SORE THROAT, PHARYNGITIS, THROAT PAIN, PAINFUL SWALLOWING

GENERAL

Clinical Manifestations	Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, a hoarse voice. Symptoms usually last three to five days. Complications can include sinusitis and acute otitis media. Pharyngitis is typically a type of respiratory tract infection. Swelling, pain and redness of the pharynx Usually seen during the winter and spring months The onset is rapid and acute At the beginning the patient report a hot or burning sensation of the throat As it progresses, the throat pain increases The throat is further aggravated by swallowing Fever Chills General malaise Dry cough Examination reveals: A bright red swelling of the pharyngeal mucosa Increased secretion Submaxillary lymph glands are swollen and tender to the touch
Treatment Principle
Herb Formulas
Points	LU-10, LU-11 DU-15, KI-6, LU-11, REN-22, REN-23 Bleed LU-11 Needle LI-4, LI-11, LU-5, ST-44, with sedation. Needle once a day LI-4, SJ-16, SJ-17 LI-10, SJ-2 DU-14, LI-18, LU-7, LU-10, REN-22 DU-14, REN-22 LI-4, PC-6 To tonify the throat: GB-20, GB-21, UB-10 To dispel inflammation: 1. LI-4, LI-11, REN-22 2. KI-3, LI-10, LI-11, ST-44 With a swollen throat: + KI-3, SJ-3 or KI-2, KI-3 With a swollen, painful throat: + LU-8, UB-17 or LI-4, LU-11, REN-22 For a swollen, painful throat with difficulty swallowing: + KI-1, KI-4 For acute inflammation: GB-20, LI-10, LI-11, LU-10, SJ-2, UB-13 Due to influenza: + DU-14, LI-4, SJ-5 For chronic inflammation: 1. GB-21, LU-10, REN-22, SI-14, SJ-2, UB-10, UB-13 2. GB-20, KI-3, KI-7, LI-17, SI-15, SJ-17, UB-12 For congestion: LI-4, LI-18, REN-22

WIND-COLD ATTACKS THE LUNGS

Clinical Manifestations	At the initial stage, the throat is slightly red with discomfort Acute pain with a feeling of spasm in the throat Pain aggravated by Cold Itching or tickling in the throat (mild cases) Cough with expectoration of thin, watery or frothy white sputum Difficulty swallowing A light red color to the throat Swelling of the throat Nasal congestion Chills with low grade fever Aversion to Cold and Heat Anhidrosis No thirst Headache Aversion to Wind Blocked and / or runny nose with clear, watery nasal discharge Sneezing General body aches Maybe asthma T: Pink C: Thin, white and moist P: Superficial and tight
Treatment Principle	Expel Wind Dispel Cold Ventilate the Lungs Resolve Phlegm Relieve the pain
Herb Formulas	Jing Fang Bai Du San modified Liu Wei Tang modified Ma Huang Tang Mild cases: Xing Su San Severe cases: Xiao Qing Long Tang Powders: Bing Peng San Zhu Huang San Gargles: 1. Decoct equal amounts of Flos Lonicerae Jin Yin Hua, Rx. Platycodi Jie Geng and Fr. Forsythiae Lian Qiao and gargle several times daily. 2. Liu Shen Wan Chinese Patent Medicine: Yin Qiao Jie Du Pian Jing Fang Bai Du Pian Gan Mao Ling Chuan Xiang Cha Tiao Wan Liu Shen Wan Huang Lian Shang Qing Pian Hua Yan Wan Shuang Lian Huo Feng San Early-stage: Niu Huang Jie Du Pian Severe cases: Niu Huang Xian Yan Wan Topical: Xi Gua Shuang
Points	GB-20, LI-4, LU-7, SJ-5, UB-12, UB-13 With severe pain: + REN-22, REN-23 For a cough with expectoration of white Phlegm: + LU-1 With a stuffed up nose and white nasal discharge: + LI-20, UB-2 With a red throat: + LU-10 With hoarseness: + LU-11, REN-21 With a headache: + DU-16, Yintang For generalized body pain with a feeling of Cold: + UB-58, UB-62 DU-16, GB-20, LI-4 + LU-7 or LI-4 + KI-7, LU-5, UB-12, UB-13 LU-7 + LI-4 or LI-4 + KI-7, DU-16, GB-20, LU-5, UB-12, UB-13 GB-20, LI-4, LU-5, LU-7, REN-17, REN-22, UB-12, UB-13 With wheezing: + Dingchuan With nasal congestion or runny nose: + DU-23 GB-20, PC-6, ST-9, UB-12 DU-16, LI-1, LI-4, REN-22, SJ-1, SJ-5, ST-40, bleed LU-6, LU-11 LI-4, LI-11, LI-18, LU-7, LU-10, LU-11, REN-22, ST-44 Ear: Throat, Tonsils 1

