Acute Tonsillitis

General

Clinical Manifestations	Acute and pressing onset Sudden chills and fever Extreme cases: shivering chills Fever may rapidly raise to  39 C or above Strong sore throat Pain reaches its peak after 1 - 2 days Pain is aggravated by swallowing Headache Generalized soreness or body aches Vomiting Constipation or diarrhea Redness of the whole throat Bilaterally engorged and swollen tonsils with a yellow whitish pus exudate The areas of exudation are either small spots or consist of a layer of white colored false membrane The membrane rarely exceeds the boundary of the tonsil and can be scraped off easily When pressure is applied to the anterior column, there may be exudation of a fluid   Submaxillary lymph glands are often enlarged and sore May be pain radiating to the ear, accompanied by tinnitus and hearing loss Fever is usually continuous and lasts 4 - 6 days
Treatment Principle
Herb Formulas	For suppurative tonsillitis: Da Huang Mu Dan Pi Tang Liang Ge San With neck and shoulder stiffness: Ge Gen Tang With vomiting but no diarrhea: Ge Gen Jia Ban Xia Tang Da Huang (single herb) 9-12g  in hot water every 1-2 hrs. For purulent tonsillitis: Da Cheng Qi Tang
Points	Bleed LU-11 Needle LI-4, LI-11, LU-5, ST-44, with sedation. Needle once a day To dispel inflammation: LI-4, LI-11, REN-22

Wind-Cold-Damp

Clinical Manifestations	Suppuration with severe chills Fever Headache Muscle spasms Inflammation Swelling Pain Anhidrosis Pain and stiffness of the head and neck Stuffy nose Swollen, blood shot eyes Sores that are red, swollen and painful Generalized body aches and pain Thirst or no thirst T: Normal C: Thin white P: Floating or Floating and rapid
Treatment Principle	Induce sweat Release the Exterior Dispel Wind Alleviate pain
Herb Formulas	Jing Fang Bai Du San
Points

Mild Wind-Cold With Dryness

Clinical Manifestations	Itching or tickling in the throat Blocked or stuffy nose Sneezing General body aches Cough with little or no mucus or Cough with expectoration of thin, watery or frothy white sputum Dry nasal passages Dry lips Mild headache Chills with low grade fever Slight headache Nasal obstruction Dry throat No thirst Intolerance of Cold Anhidrosis Maybe asthma Nasal congestion Cough Sore throat T: Pink C: Thin, white and dry P: Superficial and wiry or Tight or Wiry
Treatment Principle	Mildly Disperse Cool Dryness Disperse and descend Lung Qi Resolve Phlegm Transform thin mucus Soothe the Lungs
Herb Formulas	Xing Su San Chinese patent medicines: Chuan Bei Pi Pa Gao
Points	KI-6, KI-7, LU-5, LU-7, LU-9, UB-12, UB-13

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 Shi Gao Tang 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

Tai Yang - Yang Ming

Clinical Manifestations	Fever and chills with fever increasing and chills decreasing Headache Anhidrosis Stiffness of the extremities Orbital pain Eye pain Dry nasal passages Irritability Insomnia T: Normal C: Thin and yellow P: Floating and slightly flooding
Treatment Principle	Release the muscle layer Clear Interior Heat
Herb Formulas	Chai Ge Jie Ji Tang
Points

Yang Ming Fu

Clinical Manifestations	Persistent fever Restlessness Thirst Very evident sore throat Difficulty swallowing Extremely red and swollen tonsils with a yellow whitish area of     exudate, which, in severe cases, may all link and form a film (Knotting of the Accumulated Heat Toxins) Halitosis Constipation Reduced and dark urination T: Red C: Yellow P: Slippery and rapid
Treatment Principle	Clear Heat Detoxify poison Open the bowels Regulate the throat
Herb Formulas	Pu Ji Xiao Du Yin Jia Jian Topical: Bing Peng San
Points	Bleed LU-11, needle LI-4, LI-11, ST-44, LU-10 with strong        stimulus 1 - 2 times daily Ear: Tonsils and Throat. Bleed the 3 spots on the the small vein behind the ear

