Acute Laryngitis

General

Clinical Manifestations	Acute laryngitis is an acute infectious disease of the laryngeal mucosa. It is often part of an acute upper respiratory tract infection, or may be secondary to an acute rhinitis or acute pharyngitis. It occurs mostly in adults and more frequently in males than in females. This condition often occurs during winter and spring. If not treated properly, it may deteriorate to subacute or chronic laryngitis. At the initial stage, there is a tickle in the throat which feels dry and slightly sore, or a sensation as if a foreign object were in the throat. Very shortly thereafter, the voice becomes hoarse up to the point of complete aphonia accompanied by sudden coughing spells with expectoration of sticky thick sputum laced with pus. With each coughing spell, the hoarseness is aggravated and the sore throat becomes worse while speaking. In adults, the local symptoms are dominant and the general physical symptoms milder Acute onset Scratchy sore throat Hoarse voice Coughing spells General bodily malaise In the event of concurrent upper respiratory tract infection, one may encounter symptoms such as: Fever Aversion to Cold Stuffy nose Headache Generalized malaise Fatigue Poor appetite If acute pharyngitis extends downward, it may lead to concurrent acute tracheitis, acute bronchitis, or in elderly patients, to pneumonia
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. To dispel inflammation: LI-4, LI-11, REN-22

Wind-Cold Attacks The Lungs

Clinical Manifestations	Sudden decrease in the strength of voice Severe cases: Hoarseness Aphonia The vocal cords are slightly red and swollen Slight sore throat Difficulty swallowing Scratchy throat Cough or wheezing with thin, watery mucus Aversion to Cold Fever and chills, chills predominant Occipital headache Nasal congestion with clear discharge Sneezing Generalized body aches Neck stiffness Absence of sweating Lack of thirst T: Normal C: Thin and white P: Floating and tight
Treatment Principle	Disperse Wind Scatter Cold Regulate the pharynx Release the voice
Herb Formulas	Liu Wei Tang modified Shu Han Kai Yin Tang With Internal Heat: Da Qing Long Tang Inhalation therapy: Laryngitis #1 Gargle: Acute Laryngitis Gargle Chinese patent medicines: Gan Mao Ling Chuan Xiong Cha Tiao Wan
Points	LI-4, LU-5, LU-7 (sedate or use moxa) 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. Bailao, GB-20, LI-4, LU-7, REN-22, UB-12, UB-13 For significant wheezing: + Dingchuan For nasal congestion or rhinitis: + DU-23

Wind-Cold Attacks The Lungs With Underlying Kidney Yang Deficiency

Clinical Manifestations	Sensation of extreme cold Severe chills Chills are not relieved by clothing or covers Slight fever Anhidrosis Exhaustion Almost constant desire to sleep Pale face Cold extremities Headache Cough Pain penetrating to the back Toothache Sore throat Raspy voice Edema due to Wei Qi Stagnation Chronic wheezing T: Pale and swollen C: White and slippery P: Deep and weak
Treatment Principle	Disperse Wind-Cold Replenish Yang
Herb Formulas	Ma Huang Fu Zi Xi Xin Tang
Points	LI-4, LU-5, LU-7 (sedate or use moxa) 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. Moxa and needle UB-23, KI-3

Perverse Dryness Attacks The Lungs

Clinical Manifestations	Dry cough with little or no sputum Sputum is difficult to expectorate Maybe hemoptysis Cough may cause chest pain Dry or sore throat Hoarse voice Dry lips and mouth Thirst Dryness in nose Epistaxis Chills and fever 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 If symptoms persist for a long time: Yang Yin Qing Fei Tang
Points	KI-3, LU-1, LU-6, SP-6, UB-13

Wei Stage Wind-Heat Invades The Lungs

Clinical Manifestations	At the beginning, the patient has a low and raspy voice The vocal cords are swollen and red and there may be a white or yellow exudate on their surface Severe: swelling narrows the throat causing difficulty swallowing There is a sore throat accompanied by a dry, tickling cough with yellow sticky Phlegm that is difficult to expectorate. Sudden weakness Hoarseness Loss of voice Fever and chills with fever predominant Aversion to draft Headache Sweating Dry mouth and nose Possible nasal congestion Fatigue Malaise Anorexia T: Slightly red tip and edges C: Thin and yellow P: Floating and rapid
Treatment Principle	Scatter the Wind Clear Heat Moisten and benefit the throat Regulate the pharynx Restore the voice
Herb Formulas	Hou Jian Fang Qing Re Kai Yin Tang Shu Feng Qing Re Tang modified Qing Yan Li Ge Tang modified Sang Ju Yin Yin Qiao San Ma Xing Shi Gan Tang With a persistent cough after resolution of the External factors: Zhi Sou San For a paroxysmal or dry cough following resolution of acute symptoms: Xiao Chai Hu Tang modified Inhalation therapy: Laryngitis #2 Gargles: Acute Laryngitis Gargle #1 Liu Shen Wan (dissolve in water and gargle) Chinese patent medicines: Yin Qiao Jie Du Pian Liu Shen Wan Qing Yin Wan Gan Mao Tui Re Chong Ji Gan Mao Ling Ban Lan Gen Chong Ji
Points	LI-1, LI-4, LU-11, SI-17 DU-14, DU-16, GB-20, LU-5, LU-7, LU-10, LU-11, SJ-5, UB-12, UB-13 GB-21, PC-5, REN-17. REN-22, UB-13 Bailao, LI-4, LI-11, LI-18, LU-6, LU-10, REN-22, SJ-6 For a very, sore, swollen throat: + LU-11, SI-17 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.