WIND-COLD WITH INTERNAL HEAT

Clinical Manifestations	Fever and chills Maybe fever only Achiness Anhidrosis Occipital headache Loud cough Sticky, yellow mucus Sore throat Generalized muscle aches Nasal obstruction Asthma Aversion to Cold Edema Thirst with a desire for cold liquids Restlessness Irritability Fidgeting Constipation or Dry stools Sometimes dry achy eyes T: Normal or red or Red tip C: Yellow or white P: Floating and tight or Floating and rapid
Treatment Principle	Expel Wind Disperse Cold Cool Heat
Herb Formulas	Da Qing Long Tang Ma Xing Shi Gan Tang modified With lingering Exterior symptoms: Ge Gen Huang Qin Huang Lian Tang Chinese patent medicines: Ma Xing Zhi Ke Pian Zhi Sou Ding Chuan Wan
Points	DU-14, DU-16, GB-20, LI-4, LI-11, ST-44, UB-13, sedate LU-7, LU-9, LU-10, SJ-5, UB-12, tonify SP-1, SP-2 DU-14, LI-4, LI-11, LU-5, SJ-5, UB-12 For a severe, swollen, sore throat: + LU-11, SI-17 With Excess Internal Heat: + LU-10, SJ-2

WIND-COLD ATTACKS THE LUNGS WITH DAMPNESS ACCUMULATION

Clinical Manifestations	Itching or tickling in the throat Wheezing Sneezing Gasping Cough with expectoration of thin, watery or frothy white sputum General body aches No thirst Dyspnea Headache Body aches A sensation of heaviness Chills with low grade fever Maybe asthma Intolerance of Cold Anhidrosis Blocked and/or runny nose with watery nasal discharge Chest discomfort Neck stiffness Irritability T: Pink C: Thin, white and moist P: Superficial and tight
Treatment Principle	Disperse Wind-Cold Induce diaphoresis Dispel Dampness
Herb Formulas	Ma Huang Jia Zhu Tang
Points	To Expel Wind Cold: DU-16, GB-20, UB-12, LI-4, SJ-5 (Sedating technique) To Disperse the Lungs: UB-13, LU-7, REN-17 To Expel water: SP-6, SP-9, Moxa REN-4, REN-6, DU-4 To Resolve Phlegm: ST-40

TAI YANG SHANG HAN WITH KIDNEY YANG DEFICIENCY

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	Ma Huang Fu Zi Xi Xin Tang
Points	Moxa DU-4, DU-16, DU-20, UB-12, UB-15, UB-23

TAI YANG, YANG MING SHAO YIN HEAT

Clinical Manifestations	Dizziness Red, sore eyes Difficulty swallowing Nasal congestion and infection Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Acne Chills High fever Restlessness Urticaria Sore throat Swelling of the throat Coughing Reddish urine Dyspnea Vertigo Severe aversion to Cold Skin rashes Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation Dysuria with reddish urine Dark, rough urination Obesity Fullness of the abdomen Fullness of the epigastrium Heaviness in the head T: Red C: White or Yellow and greasy P: Flooding and rapid or Wiry and slippery or Floating, smooth and rapid or Floating, slippery, rapid and wiry or Floating, slippery, rapid and overflowing
Treatment Principle	Disperse Wind Release the Exterior Drain Heat Unblock the bowels
Herb Formulas	Fang Feng Tong Sheng San
Points

SHAO YIN HEAT

Clinical Manifestations	Dry throat and/or mouth Chronic sore throat (not acute) Restlessness Malar flush Insomnia Disturbed speech Low grade fever, worse in afternoon Yellow urine Irritability with a sensation of Heat in the chest Palpitations with anxiety Sores in the mouth or on the tongue More Heat than in Yin Deficiency (chronic low grade fever) T: Red, deep red C: None P: Deep, thready and rapid
Treatment Principle	Nourish Yin Reduce Heat
Herb Formulas	Huang Lian E Jiao Tang
Points	DU-14, HT-5, HT-7, KI-3, KI-6, KI-7, LIV-3, SP-6, UB-10, UB-15, UB-23

WIND-HEAT ATTACKS THE LUNGS

Clinical Manifestations	Acute sore, red, swollen throat with a burning sensation Swollen, red and burning throat and tonsils May be a white or yellow exudate on the throat Swallowing is difficult and causes pain Swollen cervical lymph nodes Dry mouth and nose Possible nasal congestion Hoarseness Loss of voice Cough with thick, sticky, yellow sputum Thirst with a desire to drink cold liquids Runny or blocked nose with thick, yellow discharge Fever with perspiration Slight chills Aversion to Wind Headache Nasal obstruction Maybe dyspnea with flared nostrils Maybe chest pain General malaise Sudden weakness Fatigue Anorexia T: Red tip C: Thin and white or yellow P: Superficial and rapid
Treatment Principle	Regulate the throat Expel Wind Clear Heat Eliminate toxins Ventilate the Lungs
Herb Formulas	Sang Xing Tang Gan Mao Dan Shu Feng Qing Re Tang Sheng Ma Ge Gen Tang Early stage: Cong Chi Jie Geng Tang Severe cases: Yin Qiao San modified Ma Xing Shi Gan Tang Mild cases: Sang Ju Yin With Yin Deficiency: Jia Jian Wei Rui Tang With Yin Deficiency and Qi and Blood Affected: Wei Rui Tang Powder: Bing Peng San Gargles: Acute Laryngitis Gargle #1 Liu Shen Wan (dissolve in water and gargle) Lozenges: Tie Di Wan Run Hou Wan Chinese Patent Medicines: Yin Qiao Jie Du Pian Liu Shen Wan Qing Yin Wan
Points	DU-14, LI-2, LI-4, LI-11, LU-7, LU-10, UB-12 With severe pain and a high fever: + LI-1, LU-11 With difficulty speaking or swallowing: + REN-21, REN-22 For a cough with yellow nasal discharge: + LU-1, LU-5, UB-13 With a blocked nose: + LI-20, UB-2 With a headache: + DU-16, Yintang DU-14, DU-16, GB-20, LI-4 + LU-7 or LI-4 + SJ-5, LU-5, LU-10, LU-11, UB-12, UB-13 DU-16, LI-1, LI-4, REN-22, SJ-1, SJ-5, ST-40, bleed LU-5, LU-11 GB-20, LI-4, LI-11, LU-1, PC-6, ST-9, UB-12 DU-1, DU-16, GB-20, LU-5, LU-7, LU-10, LU-11, SJ-5, UB-12, UB-13 LI-4, LI-11, SI-17, ST-44 LI-4, ST-44 KI-6, LI-4, ST-36, ST-44

