Pharyngitis

Western Diagnosis
Inflammation of the pharynx (Sore Throat)

Etiology
Usually Viral 1) Group A Beta Hemolytic Streptococcus pyrogenes -Beefy red pharynx w/ exudates (20% of cases, others have only mild symptoms)

Signs & Symptoms
-Sore Throat -Pain on swallowing -Fever -Cervical lymphadenopathy

Tests/Labs
Leukocytosis: Left shift if strep Culture: esp. for strep ASO Titers for strep (rarely done anymore)

Possible Complications
** Scarlet Fever: ** -produces erythrogenic toxin -Diffuse pink-red rash over abdomen, lat. Chest, & skin folds (Pastia’s lines) -Circumoral pallor -Strawberry tongue

** Rheumatic Fever: ** Post-strep glomerular nephritis

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Definition:
Acute inflammation or infection of the pharynx.

Etiology:
Pharyngitis is usually due to a viral agent; however, other associated microorganisms include Group A Beta-hemolytic Strep ("strep throat"), pneumococcus, gonococcus or other STD, or staphylococcus.

Somatic Therapies:
• sinus exercises

Nutrition:
eating principles: » acute: • eat as little as possible • increase fluids: diluted vegetable juices, broths, herbal teas • increase foods rich in Vitamins C and A • vegetable juice fasts • low sugar » chronic: • elimination/rotation diet, rotation diet, rotation diet expanded

therapeutic foods: • lemons, limes, honey, garlic, elderberries, turnip pack externally on throat • foods rich in Vitamins A and C

fresh juices: • lime (Shefi) • honey and water • honey and hot lemonade • carrot (Walker, p. 144) • carrot, spinach (Walker, p. 144) • orange (Yin-fang and Cheng-jun, p. 83)

specific remedies: • tea from carrots and olives, drink twice daily for 1 week (Ni, p. 157) • tea from daikon radish and green apple drink twice daily (Ni, p. 157) • honey in warm water • mix 1 tsp. rock salt in 1 cup hot water and gargle • boil 2 oz. dried tangerine skin in 1 pt water until reduced by half. Drink throughout day. (Butt and Bloomfield, p. 157) • boil 12 olives and 1 oz. scallions in 1 pt water until reduced by half. Drink and eat results divided in two portions (Butt and Bloomfield, p. 157) • lemon juice in warm water; gargle and drink • strong sage tea, gargle (Shefi) • take 1-2 fresh pomegranates, discard the skin and save the seeds. Crush them, add water and simmer, then strain to obtain the liquid. Let this cool, then use as a mouth wash (Yin-fang and Cheng-jun, p. 26) • take two pieces of pickled plum (plums soaked in vinegar), including the pits, and crush. Add a little table salt and one cup of boiling water. Mix and when cool use as a mouthwash to gargle two to three times daily (Yin-fang and Cheng-jun, p. 36) • steam in water for 30 minutes: 90 g fresh peeled loquat and 15 g sugar. Eat the fruit and drink the liquid twice daily (Yin-fang and Cheng-jun, p. 48) • squeeze fresh strawberries to obtain the juice. Drink one cup twice daily in the morning and evening (Yin-fang and Cheng-jun, p. 55) • take 60-90 g of fresh water chestnuts, remove the skins and slowly chew and eat twice daily (Yin-fang and Cheng-jun, p. 68) • for beginning inflammation: slowly chew 30-60 g fresh pitted cherries twice daily (Yin-fang and Cheng-jun, p. 94) • slowly chew 60 g of walnut kernels per day (Yin-fang and Cheng-jun, p. 106) • slowly chew 30-60 g of fresh chestnuts three times daily (Yin-fang and Cheng-jun, p. 108)

avoid: • food intolerances • heavy protein foods, fats, meats, vinegars, shellfish, dairy foods, meat, alcohol, hot sauces, spicy foods, fried foods, fatty foods, rich foods, salty foods, coffee, caffeine, sweet foods and sugar

Botanicals
• Aconitum napellus (toxic): acute; irritation, elevated temperature (Felter and Lloyd, p. 105) • Althea officinalis: demulcent for older forms with dry cough, dysphagia, or for acute inflammation and irritation; as a gargle several times daily (Weiss, p. 123) • Arnica montana (toxic): 1 tsp. to a glass of water as a mouthwash or gargle; stimulates peripheral circulation, increases mucosal resistance (Weiss, p. 124) • Atropa belladonna (toxic): congestion, according to indications; a valuable remedy (Felter and Lloyd, p. 338) • Baptisia tinctoria: especially with foul conditions, halitosis, dusky purplish, lurid discoloration; combines well with Echinacea spp., Capsicum frutescens and Commiphora myrrha (Felter and Lloyd, p. 326; British Herbal Pharmacopoeia, p. 39) • Chamomilla spp.: anti-inflammatory for acute inflammation; hot tea as a gargle every hour • Collinsonia canadensis: relaxed condition with dark discoloration and poor capillary circulation (Ellingwood, p. 266) • Commiphora myrrha: specific for pharyngitis; combines well with Echinacea spp., Baptisia tinctoria (British Herbal Pharmacopoeia, p. 73) • Echinacea spp. • Gelsemium sempervirens (toxic): with Phytolacca decandra for difficulty swallowing, aching and fullness of the throat (Harper-Shove, p. 57) • Guaiacum officinalis: stiffness and dryness of the throat, painful swallowing, burning in throat (Harper-Shove, p. 57) • Hydrastis canadensis: locally and internally; simple catarrhal, follicular or granular pharyngitis (Felter and Lloyd, p. 1027) • Phytolacca decandra (toxic): follicular pharyngitis, hard swollen glands, ulcerated; covers many varieties of pharyngitis (Ellingwood, p. 374; Felter and Lloyd, p. 1473) • Potentilla tormentilla: astringent • Salvia officinalis: for older forms with dry cough, dysphagia, or for acute inflammation and irritation; as a gargle several times daily (Weiss, p. 123) • Usnea spp.: as gargle and internally