Wind-Heat Attacks The Lungs

Clinical Manifestations	Sudden weakness Hoarseness Loss of voice Fever and chills with fever predominant Aversion to draft Headache Dry mouth and nose Possible nasal congestion Fatigue Malaise Anorexia Sweating or Absence of sweating Sore throat General bodily soreness and malaise Throat is red The tonsils are swollen and engorged but without any particular pus spots T: Slightly red tip and edges C: Thin and yellow or Thin and white P: Rapid and floating
Treatment Principle	Release the Exterior Clear Heat Regulate the throat
Herb Formulas	Niu Bang Gan Jie Tang Jia Jian Sheng Ma Ge Gen Tang Jing Jie Lian Qiao Tang Sang Ju Yin Qing Yan Li Ge Tang Shu Feng Qing Re Tang Yin Qiao San With obvious suppuration: Acute Tonsillitis #1 With Yin Deficiency: Jia Jian Wei Rui Tang With Yin Deficiency and Qi and Blood Affected: Wei Rui Tang With lower back pain: Xiao Chai Hu Tang modified For a paroxysmal or dry cough following resolution of acute symptoms: Xiao Chai Hu Tang modified With a persistent cough after resolution of the External factors: Zhi Sou San With epistaxis: Sang Ju Yin modified 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 Gan Mao Ling Xiao Chai Hu Wan Ban Lan Gen Chong Ji With epistaxis:: Qing Fei Yi Huo Pian Ma Xing Zhi Ke Pian Yunnan Bai Yao (can be blown into the nose)
Points	LU-7 + LI-4 or LI-4 + KI-7, DU-16, GB-20, LU-5, UB-12, 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 DU-14, LI-4, LI-11, LU-5, SJ-5, UB-12, UB-13 DU-14, LI-4, LI-11, SJ-5, UB-12 For a very sore, swollen throat: + LU-11, SI-17 With coughing: + LU-5 For a very sore, swollen throat: + LU-11, SI-17 LI-4, LI-11, SI-17, ST-44 For lower back pain: DU-14, LI-4, LI-11, SJ-5, UB-12, UB-13 + cups on the Ahshi points of the lower back With epistaxis: GB-20, LI-4, LI-20, LU-11, SJ-5, UB-13 With severe fever: + LI-11 With severe cough: + LU-5 With hemoptysis: LI-4, LI-16, LU-6, LU-10, SJ-5, UB-13 For a severe fever: + LI-11 For severe coughing: + LU-5 For a severe, swollen, sore throat: + LU-11, SI-17

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 C: Powdery white or yellow P: Floating, rapid and forceful
Treatment Principle	Clear Heat Eliminate Fire toxin Disperse Wind-Heat
Herb Formulas	Pu Ji Xiao Du Yin Bai Nung Tang Pai Nong San Xian Fang Huo Ming Yin Zi Xue Dan Zhen Ren Huo Ming Yin Niu Huang Shang Qing Wan
Points

Wind-Heat-Dampness With Interior 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
Points

Summerheat With Exterior Cold And Interior Dampness

Clinical Manifestations	Chills Skin that is warm to the touch Anhidrosis A heavy sensation in the head and body Headache Abdominal pain A stifling sensation in the chest Fatigued extremities Anorexia Lethargy Aversion to Cold Nausea Vomiting Diarrhea T: Pink C: White and greasy P: Floating
Treatment Principle	Release the Exterior Scatter Cold Transform Dampness Harmonize the Middle Jiao
Herb Formulas	Xiang Ru San
Points

Dry Heat Attacks The Lungs ( Wei Level: Dry Heat)

Clinical Manifestations	Dry choking cough with a husky sound and thick or blood-tinged sputum Cough with thick, sticky, hard to expectorate sputum Cough may cause chest pain Dry skin Dryness of nose, mouth and lips Dry, painful throat Thirst Little or no sweat Itching and dryness of throat Sore throat Headache Stuffy nose Fever and chills with more fever than chills Aversion to Wind T: Red tip and Dry or Red and dry C: Thin and yellow or White or Thin, yellow and dry P: Floating and rapid or Thready and rapid
Treatment Principle	Disperse Wind Clear Heat Moisten Dryness Descend Lung Qi Relieve cough
Herb Formulas	Sang Xing Tang modified Qing Zao Jiu Fei Tang Yang Yin Qing Fei Tang Yin Qiao San Sang Ju Yin For damage to Lung Yin: Qing Zao Jiu Fei Tang Chinese patent medicines: Yin Qiao JIe Du Pian Gan Mao Lin Sang Ju Yin Pian Chuan Bei Pi Pa Gao
Points	KI-6, KI-7, LU-5, LU-7, LU-9, UB-12, UB-13 Jinjin-Yuye, KI-3, LU-1, SP-6, UB-13 LI-4, LU-5, LU-7, UB-13 For hemoptysis: + LU-6, UB-17 LI-4, LU-11, REN-22, UB-12, UB-13 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