PERVERSE DRYNESS ATTACKS THE THROAT

Clinical Manifestations	Dry, sore throat Slight redness and swelling in the throat Slight aversion to Cold A low-grade fever Dry cough with little or no sputum Sputum is difficult to expectorate Maybe hemoptysis Cough may cause chest pain Hoarse voice Dry lips and mouth Thirst Dryness in nose Epistaxis Chills and fever A slight headache Anhidrosis Dry skin and hair Constipation T: Red tip C: Thin, yellow and dry P: Superficial, maybe rapid
Treatment Principle	Clear the Lungs Moisten Dryness
Herb Formulas	Qing Zao Jiu Fei Tang Cool Dryness: Xing Su San Wind-Heat Dryness: Sang Xing Tang If symptoms persist for a long time: Yang Yin Qing Fei Tang Chinese Patent Medicine: Qing Fei Yi Huo Pian
Points	LI-4, LU-5, LU-7, LU-8, SJ-5, UB-12 With severe throat pain and a fever: + LI-2, LU-10 With an obviously swollen throat: + LI-11, LU-11 With difficulty speaking and swallowing: + REN-21, REN-22 For a cough with yellow nasal discharge: + LU-1, UB-13 With a blocked nose: + LI-20, UB-2 With a feeling of spasm or blockage in the throat: + REN-23, UB-13 Jinjin-Yuye, KI-3, LU-1, LU-6, SP-6, UB-13

SUMMERHEAT AND DAMPNESS WITH LIVER AND GALLBLADDER HEAT

Clinical Manifestations	Red eyes Sore throat Mouth, tongue and lip ulcerations Urinary difficulty Diarrhea Papules Sores Prickly Heat Ocular pain Dark urine Chest pain Hemoptysis Epistaxis Hematemesis Oliguria with dark urine Scanty urine Swelling of the throat Fever Thirst Irritability Nausea Vomiting Lassitude due to Summerheat T: Normal C: Yellow and greasy P; Soggy and rapid
Treatment Principle	Clear Heat Relieve toxicity Promote urination Eliminate Summerheat TonifY Qi Cool the Blood
Herb Formulas	Bi Yu San
Points

QI STAGE LUNG HEAT

Clinical Manifestations	High fever No chills Aversion to Heat Cough Asthma Restlessness Thirst Dark yellow urine Dyspnea Chest pain Shortness of breath Thick yellow Phlegm T: Red C: Thick and yellow, maybe dry and sticky P: Rapid, maybe slippery, maybe forceful
Treatment Principle	Clear Heat in Lungs Strengthen when weak or elderly
Herb Formulas	Ma Xing Shi Gan Tang For discomfort due to Lung Heat Injuring the Yin: Xiang Sheng Po Di Wan Generating Lung Yin Deficiency: Qing Fei Tang
Points	Dingchuan, DU-13, DU-14, LI-11, LU-5, LU-10, ST-44. UB-13

QI STAGE: GALLBLADDER HEAT

Clinical Manifestations	Alternating chills and fever Bitter taste in mouth Thirst Dry, sore throat Rib pain (doesn't like touch) Hypochondriac pain Nausea Vomiting Hypogastric pain and distension T: Red C: Yellow P: Rapid and wiry
Treatment Principle	Relieve Gall Bladder Heat Pacify the Liver and Gall Bladder
Herb Formulas	Liang Ge San
Points	GB-34, Lanweixue, LI-11, LIV-2, LIV-3, LIV-4, LIV-13, LIV-14

QI STAGE: SPLEEN AND STOMACH DAMP-HEAT

Clinical Manifestations	Fever Sore throat Pressure headache - like a bandage Gastric distension Poor appetite Heaviness Body aches Chest distension Diarrhea Dysentery T: Red C: Greasy and yellow P: Soft and rapid or Soft and slow or Wiry thin and soft
Treatment Principle	Clean Damp-Heat and toxins
Herb Formulas	Gan Lu Xiao Du Dan Long Dan Xie Gan Tang
Points	LI-4, LI-11, SP-6, SP-9, ST-25, ST-36

