Throat disease

1

• Throat disease

2
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
3
Etiology Pathology

• Exterior evil poison (wind-heat or wind-cold)
  attack throat
• Spleen Stomach excess heat or fire
• Damp-heat attacking throat
• 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

4

• Diagnosis
• Inquiring
• ltagt pain location pain time degree of the
  pain character of the pain
• ltbgt Chronic or Acute diseases. ltcgt with
  fever or not
• ltdgt Caused by other diseases ltegt
  swollen condition
• ltfgt voice changing condition
  ltggt living enviroment
• lthgt medical history
• Observation
• ltagt spirit status
• ltbgt Face color
• ltcgt throat color
• ltdgt swollen
• ltegt erosion or ulcer

Deep red Fire Toxin with white pus spot Epidemic disease red purple color Over eating hot spicy food red as mirror
Slight red Deficient disease slight red or dark red Kidney Yin def. dark red moisten
Red without swollen Wind Wind-cold
Dry Qi Yin def.
5

• Treating method
• Internal medicine
• ltagt Release the exterior pathogen
• ltbgt Clear fire toxin
• ltcgt transform the phlegm
• ltdgt Invigorate the blood
• ltegt Strengthen the Spleen
• ltfgt Tonify the deficiency
• Externally applied Medicine
• ltagt bloating the powder direct to the throat
• ltbgt gargle
• ltcgt externally applied
• ltdgt needles

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• 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)

7

• Neurosis disease ( Throat )
• Mei He Qi ( ??? )
• 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

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• 1. Qi Stag. type
• Main 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 thin white coating
• Pulse slightly wiry
• Treatment principle Promote the Qi
  circulation
• Formula
• Yue Ju Wan ( Cang Zhu, Xiang Fu, Chuan Xiong,
  Shen Qu, Zhi Zi )

9

• 2. Qi stag. With phlegm rebellion
• Main Sym blocked feeling in the throat, with
  phlegm
• Concurrent sym first feel the uncomfortable in
  the throat, after coughing out the phlegm,
  patient feel comfortable. Oppressed feeling in
  the chest, coughing or vomiting phlegm in severe
  case
• tongue thick greasy white coating
• Pulse wiry slippery
• Treatment moving qi resolve phlegm
• Formular Ban Xia Hou Pu Tang Chai Hu Shu
  Gan San

10

• 3. Liver Qi Stag.
• Main Sym blocked feeling in the throat, with
  emotional changing history
• Concurrent sym easy to lose temper, rib sides
  distention, prefer sighing all the time,
  tireness, bad appetite, headache, dizziness
• tongue white coating
• Pulse wiry
• Treatment smooth the liver Qi
• Formular Xiao Yao San
• or Dan Zhi Xiao Yao San

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• 4. Yin def. fever
• Main Sym blocked feeling in the throat
• Concurrent sym irritability, insomnia,
  dizziness, sore lower back, weak knee, dry
  throat, uncomfortable feeling in rib area
• tongue red body with less coating
• Pulse wiry fine
• Treatment Nourish Yin
• Formular Yi Guan Jian Xiao Yao San

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pharyngitis ????

• 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.

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• 1. Dryness of the Lung due to Yin-Deficiency
• Main Sym dryness, slight pain or a sensation
  of burning heat or foreign body in the throat
• Concurrent sym Congestion, diffuse dark
  redness and dilatation of micrangium of the
  pharyngeal mucous membranes and thickening of the
  lateral pharyngeal bands may be present,
  accompanied with itching of the throat, cough
  with little sputum, fidgets due to deficiency and
  dreaminess.
• Tongue red body with less coating
• Pulse thready rapid
• Treatment principle Nourishing yin, moistening
  dryness and purging pathogenic fire to relieve
  sore throat.
• Formula

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• 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 Zi
• cough
• -- 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
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• 2. Stasis of Qi and Stagnation of Phlegm
• Main Sym a sensation of obstruction or foreign
  body in the throat, often wants to "hang ka"
  (make a "hang ka" sound of cough) and feels
  nausea when getting up in the morning.
• Concurrent sym He may have hyperplasis of
  lymphoid follicles in the retropharyngeal wall
  and thickening of the lateral pharyngeal bands,
  accompanied with chest distress.
• Tongue dark red with yellow fur
• Pulse thready and slippery
• Treatment principle Promoting circulation of
  qi, alleviating mental distress and reducing
  phlegm to resolve masses.

