THROAT

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Chapter 59

THROAT

Chapter contents

SORE THROAT

Interrogation, Chapter 36

REDNESS OF THE PHARYNX

Observation, Chapter 10

Invasion of Wind-Heat

Redness of the pharynx, sore throat, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Stomach-Heat

Redness of the pharynx, thirst, foul breath, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Lung-Yin deficiency with Empty-Heat

Pale-red pharynx, dry cough or with scanty, sticky sputum, dry mouth and throat at night, night sweating, tiredness, malar flush, a feeling of heat or a low-grade fever in the evening, five-palm heat, thin body, Red tongue without coating, Floating-Empty and Rapid pulse.

Kidney-Yin deficiency with Empty-Heat

Pale-red pharynx, dry mouth with desire to sip water, dizziness, tinnitus, hardness of hearing, night sweating, dry mouth at night, five-palm heat, a feeling of heat in the evening, malar flush, thirst with a desire to drink in small sips, lower backache, dark scanty urine, insomnia, Red tongue without coating, Floating-Empty and Rapid pulse.

REDNESS AND SWELLING OF THE PHARYNX

Observation, Chapter 10

Invasion of Wind-Heat

Red and swollen throat with sudden onset, sore throat, swollen tonsils, aversion to cold, fever, cough, sore throat, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Heat in the Lungs and Stomach

Red and swollen throat with sudden onset, sore throat, a feeling of obstruction in the throat, Cough, slight breathlessness, a feeling of heat, chest ache, flaring of nostrils, thirst, red face, burning epigastric pain, sour regurgitation, nausea, excessive hunger, foul breath, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Toxic Heat

Red and swollen throat with purulent spots, swollen tonsils with yellow purulent spots, sore throat, fever, thirst, headache, Red tongue with red points and thick, sticky yellow coating, Overflowing-Rapid-Slippery pulse.

Lung and Kidney-Yin deficiency with Empty-Heat

Chronic slightly swollen throat, red throat, dry throat at night with desire to drink in small sips, dry cough which is worse in the evening, thin body, breathlessness on exertion, lower backache, night sweating, dizziness, tinnitus, hardness of hearing, scanty urination, a feeling of heat in the evening, five-palm heat, malar flush, thirst with a desire to drink in small sips, Red tongue without coating, Floating-Empty and Rapid pulse.

REDNESS AND EROSION OF THE PHARYNX

Observation, Chapter 10

Toxic Heat

Redness, erosion, swelling and severe pain of the pharynx, swollen tonsils with yellow purulent spots, sore throat, fever, thirst, headache, Red tongue with red points and thick, sticky yellow coating, Overflowing-Rapid-Slippery pulse.

Heat in the Stomach and Intestines

Erosion, swelling and a yellowish-red colour of the pharynx, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Yin deficiency with Empty-Heat

Chronic erosion of the pharynx which comes and goes, slight swelling, dry mouth and throat, thirst with a desire to drink in small sips, a feeling of heat in the evening, night sweating, five-palm heat, Red tongue with coating, Floating-Empty and Rapid pulse.

Other symptoms and signs depend on the organ affected, which may be Stomach, Lungs or Kidneys.

Severe Yin deficiency

Chronic erosion of the pharynx which comes and goes, absence of swelling, dryness of the pharynx with greyish ulcers, dry throat, thirst with a desire to drink in small sips, night sweating, a feeling of heat in the evening, tongue dry without coating, Floating-Empty pulse.

Other symptoms and signs depend on the organ involved, which may be Lungs or Kidneys.

Blood stasis with Phlegm-Heat

Chronic erosion of the pharynx with ulcers with raised, hard edges, dark, dull colour of the pharynx, sore throat, mental restlessness, abdominal pain, a feeling of oppression of the chest, sputum in the throat, a feeling of heat, thirst with no desire to drink, Reddish-Purple and Swollen tongue with sticky yellow coating, Wiry-Slippery pulse.

SWOLLEN TONSILS

Observation, Chapter 10

Invasion of Wind-Heat with Toxic Heat

Acute swelling and redness of the tonsils, in severe cases oozing pus, severe sore throat, aversion to cold, fever, cough, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Toxic Heat in the throat at the Qi level

Acute redness and swelling of the tonsils, which ooze pus, severe sore throat, difficulty in swallowing, high fever, thirst, mental restlessness, a feeling of heat, dark Red tongue with red points and thick, dark-yellow coating, Overflowing-Slippery-Rapid pulse.

