CHRONIC LARYNGITIS

Clinical Manifestations
  • Chronic simple laryngitis:
    Episodic hoarseness which is most prevalent upon arising in the morning
    As the physical activity increases the sound improves
    The next morning the hoarseness returns
    Over long periods of time there is fatigue of the voice and sound cannot be emitted for an extended period
    Throat discomfort and pain upon emitting sounds
    There is often a habit of clearing ones throat but no evident sputum is coughed up
    The hoarseness is more evident when attempting to make a high pitched sound
    Diffuse hyperemia of the laryngeal mucosa
    The vocal cords have lost their original pearl white color and turned pink or progressed to a deeper red
    The vertical capillaries running parallel to the border of the vocal cords are enlarged
    The border is thickened
    The glottis cannot be closed completely, or
    The bilateral vibration is not balanced
    The exterior of the vocal cords are often covered by a sticky secretion which forms sticky silk - like strands connecting the interglottic space
  • Chronic hypertrophic laryngitis:
    Episodic hoarseness which is most prevalent upon arising in the morning
    As the physical activity increases the sound improves
    The next morning the hoarseness returns
    Over long periods of time there is fatigue of the voice and sound cannot be emitted for an extended period
    Throat discomfort and pain upon emitting sounds
    There is often a habit of clearing ones throat but no evident sputum is coughed up
    The hoarseness is more evident when attempting to make a high pitched sound
    A long history of hoarseness and aphonia
    Hoarseness is very evident
    Coughing is relatively mild
    Occasionally there are acute flare ups causing a further increase in hoarseness and deterioration in the sound quality
    Symmetrical swelling of the laryngeal mucosa is observed but the distribution is not even and is more marked in the arythenoid space where it stands out high
    When a sound is emitted it forms one or several plica in the arythenoid space
    The vocal cord is thickened, appearing like a stick that is rough and not smooth and often takes on a nodular or polypoid form which is covered by a sticky secretion
    If the disease progresses to the areas below the glottis, it prevents the vocal cords from uniting and triangular fissures appear
    If the disease progresses to the areas below the glottis, it prevents the vocal cords from uniting and triangular fissures appear
    The ventricular folds are enlarged and often press on the vocal folds when a sound is emitted
    The aryepiglottic fold may also be thickened but enlargement of the epiglottis is extremely rare
Treatment Principle
Herb Formulas
Points
  • Open the Voice # 1 point (1.5 cm medial to ST 9 Renying), with the "Sparrow pecking" method. Insert the needle at the posterior border of the thyroid cartilage with oblique slanting of the needle. Puncture in the direction of the aryepiglottic fold. Needle twice daily. Needling of this point has the effect of reducing hyperemia and edema of the vocal cords.
  • UB-13, UB-23, SP-6, ST-36. Needle four points at a time with intermediate or weak stimulus. Retain the needle for 20 minutes.
  • LI-11, LI-12, LU-7, REN-15, ST-33
  • To dispel inflammation: LI-4, LI-11, REN-22
  • Ear: Throat, Lung, Kidney, and Adrenals. Select two points at a time and imbed needle for 7 days, after which select 2 other points.