TOXIC WIND-HEAT

Clinical Manifestations	Acute, severe throat pain with a burning sensation A high fever Obvious redness and swelling in the throat Formation of pus in the throat Difficulty swallowing Red eyes Severe headache Inflammation Swelling Generalized body pain Congestion Heavy cough Fever Sweating Extensive thirst Restlessness Nasal discharge Constipation T: Red tip C: Thick and yellow P: Superficial and rapid or Slippery and rapid
Treatment Principle	Expel Wind Clear Heat Detoxify
Herb Formulas	Niu Huang Shang Qing Wan With Phlegm: Pu Ji Xiao Du Yin Chinese Patent Medicine: Niu Huang Jie Du Pian
Points	GB-8, GB-20, LI-4, Taiyang, UB-1 DU-14, LI-2, LI-4, LI-11, LU-5, LU-10, REN-22, REN-23 With a high fever: + ST-44 With with severe throat pain: + LI-6, LU-7 With a severe cough: + LU-1, REN-17 With constipation: + ST-25, ST-40 With formation of pus in the throat: + LI-1, LU-11 With a headache: + DU-16, Yintang LI-4, LU-10, LU-11, SJ-2

WIND-DAMP

Clinical Manifestations	Generalized edema that begins in the face Thirst Aversion to Wind Slight fever or no fever Slight but continuous sweating or no sweating Absence of thirst or Thirst Belching Cough Asthma Dyspnea Bulging eyes Severe cough Weak, aching feet Skin problems T: Normal C: White or Thin white P: Floating or Floating and big
Treatment Principle	Induce sweating Release the Exterior Disseminate Lung Qi Promote urination Eliminate water accumulation Eliminate Heat
Herb Formulas	Yue Bi Tang modified Yue Bi Jia Zhu Tang modified
Points

PHLEGM-HEAT CONGESTS THE LUNGS

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	Qing Yan Ning Fei Tang modified With Dryness: Bei Mu Gua Lou San Gargles: Acute Laryngitis Gargle #1 Liu Shen Wan (dissolve in water and gargle) Chinese Patent Medicines: Qing Qi Hua Tan Wan Qing Yin Wan
Points	LI-11, LI-18, LU-1, LU-5, LU-6, LU-7, LU-10, REN-17, REN-22, ST-40, UB-13 For wheezing: + Dingchuan For chest fullness: + PC-5

LUNG AND STOMACH HEAT

Clinical Manifestations	Acute sore throat Severe pain which oftewn radiates to the lower jaw or ears The tonsils are swollen and red with a white or yellow exudate on the surface In secvere cases swelling severely narrows causing difficulty swallowing Swollen, tender cervical lymph nodes High fever Thirst Constipation Scanty, concentrated urine Bad breath Abdominal distention Hoarse voice Cough with thick, yellow sputum T: Deep red C: Thick, yellow and greasy P: Flooding, big and rapid
Treatment Principle	Clear and drain toxic Heat Reduce swelling Benefit the throat
Herb Formulas	Pu Ji Xiao Du Yin modified Powder: Bing Peng San Gargles: Acute Laryngitis Gargle #1 Liu Shen Wan (dissolve in water and gargle) Lozenges: Tie Di Wan Run Hou Wan Chinese Patent Medicines: Liu Shen Wan Niu Huang Xiao Yan Wan Niu Huang Jie Du Pian Huang Lian Shang Qing Pian Chuan Xin Lian Kang Yan Pian Shuang Lian Hou Feng San
Points	LI-4, LI-11, LI-18, LU-7, LU-10, LU-11, REN-22, SI-17, SJ-5, ST-44, Ear, Throat, Tonsils

LUNG QI AND YIN DEFICIENCY

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	Bai He Gu Jin Tang Yang Yin Qing Fei Tang modified
Points

LUNG YIN DEFICIENCY

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	Bai He Gu Jin Tang Yang Yin Qing Fei Tang Qing Zao Jiu Fei Tang Zeng Ye Tang With Heat: Bu Fei E Jiao Tang With Heart Yin Deficiency: Xuan Miao San Chinese Patent Medicines: Yang Yin Qing Fei Tang Jiang Mai Wei Di Huang Wan Li Fei Chuan Bei Pi Pa Gao
Points	KI-3, KI-6, LU-1, LU-5, LU-6, LU-7, LU-9, LU-10, ST-36, UB-13, UB-17, UB-23, UB-43 KI-6, LU-1, LU-7, UB-13, UB-17 With copious Blood: + LU-6 KI-3, LU-1, LU-5, LU-10, ST-36, UB-13 KI-6, LU-1, LU-7, UB-13 With hemoptysis: + LU-6, UB-17 KI-3, KI-6, LU-5, LU-7, LU-9, UB-13, UB-23 With severe Heat: + LU-10

LUNG DRYNESS DUE TO YIN DEFICIENCY

Clinical Manifestations	Dry mouth and throat Slight pain or burning Heat or a sensation of a foreign 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	Bai He Gu Jin Tang Yang Yin Qing Fei Tang
Points	Electro-acupuncture LI-4, LU-7, Qianyifeng (at the midpoint between SJ-17 and the mandibular angle, just behind the posterior border of the ramus of the mandible), SP-6, ST-6 KI-3, KI-6, LU-1, LU-5, LU-6, LU-7, LU-9, LU-10, ST-36, UB-13, UB-17, UB-23, UB-43