Toxic Heat in the Stomach and Intestines

Chronic redness and swelling of the tonsils, thirst, foul breath, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, a feeling of heat, constipation, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Stomach and Lung-Yin deficiency with Empty-Heat

Chronic swelling and redness of the tonsils, which come and go, dry cough or with scanty, sticky sputum, dry mouth and throat especially in the afternoon, thirst with a desire to drink in small sips, dull or burning epigastric pain, a feeling of heat in the afternoon, night sweating, five-palm heat, bleeding gums, tiredness, malar flush, thin body, Red tongue without coating, Floating-Empty and Rapid pulse.

Clinical note

• In my experience, a chronic swelling of the tonsils in children denotes a residual pathogenic factor, usually Dampness.

• Heat in the Stomach and Large Intestine may also cause a chronic swelling of the tonsils in children.

PHLEGM IN THE THROAT

Phlegm with Lung-Qi stagnation

Phlegm in the throat, a feeling of a lump in the throat, a feeling of oppression or distension of the chest, slight breathlessness, difficulty in swallowing, sighing, sadness, irritability, depression, sputum in the throat, tongue slightly Swollen on the sides in the chest areas, Slippery pulse that is also very slightly Tight on the right Front position.

Phlegm obstructing the clear orifices

Phlegm in the throat, difficulty in speech, rattling sound in the throat, a feeling of oppression of the chest, dull headache as if the head were full of cotton wool, dizziness, blurred vision, expectoration of phlegm, nausea, vomiting, Swollen tongue with sticky tongue coating, Slippery pulse.

Phlegm-Heat in the Lungs

Phlegm in the throat, a rattling sound in the throat, barking cough with profuse, sticky yellow or green sputum, shortness of breath, wheezing, a feeling of oppression of the chest, a feeling of heat, thirst, insomnia, agitation, Red and Swollen tongue with a sticky yellow coating, Slippery-Rapid pulse.

Phlegm-Heat and Wind

Phlegm in the throat, a feeling of oppression of the chest, a feeling of heat, thirst with no desire to drink, headache, breathlessness, a rattling sound in the throat, expectoration of yellow sputum, dizziness, giddiness, numbness/tingling of the limbs, Red, Swollen and Stiff tongue with sticky yellow coating, Slippery-Wiry-Rapid pulse.

Spleen and Kidney-Yang deficiency

Scanty phlegm in the throat, weak rattling sound in the throat, expectoration of white watery phlegm, lower backache, cold and weak knees, a feeling of cold, bright-white complexion, impotence, decreased libido, tiredness, lassitude, abundant clear urination, urination at night, loose stools, poor appetite, slight abdominal distension, a desire to lie down, early-morning diarrhoea, Pale and wet tongue, Deep-Weak pulse.

Clinical note

• When I suspect Phlegm, I always ask patients whether they experience some phlegm in the throat, even if only in the morning. If they reply affirmatively, I take this as a sign of Phlegm, even in the absence of other symptoms.

GOITRE (swelling of the sides of the neck

Observation, Chapter 10; Interrogation, Chapter 36

Qi stagnation and Phlegm

Relatively soft and large goitre with indistinct margins, normal skin colour, not painful, a feeling of oppression of the chest, a feeling of a lump in the throat, sighing, sputum in the throat, hypochondrial distension, irritability, Swollen tongue, Wiry pulse.

Liver-Qi stagnation, Spleen-Qi deficiency and Phlegm

Large, soft goitre, depression, irritability, a feeling of a lump in the throat, difficulty in swallowing, a feeling of oppression or distension of the chest and hypochondrium, moodiness, premenstrual tension, nausea, vomiting of watery fluids, tiredness, poor appetite, a feeling of heaviness, weak limbs, loose stools, dull-pale complexion, cold limbs, Pale, and Swollen tongue with sticky coating, Soggy or Weak and slightly Slippery or Wiry pulse.