Qi Level: Obstruction Of The Chest By Heat

Clinical Manifestations	High fever or Fever Aversion to Heat Irritability Restlessness (neither activity nor resting brings relief) Heat sensation in the chest Thirst Has urge to vomit but cannot May have dark yellow urine T: Red C: Yellow P: Rapid or Forceful and rapid
Treatment Principle	Clear Heat Remove Obstructions
Herb Formulas	Zhi Zi Chi Tang If after 2-3 days the patient displays restlessness with accumulation of Phlegm and sputum, chest distension and nausea, but no other Middle Jiao symptoms: Gua Di San
Points	DU-14, HT-7, LI-11, PC-6, ST-44

Qi Level: 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

Qi Level: Gall Bladder Heat

Clinical Manifestations	Alternating chills and fever Bitter taste in mouth Thirst Dry 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 With congestion in the chest and epigastrium: Zhi Zi Chi Tang With vomiting: Zhi Zi Sheng Jiang Chi Tang With short, rapid breathing: Zhi Zi Gan Cao Chi Tang With Food Stagnation: Zhi Shi Zhi Zi Chi Tang
Points	To Pacify the Liver and Gall Bladder: LIV-3, LIV-4, LIV-13, LIV-14. To Relieve Gall Bladder Heat: Lanweixue, LI-11, LIV-2, GB-34

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 Qing Jin Hua Tan Wan 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

Liver Qi Stagnation: Phlegm And Qi Stagnant And Blocked

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 Women: 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	Ban Xia Hou Po Tang
Points	PC-5, LIV-3, SJ-6, LI-18, SI-17

Liver Fire

Clinical Manifestations	Alternating fever and chills Fullness in the chest and hypochondrium (with or without pain) Bitter taste in mouth Nausea Continuous vomiting Hard focal distension in the epigastrium Fullness and pain in the epigastrium Burning diarrhea or no bowel movement Despondency Slight fidgeting Slight irritability Headache Constipation or discharge of fluids rectally Tinnitus Diminished hearing Diminished vision Red eyes Manic behavior Asthma Mental instability T: Normal or red C: Yellow or Thick and yellow P: Wiry and forceful or Wiry tight and forceful
Treatment Principle	Harmonizes and Disperses the Shao Yang Drains Internal Heat Retention
Herb Formulas	Da Chai Hu Tang
Points	GB-12, GB-34, GB-37, LIV-2, UB-18, UB-19

Liver Fire Scorches The Lungs

Clinical Manifestations	Severe, dry and paroxysmal cough Cough with sputtering Worse with emotional turmoil or anger Difficult to cough up sputum Maybe Blood-streaked sputum The cough may drag on or may recur regularly Pain over the chest and hypochondrium During the coughing, the patient may get hot, flushed and upset Redness of eyes and face Red face during coughing Bitter taste in the mouth Dry mouth and throat Angers easily Irritability Restlessness Depression Dizziness Headaches T: Red edges and tip or Red and dry C: Thin and yellow or Thick and yellow P: Rapid and wiry or Rapid and slippery
Treatment Principle	Clear Lung Heat Calm the Liver Descend Qi Suppress Fire Moisten the Lungs Expel Phlegm
Herb Formulas	Cough #3 Xiao Yao San + Ban Xia Hou Po Tang Dai Ge San Xie Bai San Ke Xue Fang Long Dan Xie Gan Tang Jia Wei Xiao Yao San Xie Bai San + Dai Ge San modified For mild cases: Sang Dan Xie Bai Tang With Phlegm-Heat: Dai Ge San + Qing Jin Hua Tan Wan For Shen Disturbancee due to Blood Heat: An Gong Niu Huang Wan Zi Xue Dan Zhi Bao Dan Xi Jiao Di Huang Tang Qing Ying Tang Chinese Patent Medicines: Qing Qi Hua Tan Wan Long Dan Xie Gan Wan Qing Fei Yi Huo Pian With hemoptysis: Yunnan Bai Yao
Points	LIV-2, LU-5, LU-7, UB-18, UB-43 GB-34, LIV-2, LIV-3, LIV-14, LU-5, PC-6, UB-13, UB-18 With hemoptysis: LU-6 GB-34, LIV-2, LIV-3, LU-5, LU-6, SP-10, UB-13, UB-18

Fire In The Liver And Stomach

Clinical Manifestations	Headache Dizziness Red eyes Tinnitus Oral ulcers Bleeding gums Constipation
Treatment Principle	Purge Fire DetoxifY Draw out pus
Herb Formulas	Niu Huang Jie Du Pian
Points