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.

Main Points of Diagnosis

1. The patient has discomfort, dryness and itching, swelling and soreness, a feeling of foreign body in the throat or being stuck with sputum. He or she often wants to "hang ka" (make a cough sound like "hang ka" ) or has irritated coughs.

2. The patient has a sensation of obstruction and fullness in the throat and a feeling of being blocked when swallowing without any food but no difficulty in eating.

3. The patient is apt to feel nausea and vomiting when he or she gets up in the morning.

4. Examination shows that the mucous membrane of the retropharyngeal wall becomes dark red and congestive, or there are dilatation of micrangium, attachment of exudates, hyperplasia of lymphoid follicles, red swelling and thickening of the lateral pharyngeal bands and pachynsis of uvula.  

Differentiation and Treatment of Common Syndromes     

1. Internal Treatment

1) The Type of Dryness of the Lung due to Yin-Deficiency

Main symptoms and Signs: There are such symptoms as dryness, slight pain or a sensation of burning heat or foreign body in the throat. 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. The tongue is red and the pulse thready and rapid.

Therapeutic Principle: Nourishing yin, moistening dryness and purging pathogenic fire to relieve sore throat.

Recipe: Clear Dew Decoction

lucid asparagus

ophiopogon tuber

fresh rehmannia root

dendrobium

loquat leaf

prepared rehmannia root

bitter orange

platycodon root

All the above herbs are to be decocted in water for oral administration.

2) The Type of Stasis of Qi and Stagnation of Phlegm

Main Symptoms and Signs: The patient has 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. He may have hyperplasis of lymphoid follicles in the retropharyngeal wall and thickening of the lateral pharyngeal bands, accompanied with chest distress. The tongue is dark red with yellow fur and the pulse thready and slippery.

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

Recipe: Decoction for Clearing the Throat

old radish leaf

loquat leaf

scrophularia root

belamcanda rhizome

curcuma root

oroxylum seed

Sichuan fritillary bulb

bitter orange

Chinese globeflower

olive

trichosanthes root

All the above herbs are to be decocted in water for oral administration.

For those with poor appetite and loose stool, add Chinese yam and parched atractylodes rhizome. For those who have soreness and weakness of the loins and feverish sensation in the palms and soles, add dodder seed, dogwood fruit and cibot rhizome. For those with symptoms of intense fire due to yin-deficiency, add moutan bark, bark of Chinese corktree and achyranthes root.

2. External Treatment

1) Perlingual: Have slices of lily bulb immersed in honey for 7 days, then take them out for perlingual; or use frosted persimmon for perlingual instead.

2) Oral insufflations of powder drugs: Powder of Borneol and borax (see the treatment of acute pharyngitis) and Indigotic Powder Drug for Oral Insufflations are to be blown onto the pharynx wall.

3) Compress on the acu-point Yongquan. Mix Powder of Evodia Fruit with vinegar for compress on the acu-point Yongquan (K 1). This is practiced once a day.  

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