Liver-Fire blazing with Phlegm-Heat

Small or medium-sized goitre that is relatively soft and slippery under the finger, headache, exophthalmos (bulging eyeballs), red face, dizziness, tinnitus, irritability, propensity to outbursts of anger, thirst, bitter taste, constipation, dark urine, barking cough with profuse, sticky yellow or green sputum, shortness of breath, wheezing, a feeling of oppression of the chest, a feeling of heat, insomnia, agitation, Swollen and Red tongue with redder sides and tip, Wiry-Slippery-Rapid pulse.

Phlegm and Blood stasis

Relatively hard goitre with distinct margins, nodules on the thyroid, dark skin colour, painful, a feeling of oppression of the chest, headache, insomnia, anxiety, chest or abdominal pain, sputum in the throat, Purple and Swollen tongue with sticky coating, Wiry-Slippery pulse.

Heart and Liver-Yin deficiency with Phlegm

Chronic goitre that may be large or small and relatively soft with slow onset, tremor of hands, palpitations, insomnia, dream-disturbed sleep, anxiety, dry mouth and throat, night sweating, dizziness, numbness or tingling of the limbs, blurred vision, floaters in eyes, dry eyes, scanty menstruation, dull-pale complexion but with red cheekbones, withered and brittle nails, dry skin and hair, normal-coloured Swollen tongue without coating, Fine or Floating-Empty pulse.

Clinical note

• Goitre is by definition due to Phlegm.

ITCHY THROAT

Interrogation, Chapter 36

Invasion of Wind

Itchy throat with sudden onset, aversion to cold, stiff neck, fever, headache, Floating pulse.

Other symptoms and signs depend on whether it is Wind-Cold or Wind-Heat.

Lung-Yin deficiency

Chronic itchy throat, dry cough, weak voice, dry throat with a desire to sip water, hoarse voice, night sweating, tiredness, tongue without coating in the front, Floating-Empty pulse.

Lung Dryness

Itchy throat, dry cough, dry skin, dry throat, dry mouth, thirst, hoarse voice, dry tongue, Fine pulse.

Dryness invading the Lungs

Itchy throat with sudden onset, dry cough, aversion to cold, fever, dry nose, dry and sore throat, tongue Red in the front with dry, thin white coating, Floating pulse.

DRY THROAT

Interrogation, Chapter 36

Lung-Yin deficiency

Chronic dry throat, hoarse voice, dry cough, weak voice, dry throat with desire to sip water, night sweating, tiredness, tongue without coating in the front, Floating-Empty pulse.

Kidney-Yin deficiency

Chronic dry throat, dry throat at night with a desire to drink in small sips, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, vertigo, lower backache, ache in bones, nocturnal emissions, constipation, scanty dark urine, infertility, premature ejaculation, tiredness, lassitude, depression, slight anxiety, normal-coloured tongue without coating, Floating-Empty pulse.

Stomach-Yin deficiency

Chronic dryness of the throat, no appetite or slight hunger but no desire to eat, constipation (dry stools), dull or slightly burning epigastric pain, dry mouth especially in the afternoon, thirst but no desire to drink, or a desire to drink in small sips, a slight feeling of fullness after eating, normal-coloured tongue without coating in the centre, Floating-Empty pulse.

Liver-Yin deficiency

Chronic dryness of the throat, dizziness, numbness/tingling of the limbs, insomnia, blurred vision, floaters in the eyes, dry eyes, diminished night vision, scanty menstruation or amenorrhoea, dull-pale complexion without lustre but with red cheekbones, muscular weakness, cramps, withered and brittle nails, very dry skin and hair, night sweating, depression, a feeling of aimlessness, normal-coloured tongue without coating, Fine or Floating-Empty pulse.

Invasion of Wind-Heat

Dry throat with sudden onset, itchy throat, sore throat, aversion to cold, fever, cough, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Heat in the Stomach and Spleen

Dry throat, swollen throat, burning epigastric pain, thirst, sour regurgitation, nausea, foul breath, a feeling of heat, excessive hunger, red tip of the nose, dry lips, mouth ulcers, dry stools, scanty dark urine, yellow complexion, Red tongue with dry yellow coating, Overflowing-Rapid pulse.

Heat in the Liver and Gall-Bladder

Dry throat, bitter taste, thirst, blurred vision, hypochondrial pain, nausea, headache, red eyes, Red tongue with redder sides and dry yellow coating, Wiry-Rapid pulse.