Chinese Formulae
• Lonicera and Forsythia F. (Yin Qiao San) (available as patent); Forsythia 18 (patent): Wind-Heat, 1st or 2nd day of illness, no swollen glands. (Lonicera: Hsu, 1980, p. 83; Yeung, p. 275; Bensky and Barolet, p. 44; patent: Zhu, p. 46; Forsythia: Dharmananda, 1990, p. 67) • Gan Mao Dan (patent): Wind-Damp-Heat: swollen glands. (Zhu, p. 45) • Shuang Liao Hou Feng San (Superior Sore Throat Powder Spray) (patent): topically (Fratkin, p. 91, Zhu, p. 158) • Yang Yin Qing Fei Tang Jiang (patent): Lung Yin Xu (Deficiency): cough (Zhu, p. 84) • Niu Huang Jie Du Pian (available as patent): Fire Toxin (Yeung, p. 162, Zhu, p. 167) • Liu Shen Wan (patent): severe sore throat (Zhu, p. 169; Bensky and Barolet, p. 87) • Arctium C.; Qiang Lang Tang; Ilex 15 (patent); Niu Huang Xiao Yan Wan (patent): Fire Toxin, pus may be present. (Arctium C.: Hsu, 1980, p. 169; Qiang Lang Tang: Yeung, p. 168; Bensky and Barolet, p. 49; Ilex: Dharmananda, 1990, p. 70; Niu Huang Xiao Yan Wan: Zhu, p. 190) • Rehmannia and Lonicera C.: Xue (Blood) Heat (Hsu, 1980, p. 188; Dharmananda, 1986, p. 369) • Coptis and Rehmannia F. (Qing Wei San): Stomach Fire Blazing Upward (Hsu, 1980, p. 168; Dharmananda, 1986, p. 284; Bensky and Barolet, p. 93) • Ophiopogon C. (Mai Men Dong Tang): Stomach Yin Xu (Deficiency) (Hsu, 1980, p. 537; Yeung, p. 159; Bensky and Barolet, p. 165) • Pueraria Nasal C.: Common cold with sore throat, stuffy nose (Hsu, 1980, p. 37; Dharmananda, 1986, p. 208)

Acupuncture
after assessing the person and palpating, consider these patterns: Wind-Heat invasion; Lung Heat; Stomach Fire Blazing Upward; Lung Yin Xu (Deficiency); Stomach Yin Xu (Deficiency); Kidney Yin Xu (Deficiency); dysfunction of the Yang Qiao Mai (Yang Motility Vessel) and/or the Yin Qiao Mai (Yin Motility Vessel); Water element weak in Bladder or Kidney channel

» therapeutic note: differentiation of acute Shi (Excess) and chronic Xu (Deficiency) is crucial to the safe and successful treatment of pharyngitis

