throat disease. character of throat disease: -- acute diseases more than chronic diseases -- heat...
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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