Chronic Tonsillitis

General

Clinical Manifestations	Chronically enlarged tonsils or Incomplete or deformed tonsils No particular abnormal symptoms or Halitosis Mild soreness of the throat Sensation of a foreign object in  the throat Tonsils are greatly enlarged May block the respiratory passages preventing the patient from   enjoying a sound sleep or causing the patient  to snore May be low grade fever (37.5 C) May have a fever that lasts 3 – 4 weeks or longer Chronic blood engorgement especially from the anterior pillar Tonsils are swollen Tonsilar capsule often seeps out or contains exudate Pressing on the anterior pillar may elicit pus or a material that looks like cottage cheese Submaxillary lymph nodes are often enlarged The tonsils may be very large or May not be swollen at all
Treatment Principle
Herb Formulas
Points	To dispel inflammation: LI-4, LI-11, REN-22

Wind Attacks The Lungs With Qi And Blood Deficiency

Clinical Manifestations	Acute upflaring of chronic  tonsilar infections in weak and depleted individuals with repeated affliction by External pathogens Dry throat Fatigue After fatigue, it may get dryer and cause pain Aversion to Cold Sore throat The tonsils are swollen and slightly red Severe cases: the tonsils may be ulcerating and exudating Voice is hoarse T: Pale    C: White P: Deep and thready
Treatment Principle	Support the Upright Qi Release toxins Regulate the throat
Herb Formulas	Jie Geng Tang
Points	LU-7, LU-11, HT-5, HT-9, KI-4, KI-6

Dry Heat Attacks The Lungs With Yin Deficiency

Clinical Manifestations	Dry, hacking cough with little or no sputum Flushed face Sputum is difficult to expectorate Restlessness Maybe hemoptysis Hiccups Cough may cause chest pain Dyspnea Dry or sore throat Upper respiratory tract infection Hoarse voice Asthma Dry lips and mouth Fever Shortness of breath Hemoptysis Constipation Thirst Dry skin and hair Dryness in nose Sensation of fullness in chest Epistaxis Hypochondriac pain Chills and fever Headache Anhidrosis Irritability Itching T: Red tip, dry C: Thin, yellow, or White and dry, or None P: Superficial, maybe rapid or Big and weak or Deficient, big and rapid
Treatment Principle	Eliminate Dryness Moisten the Lungs
Herb Formulas	Qing Zao Jiu Fei Tang
Points	Jinjin-Yuye, KI-3, LU-1, SP-6, UB-13

Lung Yin Deficiency

Clinical Manifestations	Development of a white curd-like membrane in the throat that is difficult to scrape off Dry mouth and throat worse at night Soft or hoarse voice Low back and legs sore and weak Night sweats Malar flush Afternoon fever Sterility Spermatorrhea Sore and swollen throat Asthma Dry nose and lips Low grade fever Raspy breathing resembling wheezing Cough with dry or little Phlegm Five sole heat May be fever Blood flecked Phlegm Irritability Insomnia Steaming bones White complexion Maybe a red face Skinniness Shortness of breath (maybe exertional) Urgent panting Allergies Seminal emission with dreams Diminished urination Feeling miserable and agitated with fever T: Red and dry C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Clear the Lungs Improve the condition of the throat Relieve toxicity Cool the Blood
Herb Formulas	Bai He Gu Jin Tang Sha Shen Mai Men Dong Tang Yang Yin Qing Fei Tang Yue Hua Wan With Phlegm-Fire: Bei Mu Gua Lou San 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 And Spleen Qi Deficiency

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	Si Jun Zi Tang
Points	LU-9, REN-17, SP-3, ST-36, UB-13, UB-20, UB-43

Lung And Stomach Yin Deficiency

Clinical Manifestations	Low grade fever (around  37.5 C) Fever is higher in the p.m. Dry throat Patient experiences a sensation as if a foreign  object is stuck in  the throat Low grade pain Tonsils are enlarged Surface is uneven: either sunken in or standing out T: Red and dry C: Scanty P: Thready and rapid
Treatment Principle	Nourish the Yin Lubricate the Lungs Moisten the Stomach
Herb Formulas	Sha Shen Mai Dong Tang modified
Points	LU-7, LU-11, KI-6, KI-7