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• Formula
• Modifications
• cough with profuse sputum
• -- Zi Wan, Zhe Bei Mu Gua Lou Pi
• rib area pain or distention
• -- Dang Gui Tao Ren Dan Shen Yu Jin
• reddish sore throat
• -- Chi Shao Niu Xi
• food 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
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• 3. Blood Stasis
• Main Sym dry sore throat with burning
  sensation or blocked feeling but with no
  difficult to swollen
• Concurrent sym He may have hyperplasis of
  lymphoid follicles in the retropharyngeal wall
  and thickening of the lateral pharyngeal bands,
  dark red color
• Tongue purple body color with spots
• Pulse deep acerbity
• Treatment principle
• Formula moving blood resolveing blood
  stasis benefit throat

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• Formula
• Modifications
• headache or dizziness
• -- Shi Jue Ming Zhen Zhu Mu
• sore throat
• -- jin yin hua Xuan Shen
• constipation
• -- da Huang Quan Gua Lou
• sore reddish throat
• -- Sang Lin, E Zhu
• dry 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
19
tonsillitis ??????

• 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.

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• Acute type
• Pathogenesis
• External pathogenic factors attacking
• Lung or Stomach heat
• Liver Qi stagnation
• Phlegm-dampness
• Weak body constitution
• Diagnosis
• Seasons frequent occurred in Spring winter
• Ages 10-40 years

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• 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

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• 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 ????? Qing Yan Tou Biao Fang ????? Qing Yan Tou Biao Fang ????? Qing Yan Tou Biao Fang ????? Qing Yan Tou Biao Fang ????? Qing Yan Tou Biao Fang ?????
JingJie 9g Bo He 9g(add later) Lian Qiao 9g Jing Yin Hua 15-30g Shan Dou Gen9g Zhe Bei Mu 9g
Sheng Shi Gao 15-30g Niu Pang Zi 9g Jie Gen 6g Gan Cao 6g Peng Sha 1.5g
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• 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

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San Huang Liang Ge San ????? San Huang Liang Ge San ????? San Huang Liang Ge San ????? San Huang Liang Ge San ????? San Huang Liang Ge San ????? San Huang Liang Ge San ?????
Huang Qin 9g Huang Lian 6g Da 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

• 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

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• Chronic type
• Pathogenesis
• Remaining fire toxin
• Liver Qi stagnation
• Yin def. fire
• Weak body constitution
• Diagnosis
• Seasons Could occurred in 4 seasons
• Ages Female or adults
• Frequent occurred

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• 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

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• 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 ????? Yan Yin Qing Fei Tang ????? Yan Yin Qing Fei Tang ????? Yan Yin Qing Fei Tang ????? Yan Yin Qing Fei Tang ????? Yan Yin Qing Fei Tang ?????
Sheng Di Huang 30g Mai Dong 18g Bai Shao 12g Bo He 8g add later Xuan Shen 24g Mu Dan Pi 12g
Chuan Bei Mu 12g
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• 2. Kidney Yin def.
• Main Sym frequent occurred tonsils
  inflamation
• Concurrent sym chronic diseases sore
  uncomfortable throat dizziness tinnitus dry
  mouthsore 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

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• Case History 1
• 1. Male 45 years
• 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 cant resolve the dry feeling pain throat
  sometime tire four limbs, bad appetite
• Tongue slightly greasy coating
• Pulse thready weak
• TCM 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

30

• Case History 3
• 1. Male 9 years
• 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 coating
• Pulse even
• TCM 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