CHRONIC PHARYNGITIS

Clinical Manifestations
  • Chronic pharyngitis is a recurrent inflammation of the mucosa of the pharynx and the submucosal and lymphatic structures which often occurs as part of a chronic upper respiratory tract disorder.
  • There is often a history of repeated acute tonsillary or pharyngeal infections, sinusitis, rhinitis, mouth breathing, excessive alcohol consumption, predilection for spicy foods, cigarette smoking, and dry air with low humidity levels, or irritation by dust and pollen.
  • Clinical symptoms:
    Sore throat
    Sensation of an abnormal object in the throat
    Scratchy, itchy throat
    Sensation of burning, dryness and occlusion
    Irritating cough
    Hypersensitive pharyngeal reflex
    Tendency toward nausea
  • Simple chronic pharyngitis:
    The pharyngeal mucosa are dark red
    The capillaries are distended
    Lymph follicles are scattered throughout the post pharyngeal wall, possibly with small amounts of sticky fluid
  • Chronic hypertrophic pharyngitis:
    There is thickened mucosa that is dark red in color
    Increased lymph follicles throughout the posterior pharyngeal wall may have a granulometous appearance
    They may stick out or may be continuous
    The sides of the throat are swollen t
    The soft palate and the arched palate are thickened
  • Atrophic pharyngitis:
    The mucous membranes of the throat are dry, thinning, or shiny
    There is a mucosal secretion often caused by atrophic rhinitis extending downwards
Treatment Principle
Herb Formulas
Points
Clinical Manifestations
  • Severe chills
  • May have mild fever
  • No sweat
  • May be a sore throat
  • Aversion to Cold
  • Cold extremities
  • Cold sensation on back
  • Pale face
  • Extreme fatigue
  • Muscle aching
  • T: Pale with scallop
  • C: White
  • P: Deep, weak and thready
Treatment Principle
  • Warm Yang
  • Expel Cold from the Exterior
  • Dispel Cold from the Interior
Herb Formulas
Points
Clinical Manifestations
  • This is often seen in repeated relapses of acute pharyngitis
  • It may also be caused by depletion of Qi and Blood when patients with acute throat infections are not completely cured
  • Symptoms include:
    D discomfort in the throat
    A slight dryness, and a constant low grade pain that is aggravated by frequent talking
    The voice is hoarse
    The spirit is fatigued
  • The patient lacks vigor
  • There may be a large amount of sputum that is easily expectorated
  • T: Red
  • P: Thready and rapid
  • Local examination:
    There is mild hyperemia and swelling of the pharynx with increased lymph follicles
Treatment Principle
  • Augment the Lung
  • Increase fluids
Herb Formulas
Points
Clinical Manifestations
  • Severe, dry hacking cough
  • No sputum expectorated
  • Small amounts of difficult to expectorate sputum
  • Blood tinged sputum (when Yin Deficiency Fire is present)
  • Afternoon fever
  • Night sweats
  • Malar flush (especially in afternoon)
  • Five sole Heat
  • Dry mouth and throat
  • Itching in throat
  • Hoarse voice, low voice or loss of voice
  • Emaciation
  • T: Red and dry
  • C: None
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Moisten the Lungs
Herb Formulas
Points
Clinical Manifestations
  • Dry mouth and throat
  • Slight pain or burning Heat or a sensation of a foreigh object in the throat
  • Itching in the throat
  • Fidgeting
  • Excessive dreaming
  • Congestion
  • Diffuse dark redness of the blood vessels of the pharyngeal mucous membranes
  • Thickening of the lateral bands
  • Severe, dry hacking cough
  • No sputum expectorated
  • Small amounts of difficult to expectorate sputum
  • Blood tinged sputum (when Yin Deficiency Fire is present)
  • Afternoon fever
  • Night sweats
  • Malar flush (especially in afternoon)
  • Five Sole Heat
  • Hoarse voice, low voice or loss of voice
  • Emaciation
  • T: Red
  • C: Little or None
  • P:Thready and rapid
Treatment Principle
  • Nourish Yin
  • Moisten the Lungs
Herb Formulas
Points
Clinical Manifestations
  • Long-term sensation of a foreign body lodged in the throat
  • Worse with talking or swallowing
  • Frequent desire to clear the throat
  • Congestion and swelling of the pharyngeal mucosa
  • Protracted, incessant cough
  • Expectoration of copious, clear, watery or white Phlegm
  • Short, weak, breathing
  • Asthma
  • Four limbs tired
  • Anorexia
  • General lassitude
  • Distention and pain of the epigastrium and abdomen
  • Loose stools
  • Severe cases: Frightens easily
  • Fatigue
  • Lack of desire to talk
  • T: Pale-red with teethmarks
  • C: Thin and white
  • P: Feeble and thready
Treatment Principle
  • Reinforce the Spleen
  • Benefit the Lungs
  • Warm and transform Phlegm-Dampness
Herb Formulas
Points
Clinical Manifestations
  • Cough with little yellow sputum or
  • No sputum expectorated
  • Blood tinged sputum (when Yin Deficient Fire is present)
  • Spitting saliva
  • Wheezing
  • Shortness of breath
  • Dry, uncomfortable sensation in throat
  • Hiccups
  • Dry mouth
  • Dry mouth and throat