Lesser-Yang pattern (Six Stages)

Dry throat, bitter taste, hypochondriac fullness and pain, alternation of chills and feeling of heat with predominance of the former, irritability, unilateral white tongue coating, Wiry pulse.

Gall-Bladder-Heat pattern (Qi level of Four levels)

Dryness of the throat, thirst, bitter taste, hypochondrial pain, alternation of chills and feeling of heat with predominance of the latter, irritability, unilateral yellow tongue coating, Wiry-Rapid pulse.

Wind-Dryness-Heat invading the Lungs

Dry throat with sudden onset, sore throat, itchy throat, aversion to cold, fever, dry cough, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, dry nose, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

HOARSE VOICE OR LOSS OF VOICE

Interrogation, Chapter 36; Hearing, Chapter 53

Lung and Kidney-Yin deficiency

Chronic hoarse voice, dry throat at night, itchy throat, dry cough which is worse in the evening, thin body, breathlessness on exertion, lower backache, night sweating, dizziness, tinnitus, hardness of hearing, scanty urination, normal-coloured tongue without coating, Floating-Empty pulse.

Lung-Yin deficiency

Chronic hoarse voice, cough which is dry or with scanty sticky sputum, weak voice, dry mouth and throat, tickly throat, tiredness, dislike of speaking, thin body or thin chest, night sweating, normal-coloured tongue without coating (or with rootless coating) in the front part, Floating-Empty pulse.

Invasion of Wind-Heat and Dryness

Hoarse voice with sudden onset, dry throat with sudden onset, sore throat, itchy throat, aversion to cold, fever, dry cough, stuffed or runny nose with yellow discharge, headache, body aches, slight sweating, slight thirst, swollen tonsils, dry nose, tongue slightly Red on the sides in the chest area or on front part, Floating-Rapid pulse.

Lung-Heat

Hoarse voice, sore throat, a feeling of blockage of the throat, cough, slight breathlessness, a feeling of heat, chest ache, flaring of nostrils, thirst, red face, Red tongue with yellow coating, Overflowing-Rapid pulse.

Blood stasis and Phlegm

Chronic hoarse voice, sore throat, a feeling of obstruction of the throat, thickening of the vocal chords, nodules on the vocal chords, swelling of the throat, headache, chest pain, a feeling of oppression of the chest, sputum in the throat, Purple tongue, Wiry pulse.

WHITE PURULENT SPOTS IN THE THROAT

Epidemic Toxic Heat on the Exterior

White purulent spots in the throat, small and with distinct margins, sore and swollen throat, swollen tonsils, fever, aversion to cold, headache, body aches, thin white tongue coating, Floating-Rapid pulse.

Epidemic Toxic Heat in the Interior

White purulent spots in the throat, large spots which may ooze blood, red, swollen and sore throat, high fever, profuse sweating, red face, thirst, mental restlessness, a feeling of heat, Red tongue with yellow coating, Overflowing-Rapid pulse.

Turbid Phlegm in the throat

Chronic white purulent spots in the throat, dull-pasty complexion, mental restlessness, a feeling of oppression of the chest, wheezing, expectoration of sputum, barking voice, hoarse voice, Swollen tongue with white coating, Slippery pulse.

Lung and Kidney-Yin deficiency

White purulent spots in the throat, dry throat, dry cough which is worse in the evening, dry throat and mouth, thin body, breathlessness on exertion, lower backache, night sweating, dizziness, tinnitus, hardness of hearing, scanty urination, normal-coloured tongue without coating, Floating-Empty pulse.

Lung and Kidney-Yin deficiency with Empty-Heat

White purulent spots in the throat, dry throat at night, dry cough which is worse in the evening, thin body, breathlessness on exertion, lower backache, night sweating, dizziness, tinnitus, hardness of hearing, scanty urination, a feeling of heat in the evening, five-palm heat, malar flush, thirst with a desire to drink in small sips, Red tongue without coating, Floating-Empty and Rapid pulse.

Heat in the Lungs and Stomach

White purulent spots in the throat, swollen throat, painful throat, swollen tonsils, cough, slight breathlessness, a feeling of heat, chest ache, flaring of nostrils, thirst, red face, burning epigastric pain, thirst, sour regurgitation, nausea, excessive hunger, foul breath, Red tongue with a yellow coating, Overflowing-Rapid pulse.