LUNG AND SPLEEN QI DEFICIENCY

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	Shen Ling Bai Zhu San Si Jun Zi Tang
Points	Electro-acupuncture LI-4, LU-7, Qianyifeng (at the midpoint between SJ-17 and the mandibular angle, just behind the posterior border of the ramus of the mandible), SP-6, ST-6 LU-9, REN-17, SP-3, ST-36, UB-13, UB-20, UB-43

LUNG, SPLEEN AND KIDNEY QI DEFICIENCY

Clinical Manifestations	A history of chronic slight throat pain A feeling of cold in the throat Hoarseness A low, weak voice Throat pain is aggravated by fatigue No throat swelli8ng Sometimes slight, white Phlegm in the throat T: Pale and swollen with teethmarks C: Wet and watery P: Thready, deep and slow With Lung Qi Deficiency: Pale complexion Spontaneous sweating Aversion to Cold Cold hands and feet Listlessness Fatigue A tendency to catch Cold easily A slight cough with expectoration of white Phlegm With Spleen Qi Deficiency: A poor appetite Loose stools Abdominal distention Nausea Weak muscles With Kidney Qi Deficiency: General fatigue Lower back pain Weak knees Nocturia Impotence Clear, profuse urination
Treatment Principle	Reinforce Qi Tonify Yang Dispel Cold Alleviate the pain
Herb Formulas	Ba Wei Di Huang Wan modified Chinese Patent Medicine: Ba Wei Di Huang Wan
Points	Moxa needle KI-3, REN-4, REN-3, REN-23, SP-3, ST-36, UB-23 With lower back and knee weakness and pain: + moxa or moxa needle SP-6, UB- 58 With general fatigue with cold hands and feet: + moxa needle KI-10 With loose stools or diarrhea, a poor appetite and nausea: + SP-4, SP-9 For a tendency to catch colds easily, cough with expectoration of white Phlegm, a low voice and spontaneous sweating: + LU-9, UB-13

LUNG AND STOMACH HEAT ACCUMULATION

Clinical Manifestations	There is more severe throat pain than in the previous syndromes The pharyngeal mucosa are greatly swollen, red, and inflamed Fever Theirs Dark urine Constipation T: Red C: Yellow P: Floating and rapid
Treatment Principle	Clear Heat Detoxify poison Reduce swelling
Herb Formulas	Qing Yan Li Ge Tang modified
Points

LUNG AND STOMACH FIRE

Clinical Manifestations	Gradual onset of throat pain that moves up and down Redness of the throat with a burning sensation Difficulty swallowing The pain is aggravated by smoking, drinking alcohol and eating sweet, fatty or spicy foods Coughing Expectoration of yellow Phlegm Thirst Constipation Foul breath Bleeding and swollen gums sometimes pus in the throat T: Red C: Yellow and dry P: Rapid
Treatment Principle	Clear Heat Promote defecation Reduce the swelling Relieve the pain
Herb Formulas	Liang Ge San Chinese Patent Medicines: Wei Te Ling Qing Fei Yi Huo Pian
Points	LI-4, LU-5, LU-6, LU-10, ST-42, ST-44, UB-13 With difficulty swallowing: + REN-22 With a cough and expectoration of copious yellow Phlegm: + REN-17, ST-40 With a fever: + DU-14, LI-11 With severe constipation: + ST-25 With severe thirst: + LI-2, LU-8

LUNG AND STOMACH YIN DEFICIENCY

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	Mai Men Dong Tang Sha Shen Mai Men Dong Tang
Points	UB-13, UB-17, UB-21, UB-43, ST-36, SP-6, REN-12, LU-1, LU-5, LU-, LU-7 + KI-6, LU-9, LU-10, KI-3

LUNG, HEART AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Prolonged persistence of slight throat pain Dryness in the throat Thirst, especially at night A lack of desire to drink An occasional burning feeling in the throat With Kidney Yin Deficiency: Night sweats Five-Sole-Heat Dry stools Scanty urine Fatigue Dizziness Tinnitus Poor memory Weak knees Low back pain With Lung Yin Deficiency: Hoarseness A dry cough or Coughing with scanty Phlegm Maybe Blood breaks in the sputum With Heart Yin Deficiency:\| Insomnia Restlessness Palpitations\| T: Red C: Peeled P: Rapid, thready and weak
Treatment Principle	Nourish Yin Clear Deficiency Fire Moisten the throat Alleviate the pain
Herb Formulas	Sha Shen Mai Men Dong Tang modified Chinese Patent Medicine: Qi Ju Di Huang Wan
Points	HT-3, KI-6, KI-7, LU-5, LU-7, LU-8, REN-23 With dizziness, weakness, poor memory, low back pain and weak knees: + KI-3, KI-10 With night sweats, Five-Sole-Heat and thirst: + HT-6, KI-2 With a dry mouth, hoarseness or Blood breaks in the Phlegm: + LU-6, UB-13 With insomnia, restlessness and palpitations: + REN-14, UB-15 With nervousness,a headache and irritability: + GB-20, LIV-3