Clinical Manifestations
  • Severe chills
  • May have mild fever
  • No sweat
  • 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
  • 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
  • Chronic cough with sparse sputum
  • Sputum difficult to expectorate
  • Shortness of breath
  • Spontaneous perspiration
  • Dry mouth and tongue
  • Palpitations with a stifling sensation in chest
  • Fatigue
  • Irritability
  • Thirst
  • Dry throat
  • Insomnia
  • Listless speech
  • T: Red and dry or Pink and dry
  • C: Thin and dry
  • P: Deficient and rapid or Irregular and slow or Thready and deficient or Consistently irregular
Treatment Principle
  • Augment Qi
  • Clear Heat
Herb Formulas
Points
Clinical Manifestations
  • Protracted, incessant cough
  • Expectoration of copious, clear, watery or white Phlegm
  • Short, weak, breathing
  • Asthma
  • Four limbs tired
  • General lassitude
  • Distention and pain of the epigastrium and abdomen
  • Loose stools
  • T: Pale
  • C: White
  • P: Thready and weak
Treatment Principle
  • Reinforce the Spleen
  • Benefit the Lungs
  • Warm and transform Phlegm-Dampness
Herb Formulas
Points
Clinical Manifestations
  • A chronic or recurrent raspy or hoarse voice which is sometimes more mild then severe
  • The voice is low and talking can be accomplished with great effort only
  • It is difficult to speak for a long time
  • The condition is aggravated with fatigue or excessive speaking gradually getting worse or recurs in the afternoon or evening
  • After rest, the hoarse voice may improve
  • Mild soreness of the laryngeal area which is dry and uncomfortable
  • Dry itch
  • Dry cough with scanty sputum
  • Often the habit of clearing one's throat is noted
  • The larynx and the vocal cords are mildly red, slightly swollen and the borders are dull
  • Often there is a sticky exudate
  • Opening and closing of the glottis is impeded or incomplete
  • Weak and soft lower back and knees
  • Restlessness
  • Insomnia
  • Thirst
  • Dry mouth
  • Dry throat
  • Malar flush in the afternoon
  • Night sweats
  • Five sole Heat
  • Dizziness
  • Tinnitus
  • Insomnia
  • Low back pain
  • T: Red
  • C: Scanty
  • P: Thready and rapid
Treatment Principle
  • Moisten and nourish the Lung and Kidney Yin
  • Restrain Fire
  • Support the voice
Herb Formulas
Points
  • Open the Voice # 1 point (1.5 cm medial to ST-9), with the "sparrow pecking" method. Insert the needle at the posterior border of the thyroid cartilage with oblique slanting of the needle. Puncture in the direction of the aryepiglottic fold. Needle twice daily. Needling of this point has the effect of reducing hyperemia and edema of the vocal cords.
  • UB-13, UB-23, SP-6, ST-36. Needle four points at a time with intermediate or weak stimulus. Retain the needle for 20 minutes.
  • KI-3, KI-6, LU-7, LU-9, UB-13, UB-23
    With Heat: LU-10
  • Ear: Throat, Lung, Kidney, and Adrenals. Select two points at a time and imbed needle for 7 days, after which select 2 other points.
Clinical Manifestations
  • Cough with little yellow sputum
  • Spitting saliva
  • Wheezing
  • Shortness of breath
  • Dry, uncomfortable sensation in throat
  • Hiccups
  • Dry mouth
  • Coughing up difficult-to-expectorate Phlegm
  • Nausea
  • Hoarseness
  • Thirst
  • Asthma
  • Flushed face
  • Five sole Heat
  • Vomiting
  • T: Red and dry
  • C: Little or None
  • P: Thready and rapid or Deficient and rapid
Treatment Principle
  • Benefits the Stomach and Lungs
  • Generate Fluids
  • Descend Qi
  • Harmonize the Middle Jiao
Herb Formulas
Points
Clinical Manifestations
  • 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
Points
Clinical Manifestations
  • Sudden loss of voice brought on by depression, anger worry, emotional turmoil or sudden upset
  • 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
  • Premenstrual syndrome
  • Chronic cases:
    Heat-flushing
    Red eyes
    Tidal fever
    Dry mouth
    Short temper
  • T: Pink or Dark (Red edges with Heat)
  • C: Thin and white
  • P: Wiry or Choppy (Rapid with Heat)
Treatment Principle
  • Soothe the Liver
  • Clear Stagnation
  • Benefit the throat
  • Clear Heat if necessary
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
  • Distention and pain in the sides or flanks
  • Suffocating sensation in the chest and hypochondrium
  • Tendency to sigh
  • Melancholy
  • Depression
  • Irritability