Kidney-Yang deficiency

White purulent spots in the throat, lower backache, cold knees, a sensation of cold in the lower back, a feeling of cold, weak legs, bright-white complexion, weak knees, tiredness, lassitude, abundant clear or scanty clear urination, urination at night, apathy, oedema of lower legs, infertility in women, loose stools, depression, impotence, premature ejaculation, low sperm count, cold and thin sperm, decreased libido, Pale and wet tongue, Deep-Weak pulse.

FEELING OF OBSTRUCTION OF THE THROAT

Interrogation, Chapter 36

Liver-Qi stagnation

A feeling of lump in the throat that comes and goes according to the emotional state, hypochondrial or epigastric distension, irritability, moodiness, a feeling of lump in the throat, premenstrual tension, Wiry pulse.

Lung and Stomach-Qi stagnation

A feeling of lump in the throat that comes and goes according to the emotional state, sadness, worry, grief, depression, a slight feeling of tightness, oppression or distension of the chest, slight breathlessness, difficulty in swallowing, sighing, irritability, epigastric pain and distension, belching, nausea, vomiting, hiccup, tongue slightly Red on the sides in the chest areas, pulse slightly Wiry on the right.

Qi stagnation and Phlegm

A feeling of lump in the throat, phlegm in the throat that needs frequent clearing, expectoration of scanty sputum, a feeling of oppression of the chest, irritability, Swollen tongue with sticky coating, Slippery-Wiry pulse.

Lung-Yin deficiency

A feeling of lump in the throat, dry throat at night, tickly throat, cough which is dry or with scanty sticky sputum, weak/hoarse voice, tiredness, dislike of speaking, thin body or thin chest, night sweating, normal-coloured tongue without coating (or with rootless coating) in the front part, Floating-Empty pulse.

Kidney-Yin deficiency

A slight feeling of lump in the throat, dry throat at night, dizziness, tinnitus, hardness of hearing, poor memory, night sweating, vertigo, lower backache, ache in bones, nocturnal emissions, constipation, scanty dark urine, infertility, premature ejaculation, tiredness, lassitude, depression, slight anxiety, normal-coloured tongue without coating, Floating-Empty pulse.

Clinical note

• In my experience, a feeling of obstruction in the throat strongly indicates emotional stress with Qi stagnation.

• Note that this is not always related to the Liver and may be related also to Lungs or Heart.

• Ban Xia Hou Po Tang is for stagnation of Lung-Qi in the throat from worry or grief.

REDNESS ON THE THROAT

Observation, Chapter 10

By ‘redness on the throat’ is meant not a redness inside the throat (pharynx) but a redness on the skin overlying the throat.

Heart-Fire

Redness on the throat that gets worse when patient talks, thirst, bitter taste, palpitations, anxiety, red face, Red tongue with redder tip and yellow coating, Overflowing-Rapid pulse.

Heart-Yin deficiency with Empty-Heat

‘Floating’ redness on the throat, dry mouth and throat, palpitations, insomnia, dream-disturbed sleep, poor memory, anxiety, mental restlessness, a feeling of heat in the evening, malar flush, night sweating, five-palm heat, Red tongue with redder tip and without coating, Floating-Empty and Rapid pulse.

Lung-Heat

Redness on the throat, dry throat, thirst, cough, slight breathlessness, a feeling of heat, chest ache, flaring of the nostrils, red face, Red tongue with yellow coating, Overflowing-Rapid pulse.

Lung-Yin deficiency with Empty-Heat

‘Floating’ redness on the throat, malar flush, dry cough or with scanty, sticky sputum, dry mouth and throat at night, night sweating, tiredness, a feeling of heat or a low-grade fever in the evening, five-palm heat, thin body, Red tongue without coating, Floating-Empty and Rapid pulse.

Liver-Yang rising

‘Floating’ redness on the throat, headache, dizziness, tinnitus, irritability, red face, Wiry pulse.

Liver-Fire

Redness on the throat, thirst, bitter taste, red face, irritability, propensity to outbursts of anger, headache, constipation, dark urine, Red tongue with redder sides and dry-yellow coating, Wiry-Rapid pulse.

Clinical note

• I have noticed that a redness on the throat appearing as the patient talks, indicates severe anxiety with Heat or Empty-Heat.

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