Wind-Heat Toxin With Phlegm

Clinical Manifestations	Strong fever and chills Redness of the head and face Swelling and burning pain of the head and face Throat dysfunction Swelling and pain of the throat Thirst Red and swollen eyes Difficulty opening the eyes Aversion to Cold Throat Dryness Facial edema Restlessness T: Red or Dry and red C: Powdery white or Yellow P: Floating, rapid and forceful or Rapid and forceful
Treatment Principle	Clear Heat Eliminate Fire Toxin Disperse Wind-Heat
Herb Formulas	Pu Ji Xiao Du Yin
Points	LI-1, LI-4, LU-11, SI-17 DU-14, DU-16, GB-20, LU-5, LU-7, LU-10, LU-11, SJ-5, UB-12, UB-13 GB-21, PC-5, REN-17. REN-22, UB-13 Bailao, LI-4, LI-11, LI-18, LU-6, LU-10, REN-22, SJ-6 For a very, sore, swollen throat: + LU-11, SI-17 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.

Wei Stage Dry Heat

Clinical Manifestations	Hoarse, husky or raspy voice Dry, hacking cough or Cough with thick, sticky, hard to expectorate sputum Dry skin Dry mouth, nose and lips Dry, ticklish, painful throat Thirst Little or no sweat Fever and chills with more fever than chills T: Dry or Red and dry C: Thin white P: Floating and rapid or Slightly rapid
Treatment Principle	Disperse Wind Clear Heat Moisten Dryness
Herb Formulas	Sang Xing Tang Qing Zao Jiu Fei Tang Chinese patent medicines: Ling Bei Qiu Li Gan Li Fei Yang Yin Qing Fei Tang Jiang
Points	Bleed UB-40, needle DU-14, DU-23, DU-24, GB-20, KI-3, KI-6, LI-4, LI-11, LU-5, LU-6, LU-7, LU-10, REN-22, SJ-5, SP-6, ST-8, Taiyang, UB-12, UB-13 KI-3, KI-6, LU-5, LU-7, LU-10, REN-22

Wei Stage Moving To Qi Stage Lung Heat

Clinical Manifestations	All symptoms of Wind Heat are aggravated The hoarseness is more severe in the extreme Complete loss of voice Vocal cords red and very swollen and covered with a thick, purulent exudate Whole throat is burning, hot, and painful accompanied by incessant coughing Yellow sticky sputum that is difficult to expectorate High fever Thirst Severe dyspnea Stridor Increased fluid intake Halitosis Abdominal distention Dark yellow and reduced urination Possibly constipation T: Red, C: Thick yellow P: Huge and rapid
Treatment Principle	Drain Heat Detoxify Fire poison Regulate the pharynx Restore the voice
Herb Formulas	Qing Yan Li Ge Tang modified Qing Re Kai Yin Tang modified When normal and the strength of the Fire greatly reduced: Yang Yin Qing Fei Tang Gargle: Shu Kou Jie Du Fan Shu Kou Fang Laryngitis Gargle #1 Inhalation therapy: Laryngitis #2
Points	LI-4, LU-11, LI-1, LU-5, SJ-17 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.

Qi Stage: Lung Heat

Clinical Manifestations	Fever No chills Aversion to Heat Cough Asthma Restlessness Thirst Dry mouth Red face Worse in the afternoon Dark yellow urine Dyspnea Chest pain Shortness of breath Thick yellow Phlegm which is difficult to expectorate 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 Qing Xin Li Ge Tang With Lung Yin Deficiency: Qing Fei Tang With Phlegm: Ren Shen Xie Fei Tang With epistaxis: Ma Xing Shi Gan Tang modified With Liver and Gall Bladder Heat: Xiao Chai Hu Tang Chinese Patent Medicines: Ma Xing Zhi Ke Pian Qing Fei Yi Huo Pin Niu Huang Jie Du Pian With epistaxis:: Qing Fei Yi Huo Pian Ma Xing Zhi Ke Pian Yunnan Bai Yao (can be blown into the nose)
Points	Early-stage: LI-2, LU-10 Dingchuan, DU-13, DU-14, LI-11, LU-5, LU-10, ST-44, UB-13 LU-1, LU-5, LU-9, LU-10, PC-6, SI-4, UB-13, UB-15 LU-1, LU-5, LU-6, LU-10, UB-13 DU-14, LI-4, LU-1, LU-5, LU-6, LU-10, REN-17, UB-13 With epistaxis: GB-20, LI-4, LI-20, LU-11, SJ-5, UB-13 With severe fever: + LI-11 With severe cough: + LU-5

Wind-Heat-Dampness With Internal Heat Toxins

Clinical Manifestations	Fever Anhidrosis Aversion to Cold Headache Muscle aches Nasal congestion Cough with sputum Suppurative infection Carbuncles Stiffness of the muscles T: Red White and greasy or Yellow and greasy P: Floating and feeble or Floating and rapid or Deep and rapid
Treatment Principle	Dispel External Wind Heat and Dampness Relieve toxicity
Herb Formulas	Yin Qiao Bai Du San Chinese patent medicines: Gan Mao Tui Re Chong Ji
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 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

Kidney Yin Deficiency With Empty Fire Rising

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 Yin Restrain Fire
Herb Formulas	Zi Yin Jiang Huo Tang
Points	KI-1, KI-2, KI-3, KI-6, KI-9, REN-4, SP-6, UB-23