  • Itching in throat
  • Coughing up difficult-to-extectorate Phlegm
  • Nausea
  • Hoarse voice, low voice or loss of voice
  • Thirst
  • Asthma
  • Flushed face
  • Five sole Heat
  • Afternoon fever
  • Night sweats
  • Malar flush (especially in afternoon)
  • Emaciation
  • Vomiting
  • No appetite or
  • Famished but with no desire to eat
  • Abdominal distention after meals
  • Dry stools
  • Irritability with low grade fever
  • Maybe dry retching or
  • T: Red and dry
  • C: Little or None
  • P: Thready and rapid or Deficient and rapid
Treatment Principle
  • Moisten Lung and Stomach Yin
Herb Formulas
Points
Clinical Manifestations
  • There is a long history of throat infections
  • Loose stools
  • The extremities are swollen and lacking strength
  • Local examination:
  • Mild or un-noticeable swelling or hyperemia of the throat
  • Severe cases:
    Sensation of edema
    No signs of dryness exist
    The postpharyngeal wall has lymph follicle enlargements that are caseinated
  • T: Fat, flabby and may have teethmarks
  • C: Pale white
  • P: Soft and lacking strength
Treatment Principle
  • Tonify the Spleen
Herb Formulas
Points
Clinical Manifestations
  • Feeling of obstruction in throat as if a slice of roast meat were stuck there which cannot be coughed up nor swallowed down. This sensation becomes more prominent during emotional upset and subsides when relaxed
  • Frequent desire to clear the throat
  • Nausea on arising
  • Chest distention
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Inappropriate anger
  • Irregular menses
  • Dysmenorrhea
  • Breast distention and pain before and during menses
  • T: Pink
  • C: Thin and white
  • P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle
  • Spread Qi
  • Resolve Phlegm
Herb Formulas
Points
Clinical Manifestations
  • This illness has a longer course and the condition lingers on without cure.
  • Very dry throat
  • Frequent desire for fluids
  • Burning or pricking pain or paroxysmal itching and tickle of the throat that is followed by a constant dry cough
  • The sputum is dry, sticky and difficult to expectorate
  • Headache
  • Tinnitus
  • Weak and sore back and knees
  • An irritated, angry and impatient mood
  • Dry stools
  • The pharynx is inflamed, dark red and swollen
  • The capillaries are sticking out, forming a netlike appearance
  • Post pharyngeal lymph follicles are enlarged and increased
  • Some mucosa have atrophied, causing a meeting of red and white color
  • T: Deep red
  • C: Little or none
  • P: Thready and rapid
Treatment Principle
  • Moisten the Yin
  • Restrain the Fire
Herb Formulas
Points
Clinical Manifestations
  • Difficult to swallow food
  • Swallowing with a choking sensation
  • Swallowing eventually becomes impossible
  • Dull or burning pain
  • Distention with indistinct pain that is relieved by belching, dry retching or spitting up of Phlegm or mucus
  • A feeling of esophageal constriction
  • Dry mouth and throat
  • Focal distention of the chest and diaphragm
  • Difficult bowel movements
  • Severe weight loss
  • Gradual emaciation
  • Sometimes acute pain
  • Maybe severe coughing
  • Maybe aspiration of fluids
  • Maybe fever
  • Maybe aortic erosion
  • T: Red
  • C: White
  • P: Thready and wiry
Treatment Principle
  • Regulate Qi
  • Moisten Dryness in the Stomach
Herb Formulas
Points
Clinical Manifestations
  • Husky, raspy or hoarse voice
  • Throat clearing
  • Expectoration of thick, yellow mucus
  • Maybe worse in the morning
  • Worse with smoking
  • Worse with prolonged use
  • Dry throat
  • Sore throat
  • Throat congestion
  • Dry mouth
  • Bitter taste in the mouth
  • Maybe low-grade fever
  • Cough with yellow mucus
  • T: Normal
  • C: Greasy and yellow
  • P: Slippery and maybe rapid
Treatment Principle
  • Clear the Lungs
  • Resolve Phlegm
  • Clear Heat
  • Benefit the throat
Herb Formulas
Points
Clinical Manifestations
  • Acute lower abdominal pain
  • Incontinence of urine
  • Night fevers
  • Delirious speech
  • Irritability
  • Restlessness
  • Thirst
  • May be mania (severe)
  • Dysmenorrhea
  • Amenorrhea
  • Hard stool
  • Dark red complexion
  • Headache
  • Vertigo
  • Tinnitus
  • Insomnia
  • Palpitations
  • Constipation
  • Frequent urination
  • Emotional instability
  • Chills in the waist and feet
  • Tremors
  • Excruciating abdominal pain with cold
  • Black stool
  • May be chills and fever
  • Hemoptysis
  • Hematuria
  • Red eyes
  • Pain and distention of the head
  • Toothache
  • Irregular menstruation
  • Lochioschesis
  • Severe wheezing
  • Distention of the chest
  • T: Red and dry
  • C: Yellow
  • P: Deep and forceful or Choppy
Treatment Principle
  • Drain Heat
  • Break up Blood Stasis
Herb Formulas
Points
Clinical Manifestations
  • Irritated throat
  • Loss of voice
  • Swelling of the vocal cords
  • Inflammation of the oral cavity
Treatment Principle
  • Clear Lung Heat
  • Cool the throat
  • Dispel Phlegm
  • Disperse accumulations
  • Moisten Dryness
  • Nourish Yin
Herb Formulas
Points