  • Inappropriate anger
  • Hypochondriac pain
  • Coughing with profuse phlegm
  • Vomiting
  • Difficulty swallowing
  • A delicate constitution
  • A tendency towards fatigue
  • Palpitations
  • Abdominal distention
  • Muscular and skin flaccidity
  • Fear
  • Edema
  • Asthma
  • Insomnia
  • 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
  • Dizziness
  • Tinnitus or deafness
  • Poor memory
  • Aching, soreness or weakness of low back
  • Spermatorrhea or premature ejaculation
  • Aching in bones
  • Aching in leg and heel
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Nourish Yin
  • Reinforce the Kidneys
Herb Formulas
  • Liu Wei Di Huang Wan modified
  • For Yin and Blood Deficiency: Si Wu Tang modified
  • For Qi and Yin Deficiency: Si Jun Zi Tang modified
  • Chinese Patent Medicines:
    Liu Wei Di Huang Wan
    Zhi Bai Di Huang Wan
    Mai Wei Di Huang Wan
    Li Fu
    Yang Yin Qing Fei Tang Jiang

    Qing Yin Wan
    Jin Gui Shen Qi Wan
Points
Clinical Manifestations
  • Dry cough
  • Dizziness
  • Tinnitus or 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 throat, maybe recurrent sore throat
  • Dry stools and / or constipation
  • Urine short and red
  • Heightened libido
  • T: Red
  • C: Little or None
  • P: Thready and rapid
Treatment Principle
  • Moisten the Yin
  • Restrain the Fire
Herb Formulas
Points
Clinical Manifestations
  • Relatively severe hoarseness and huskiness of the voice
  • A sensation of something in the throat
  • Frequent clearing of the throat
  • Polyps on the vocal cords
  • Thickening, lumpiness and darkness of the vocal cords
  • T: Varies according to the accompanying symptoms
  • C: Varies according to the accompanying symptoms
  • P: Varies according to the accompanying symptoms
Treatment Principle
  • Activate Blood
  • Move Qi
  • Resolve Phlegm
Herb Formulas
Points
Clinical Manifestations
  • Hoarseness of the voice
  • Daily worsening of the hoarseness which continues unabated
  • Talking takes a great effort
  • Sensation of an abnormal object in the pharynx
  • Dry cough with scanty phlegm which causes the patient to attempt clear his throat frequently
  • Throat is dark red and swollen
  • The glottis cannot be properly opened or closed and a fissure is visible
  • Vocal cords are dark red swollen and appear like a stick with an uneven, rough surface covered by a sticky exudate
  • Chest, abdominal and epigastric discomfort and distention
  • Dry throat, which is alleviated by drinking small amounts of fluids
  • No desire for large amounts of fluids
  • T: Pink, may be thick and moist
  • C: Thick
  • P: Sticky
Treatment Principle
  • Astringe leakage of Lung Qi
  • Dry Dampness
  • Transform Phlegm
  • Descend Qi
  • Improve the condition of the throat
Herb Formulas
Points
  • General 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
  • Hoarseness of the voice
  • Daily worsening of the hoarseness which continues unabated
  • Talking takes a great effort
  • Sensation of an abnormal object in the pharynx
  • Dry cough with scanty phlegm which causes the patient to attempt clear his throat frequently
  • Throat is dark red and swollen
  • Vocal cords are dark red swollen and appear like a stick with an uneven, rough surface covered by a sticky exudate
  • The glottis cannot be properly opened or closed and a fissure is visible
  • Chest, abdominal and epigastric discomfort and distention
  • Dry throat, which is alleviated by drinking small amounts of fluids
  • No desire for large amounts of fluids
  • T: Dark, or with petechiae
  • C: Normal
  • P: Choppy
Treatment Principle
  • Transform Phlegm
  • Scatter knotting
  • Activate Blood
  • Eliminate Blood Stasis
Herb Formulas
Points
  • Open the Voice # 1 point (1.5 cm medial to ST-9 Renying), with the "Sparrow pecking" method. Insert the needle at the posterior border of the thyroid cartilage with oblique slanting of the needle. Puncture in the direction of the aryepiglottic fold. Needle twice daily. Needling of this point has the effect of reducing hyperemia and edema of the vocal cords.
  • UB-13, UB-23, SP-6, ST-36. Needle four points at a time with intermediate or weak stimulus. Retain the needle for 20 minutes.
  • Ear: Throat, Lung, Kidney, and Adrenals. Select two points at a time and imbed needle for 7 days, after which select 2 other 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
  • General points