Lung And Kidney Yin Deficiency

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 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	Bai He Gu Jin Tang modified If Kidney Deficiency is prominent: Mai Wei Di Huang Wan With Lung Heat: Er Dong Tang Gargle: Chronic Laryngitis Gargle Chinese patent medicines: Mai Wei Di Huang Wan Li Fei Yang Yin Qing Fei Tang Jiang
Points	KI-3, KI-6, LU-7, LU-9, UB-13, UB-23 With Heat: LU-10

Spleen And Stomach Deficiency Cold

Clinical Manifestations	Mild constant epigastric pain; relieved by warmth and pressure Anorexia Abdominal pain and fullness after meals Nausea / vomiting Loose, unformed stools Excessive salivation Cold limbs Lassitude Weakness Sallow or pale, dull complexion Maybe edema Maybe scanty urination Maybe clear, watery, copious vaginal discharge T: Pale C: White and greasy P: Deep, thready and forceless
Treatment Principle	Warm Yang Strengthen the Spleen Warm the Center Dispel Cold
Herb Formulas	Xiao Jian Zhong Tang
Points	Moxa and/or warm-needle UB-20, UB-21, LIV-13, REN-12, SP-3, SP-6, ST-36

Liver Qi Stagnation Attacks The Stomach

Clinical Manifestations	Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea / vomiting Anorexia Epigastric distention 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 T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Xiao Chai Hu Tang
Points	LIV-13, LIV-14, PC-6, REN-12, ST-36, ST-44

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 For a chronic condition: Xiao Yao San Si Ni San Yue Ju Wan Chai Hu Shu Gan Tang For mild cases: Sang Dan Xie Bai Tang With Phlegm-Heat: Dai Ge San + Qing Jin Hua Tan Wan Chinese patent medicines: Qing Qi Hua Tan Wan Long Dan Xie Gan Wan Qing Fei Yi Huo Pian
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

Liver And Gall Bladder Channel Heat

Clinical Manifestations	Fever Chills Severe headache Flushed cheeks Bad breath Tinnitus Hearing loss Irritability Insomnia Coughing up viscous, thick sputum Dark urine Swollen lymph nodes Abdominal tension and itching Darkened skin Epistaxis Itching Formation of cellulitis T: Red C: Normal or Yellow P: Wiry and rapid
Treatment Principle	Drains Fire Relieves toxicity Spreads the Liver Qi Strengthens the Spleen
Herb Formulas	Chai Hu Qing Gan Tang
Points

Kidney Yin Deficiency

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	KI-1, KI-3, KI-6, REN-4, SP-6, UB-23 For a sore throat: Bailao, KI-3, KI-6, LI-4, LI-11, LI-18, LU- 7, LU-9, LU-10, ST-6, ST-36, UB-13, UB-23

Blood Deficiency

Clinical Manifestations	Postpartum emaciation and weakness Persistent, tight abdominal pain Abdominal pain with spasms or radiates to back and waist Cannot eat Shortness of breath Dyspnea Pale face Intermittent spasmodic abdominal pain which is better with Heat and pressure Epigastric pain Lusterless complexion Fidgeting Reduced appetite Maybe low-grade fever Palpitations Irritability Cold and sore extremities Nonspecific discomfort Dry mouth and throat Nocturnal emission Five sole Heat	Debilitated constitution in children Enuresis in children Insomnia Fatigue Anemia Bleeding Abdominal weakness Epistaxis Habitual constipation Maybe warm extremities Night sweats Tired limbs Frequent urination Night crying Diarrhea in children Habitual headache in children Hernia pain in children Chronic constipation Purpura Asthma T: Pale C: White. P: Weak and slow or Thready, wiry and even or Thready and weak
Treatment Principle	Warm and tonify the Spleen and Stomach Relieve spasmodic pain
Herb Formulas	Dang Gui Jian Zhong Tang
Points

Internal Cold

Clinical Manifestations	Abdominal pain Constipation Hypochondriac pain Chills Low-grade fever Cold hands and feet Intolerance of Cold Pain in the armpits Unilateral pain in the abdomen and hypochondrium Stiffness and spasms beside and below the umbilicus Pain in the waist and legs T: Normal C: Greasy and white P: Deep, tight and wiry
Treatment Principle	Warm the Interior Disperse Cold Unblock the bowels Alleviate pain
Herb Formulas	Da Huang Fu Zi Tang
Points

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 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