LUNG AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Unproductive cough or Scanty, sticky phlegm or Sometimes blood-streaked sputum Dry mouth Dry, sore throat Low back and knees sore and weak "Steaming Bone" tidal fever Night sweats Malar flush Maybe hoarse voice Maybe pain in shin, foot, and heel Sterility Spermatorrhea T: Red and dry C: None P: Thready and rapid
Treatment Principle	Nourish Yin Moisten the Lungs Reinforce the Kidneys
Herb Formulas	Bai He Gu Jin Tang Ba Xian Chang Shou Wan Yang Yin Qing Fei Tang + Da Bu Yin Wan
Points	HT-6, KI-3, KI-6, LU-6, LU-9, UB-13, UB-23

LARGE INTESTINE HEAT

Clinical Manifestations	Sore throat Dry stools Knotted constipation Mouth parched Sensation of burning heat, swelling and pain of anus Urine short and dark T: Pink C: Yellow and dry P: Slippery and rapid
Treatment Principle	Clear Heat Purge constipation
Herb Formulas	Liang Ge San Mild cases: Ma Zi Ren Wan
Points	LI-4, LI-11, SJ-6, ST-25, ST-37, ST-44, UB-25

DAMP-HEAT IN THE SPLEEN AND STOMACH

Clinical Manifestations	Severe sore throat Red mucosa of the mouth Fever Swelling and inflammation of the gums with or without pus Cough with yellow sputum Mouth ulcers Bad breath Toothache Dry mouth Constipation Dysuria Bleeding from the gums T: Red and dry C: Yellow-green P: Thready and rapid
Treatment Principle	Disperse Heat Eliminate Dampness
Herb Formulas	Gan Lu Yin
Points	KI-3, LI-4, LI-11, PC-6, REN-9, SP-6, SP-9, ST-9

SPLEEN QI DEFCIENCY

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	Shen Ling Bai Zhu San Bu Zhong Yi Qi Tang modified
Points

STOMACH FIRE

Clinical Manifestations	Sore, inflamed throat Burning Heat and pain in the epigastrium Irritating thirst: drinks copious fluids and prefers cold drinks Excessive appetite: hungry again quickly after eating (as if food vanishes) Swelling, pain, ulceration and bleeding of gums Foul breath Toothache Maybe vomiting right after eating Vomiting acid or undigested food Constipation Maybe scanty, red urine T: Red C: Thick, yellow and dry P: Slippery, big, Excess and rapid
Treatment Principle	Clear and Purge Stomach Fire
Herb Formulas	Qing Wei San modified
Points	LI-4, LI-11, PC-6, PC-8, ST-6, ST-34, ST-36, ST-43, ST-44, ST-45, UB-21

HEAT IN THE HEART CHANNEL TRANSFERRING TO THE SMALL INTESTINE

Clinical Manifestations	Parched throat Severe sore throat Dark, turbid, scanty, difficult urination or Frequent, urgent and painful Urination may be red Maybe fever Sores in mouth, on tongue or throat Dry mouth and throat Maybe urinary retention (severe) Maybe lower abdominal distention and pain (severe) Thirst Maybe total obstruction Maybe anuria (severe) Dribbling urination May be profuse whitish, yellow vaginal discharge Maybe be urinary calculi Constipation Eye redness and pain Epistaxis Distending lower back pain Irritability Scorched lips T: Red C: Thick, yellow and greasy P: Slippery and rapid or Smooth and rapid
Treatment Principle	Clear Heat Purge Fire Promote urination Unblock painful urinary dysfunction
Herb Formulas	Ba Zheng San
Points

SMALL INTESTINE EXCESS HEAT

Clinical Manifestations	Irritability Ulceration and erosion of the mouth and tongue Sore throat Dry mouth Thirst Desire for cold drinks Maybe deafness Urination short, dark, difficult and painful or Hematuria or Pain in the urethra Fullness and distention of lower abdomen T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Excess Heat Promote diuresis
Herb Formulas	Dao Chi (Re) San
Points	HT-8, LIV-2, REN-3, SP-6, SP-10, UB-27 PC-7, REN-4

LIVER QI STAGNATION: PHLEGM AND QI STAGNANT AND BLOCKED

Clinical Manifestations	Gradual onset of throat pain with spasms and a feeling of tension which moves up and down and is closely associated with the emotional situation 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 Stress Irritability Inappropriate anger Insomnia Poor appetite Headache A bitter taste in the mouth Irregular menses Dysmenorrhea Breast distention and pain before and during menses T: Pink or Slightly purplish C: Thin and white P: Slippery and wiry (slippery due to Phlegm)
Treatment Principle	Spread Qi Resolve Phlegm
Herb Formulas	Ban Xia Hou Po Tang Xiao Yao San modified Chinese Patent Medicines: Xiao Yao Wan Shu Gan Wan
Points	LI-18, LIV-3, PC-5, SI-17, SJ-6 GB-20, LIV-3, PC-6, REN-12, REN-17, REN23 With depression and a sensation of pain and fullness in the chest: + LIV-14 With irritability: + GB-43, LIV-2 With a poor appetite: + LIV-13, UB-20 With a headache: + DU-20 With insomnia, dream-disturbed-sleep and sighing + HT-3, Sishencong With a bitter taste in the mouth and constipation: + GB-40, SJ-6 Electro-acupuncture LI-4, LU-7, Qianyifeng (at the midpoint between SJ-17 and the mandibular angle, just behind the posterior border of the ramus of the mandible), SP-6, ST-6

