excessive heat toxin

-- Xuan Shen ； tu Niu Xi; Jin yin Hua

itchy & sore throat

-- she Gan; Zhi Pi Pa Ye

Dry stools:

-- Quan Gua Lou; Huo Ma Ren;

Tidal fever & night sweats

-- Bai Wei; Di Gu Pi

Heart fire:

-- Huang Lian; DanZhu Ye

Yan Yin Qing Fei Tang 养阴清肺汤Sheng Di

Huang 30gMai Dong

18gBai Shao

12g

Bo He

8g add later

Xuan Shen

24g

Mu Dan Pi

12g

Chuan Bei Mu

12g

• 2. Kidney Yin def.

Main Sym: frequent occurred tonsils inflamation;

Concurrent sym: chronic diseases; sore & uncomfortable throat; dizziness; tinnitus; dry mouth;sore & weak lower back; night sweats; insomnia; fatigue

tongue: red body with less coating

Pulse: fine & weak

Treatment principle:

-- Nourish Kidney Yin & clear def. heat

Formula:

Liu Wei Di Huang Wan

Case History 1 1. Male 45 years

First visiting:First visiting: Main complain: Nasopharyngenl Carcinoma ， NPC

patient had suffered from chronic pharyngitis for years, and patient just finished the chemical threapy for the cancer, no stuff nose, no blood secretion, only feel dry throat , even drinking water can’t resolve the dry feeling; pain throat sometime; tire four limbs, bad appetite

Tongue: slightly greasy coatingPulse: thready & weakTCM diagnose:

Qi & Yin Def.Empty fire rising up

Treatment protocol:-- Tonify Spleen & Qi-- Nourish Yin & clear empty fire

Formula:Tai Zi Shen 10; Mai Dong 10; Wu Wei Zi 10; Shan

Yao 10; Bai Bian Dou 10; Wu Mei 10; Xuan Shen 10; Shi Hu 10; Gan Cao 3

Case History 3 1. Male 9 years

First visiting:First visiting: Main complain: allergic rhinitis 4 y

symptoms occurred every time, when patient catched little cold; stuffed nose; feel headache in severe case; even had profuse secretion in normal time and with yellow & white color; easy sweating during the whole year;

Tongue: thin white coatingPulse: evenTCM diagnose:

Qi def.

Treatment protocol:-- Tonify the defensive Qi

Formula:Ru Dou Yi 10; Huang Qi 10; Fang Feng 6; Gan Di

Long 10; Xu Chang Qin 10; Wu Mei 10; Bai Zhu 6; Shi Liu Pi 10; Chan Yi 3; Xing Yi Hua 6

X 7