LIVER FIRE

Clinical Manifestations	Restlessness Anxiety Anger Dark, rough urine Red or yellow urine Excruciating headache Constipation Rashness Impatience Irascibility Tinnitus Abdominal fullness Fright palpitations Hypertension Throat blockage with difficulty swallowing Sore throat Semi-unconsciousness Dry throat Vertigo Delirium Mania Dizziness Red face Red eyes Irritability Bitter taste in the mouth Abdominal pain Clonic spasm Fright Wind in children Dysuria Pain with swelling and inflammation T: Red C: Yellow P: Wiry or Taut and rapid
Treatment Principle	Purges Liver and Gall Bladder Fire Clears the bowels
Herb Formulas	Dang Gui Long Hui Wan
Points

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Sore throat Facial complexion pale and sallow Both cheeks slightly red Dizziness Dry eyes Blurred vision Spots before the eyes Numbness of limbs Flaccid paralysis (Wei syndrome), weakness Tinnitus Deafness Forgetfulness Low back and knees sore and painful Throat dry and painful Five Sole Heat Low-grade fever Night sweats Irritability Insomnia Stools difficult to pass Constipation Men: Spermatorrhea Women: Irregular menses or Scanty menses or Amenorrhea Vaginal discharge T: Red C: None P: Thready and rapid
Treatment Principle	Nourish and Reinforce the Liver and Kidneys
Herb Formulas	Qi Ju Di Huang Wan Da Bu Yin Wan Liu Wei Di Huang Wan With Fire Flaring: Zhi Bai Di Huang Wan With Liver Qi Stagnation: Yi Guan Jian
Points	KI-3, LIV-3, SP-6, UB-18, UB-23

KIDNEY YIN DEFICIENCY WITH EMPTY FIRE RISING

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 The pharynx is inflamed, dark red and swollen The capillaries are sticking out, forming a net-like appearance Post pharyngeal lymph follicles are enlarged and increased Some mucosa have atrophied, causing a meeting of red and white color Dry cough Dizziness Deafness Poor memory Aching, soreness or weakness of low back Spermatorrhea or premature ejaculation Aching in bones Aching in leg and heel Dry mouth Thirst Night sweats Five Sole Heat Malar flush Low grade fever in the afternoon Dry stools and / or constipation Urine short and red Heightened libido T: Deep red C: Little or none P: Thready and rapid
Treatment Principle	Moisten Yin Restrain the Fire
Herb Formulas	Zhi Bai Di Huang Wan Liu Wei Di Huang Wan Zuo Gui Wan Zi Yin Jiang Huo Tang
Points	KI-1, KI-2, KI-3, KI-6, KI-9, REN-4, SP-6, UB-23

YIN DEFICIENCY

Clinical Manifestations	Intermittent sore throat Gradual onset Dry mouth and throat Dry stools Maybe a cough Can't cough up sputum Worse in the afternoon or evening Low-grade fever Heart vexation Dark red pharyngeal mucosa Five-Sole-Heat Night sweats Scanty urination T: Red C: Little or None P: Thready and rapid
Treatment Principle	Tonify Yin
Herb Formulas	Yang Yin Qing Fei Tang Zhi BaI Di Huang Wan
Points	Jinjin-Yuye, KI-3, LU-1, PC-6, SP-6, ST-9, UB-13 KI-1, KI-2, KI-3, KI-6, REN-4, SP-6 With Heart Fire: + HT-7, PC-7, UB-15 With Liver Yang Rising: + LIV-3, UB-18 KI-3, LU-10 alternate with KI-6, LU-7 DU-16, KI-3, LI-4, LU-5, ST-36, ST-44

QI STAGNATION

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	Qi Ge San
Points	PC-6, REN-12, REN-17, REN-21, REN-22, ST-36

QI AND YIN DEFICIENCY

Clinical Manifestations	Dry, sore throat Light pain Pain worse on exertion Profuse sweat Shortness of breath Headaches Fatigue Tidal fever Dry stools Sometimes Five-Sole-Heat T: Pale or Red C: Thin and white P: Thready and rapid or Forceless
Treatment Principle	Tonify Qi Nourish Yin
Herb Formulas	Bai He Gu Jin Tang
Points	PC-6, REN-6, REN-17, SP-6, SP-9, ST-9

STAGNATION OF FIRE

Clinical Manifestations	Sore, swollen throat Gradually worsens Difficulty swallowing Shortness of breath Swollen mucosa Obstruction of the larynx Great thirst Constipation T: REd C: Yellow P: Rapid and full
Treatment Principle	Reduce Fire Remove Stagnation
Herb Formulas	Dan Zhi Juan Bi Tang
Points	LI-4, LI-11, LIV-2, PC-6, ST-9, Ear: tonsils (4 points) Bleed Jinjin-Yuye, LI-4, LU-10, LU-11, SJ-2 For a sudden sore throat: bleed LI-1, LU-1

BLOOD STAGNATION

Clinical Manifestations	Prolonged, persistent throat pain with a stabbing sensation Pain worse at night Swelling in the throat with a purplish color Difficulty speaking Difficulty swallowing Hoarseness Bleeding from the throat Expectoration of Blood breaks in the sputum Coughing Shortness of breath Maybe a dark complexion Maybe emaciation T: Purple or Purple spots on the edges C: White P: Choppy, deep and wiry or Tight
Treatment Principle	Invigorate the Blood Eliminate Blood Stasis Harmonize the collaterals Alleviate the pain
Herb Formulas	Tao Hong Si Wu Tang modified Chinese Patent Medicine: Yan Hu Suo Zhi Tong Pian
Points	LI-4, LIV-3, LU-7, PC-6, REN-21, REN-22, SP-6, UB-17 With severe throat pain which is worse at night: + ST-9, ST-10 With difficulty swallowing: + KI-27, SP-4 With swelling in the throat: + ST-40 With restlessness due to severe throat pain: + HT-3 With expectoration of profuse Phlegm: + REN-12, SP-9

FENG TAN (WIND-PHLEGM)

Clinical Manifestations	Sore throat Paralysis Numbness Slurred speech Deviated eyes Deviated mouth (wry mouth) Dizziness Tinnitus Sputum in the throat Chest fullness and distention Epigastric fullness and distention Hypertension Stroke T: Deviated and trembling C: Thick P: Slippery and maybe wiry
Treatment Principle	Resolve Phlegm Subdue Wind
Herb Formulas	Ban Xia Bai Zhu Tian Ma Tang Er Chen Tang modified
Points	Pre-stroke: ST-40, UB-40 Stroke (emergency): DU-26, KI-1, PC-9, Ting Points Post-stroke: Arm: LI-4, LI-11, LI-15, SI-3, SJ-5 Leg: GB-34, GB-35, UB-40, UB-60 Scalp: Motor area (contralateral - upper one-fifth)

PHLEGM-DAMP ACCUMULATION IN THE THROAT

Clinical Manifestations	Gradual onset of a slight sore throat No redness in the throat Slight swelling, itching and a prickling feeling in the throat Symptoms are aggravated after eating fatty or sweet foods The pain is accompanied by a diminished or lack of the sense of smell and taste Nasal discharge Cough Occasional expectoration of Phlegm from the throat A feeling of fullness in the abdomen A poor appetite Loose stools T: Pink C: Greasy P: Slippery
Treatment Principle	Activate the Spleen and Stomach Eliminate Dampness Resolve Phlegm
Herb Formulas	Dao Tan Tang modified Chinese Patent Medicines: Qing Qi Hua Tan Wan Er Chen Wan
Points	LU-5, LU-7, REN-12, REN-23, SP-6, SP-9, ST-40, UB-2 For a cough with discharge of yellow Phlegm: + LI-4, LU-10 With loss of the sense of smell and taste: + Bitong, LI-20, SI-18 With a red, swollen throat: + LI-2, LU-11 With a poor appetite, a sense of fullness in the abdomen and loose stools: + SP-3, SP-4 With Accumulation of Cold-Phlegm (a white greasy tongue coat, a slow pulse expectoration of Phlegm and nasal discharge): + UB-13

PHLEGM-HEAT

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	Qing Yan Ning Fei Tang modified With Lung Dryness: Bei Mu Gua Lou San Chinese Patent Medicines: Qing Qi Hua Tan Wan Qing Yin Wan Gargles: Acute Laryngitis Gargle #1 Liu Shen Wan (dissolve in water and gargle)
Points	LI-11, LI-18, LU-1, LU-5, LU-6, LU-7, LU-10, REN-17, REN-22, ST-40, UB-13 For wheezing: + Dingchuan For chest fullness: + PC-5

LOWER JIAO BLOOD STAGNATION WITH HEAT

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	Tao He Cheng Qi Tang
Points

SEASONAL EVIL

Clinical Manifestations	Throat swollen and painful Fever Aversion to cold Eating and drinking are difficult Voice croaks P: Floating and rapid
Treatment Principle
Herb Formulas
Points	DU-16, LU-5, REN-22, SJ-1, SJ-5, Bleed LI-1, LI-4, LI-11

OVER USE OF THE VOICE IRRITATING THE THROAT

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	Xiang Sheng Po Di Wan
Points

IMPAIRMENT OF THE TRANSVERSE LUO CHANNEL OF THE KIDNEY

Clinical Manifestations	Throat pain Can't swallow Throat swelling Can't spit Chest and flank pain Abdominal swelling Heart pain
Treatment Principle
Herb Formulas
Points	KI-4, UB-58 KI-4, UB-67

IMPAIRMENT OF THE TRANSVERSE LUO CHANNEL OF THE SAN JIAO

Clinical Manifestations	Throat pain Tongue contracted Dry mouth Outer arm pain Can't draw arm to head
Treatment Principle
Herb Formulas
Points	PC-9, SJ-5 PC-7, SJ-5

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