» illustrative combinations: • Lu-10, CV-22 and LI-4 for swollen painful throat (Shanghai, p. 246) • Lu-10 and Lu-11: reduce Lung Fire to stop sore throat (Flaws, 1989, p. 80; Finkelstein, p. 4) • UB-17 and Lu-8 for swollen and painful throat (Shanghai, p. 204) • Kd-2 and Kd-3 for swelling at throat (Shanghai, p. 297) • Kd-1 and Kd-4 swollen, painful throat with difficulty swallowing (Shanghai, p. 298) • UB-10 and Lu-11 for chronic cough, pharyngitis (Shanghai, p. 168) • Lu-9 and LI-6; GB-20, UB-17, UB-18, SI-4, St-9 and St-10; CV-22, CV-23, TW-16 and TW-15; St-6 and St-5 for pharyngitis (Mann, p. 138) • Lu-11 and TW-1: bleed few drops with triangular needle to clear Heat Shi (Excess) • UB-10, Lu-1, Lu-10 and Lu-11: cool the throat (Finkelstein, p. 38) • Kd-6 and Lu-7: nourishes Yin; induce Xu (Deficiency) Fire downward; clear Lung; ease throat (Finkelstein, p. 3); open the Yin Qiao Mai (Yin Motility Vessel) which transports Yin and for which throat pain is a symptom of dysfunction, usually Shi (Excess) • Kd-2 and Lu-10: nourish Yin and reduce Fire; relieve sore throat (Finkelstein, p. 52) • UB-13 and LI-4: clear Heat of the Upper Warmer and moisten the Lung (Finkelstein, p. 39) • Lv-2 and Lv-3 for parched throat with thirst (Shanghai, p. 293) • Lv-3 and Sp-6 (+): nourish Yin of Liver and Kidney to relieve Shi (Excess) Fire (Finkelstein, p. 73) • TW-2 and Lu-10 (-): reduce swelling and relieve pain; clear and drain Toxic Heat from Triple Warmer channel (Ellis, et al, 1988, p. 86); treats sore throat (Ellis, et al, 1988, p. 281) • Lu-10 and Kd-6: tonify Yin and ease sore throat due to Yin Xu (Deficiency); benefit larynx, pharynx, chest and pleura (Finkelstein, p. 54) • Kd-6 and UB-62: adjust Shi (Excess) in Yin and Yang Qiao Mai (Motility Vessels) (Finkelstein, p. 54) • Kd-6, Kd-7 and Sp-6: nourish Yin and moisten dryness (Finkelstein, p. 54) • Kd-2, Sp-6 and UB-23 (+): reinforce the Kidney and nourish Yin (Finkelstein, p. 52) • Kd-6, Sp-6, Kd-2, Kd-3, and wei guan xia shu: treat dry mouth, thirst and dry throat (Flaws, 1989, p. 100) • UB-62 and SI-3: open the Yang Qiao Mai (Yang Motility Vessel) which transports Yang and for which throat pain is a symptom of dysfunction, usually Shi (Excess) • UB-38/43, SI-8, GB-41 and TW-5; TW-10, Ht-3, LI-14 and LI-13; St-12, CV-17, PC-1 and Lv-3 for cervical adenitis (Mann, p. 138) • Kd-1, Lu-2, SI-17, St-12, UB-11, UB-17, Lu-2, Lu-5, LI-2, St-45 and Kd-2 for throat blockage with Cold and Hot Obstruction (Shanghai, p. 691) • LI-18 and Kd-3: treat the throat (Finkelstein, p. 11)

Homeopathy
• Aconitum napellus: throat very red, tingling, uvula feels long, comes in contact with throat; sudden onset at night after exposure to cold wind; burning, tearing sore throat; cannot swallow; high fever with great thirst for cold water; anxiety and fear • Apis mellifica: swelling of uvula, can hardly swallow > cold < heat; no thirst; burning, stinging • Belladonna: pharynx is hot, dry, red, esp. right side; rapid progress, constriction on attempting to swallow; aversion to liquids • Cantharis: very severe burning and rawness; constriction of throat and larynx; suffocation on any attempt to swallow water • Capsicum: hot smarting sensation as if caused by pepper < not swallowing • Gelsemium: develops several days after exposure; soreness comes on gradually; muscular weakness local and general • Hepar sulphur: fish bone or crumb sensation < any exposure, cold dry wind; throat extremely sensitive to touch; pain on swallowing as if full of splinters • Kali bichromicum: sensation of a hair stuck in throat; discharge ropey, stringy, exudate in throat looks like fine ashes sprinkled on the part • Lac caninum: goes from side to side; sensation they will "choke" > cold or warm drink • Lachesis: bluish tinge of the pharynx; sense of constriction and dysphagia • Lycopodium: < 4-8 p.m.; right side; may extend to left side; from above downward > swallowing warm fluids and holding cold fluids in mouth; throat extremely painful • Mercurius cyanatus: gray exudate present; looks raw in spots, as if denuded • Mercurius solubilis: much saliva and retching • Nitric acid: prickling sensation as if from a fish bone; violent pain extending to ears at least swallowing; ulcers with bluish margins • Nux vomica: sensitive to least draught; sneezing from itching in nose, throat, trachea; great heat, burning but if uncover become chilly • Phytolacca: feeling of a hot lump in the throat, swallowing causes pain which radiates to the ears, "as if a ball of red hot iron lodged in the throat" • Spongia tosta: dryness, burning, stinging; clears throat constantly < eating sweets • Sulphur: great burning and dryness; chronic soreness; tonsils enlarged with purplish aspect lasting for weeks and months

Subtle Support
• notes: A#, B, C, D#, E, G, G#

• chords: diminished 8th, C Major, D# Major, G# Major (Gimbel, p. 116)

Mind/Body
• Associated with restrained anger. (Dychtwald, p. 21) • The inability to speak up for one's self; swallowing anger; stifled creativity; refusal to change. The throat is an avenue of expression and channel of creativity. (Hay, 1984, p. 186) • Inflammation: fear; inflamed thinking; seeing red; anger and frustration about conditions in one's life. (Hay, 1984, p. 170-1)

• Lung ~ Fei governs the Qi; regulates the rhythm of respiration, the pulse, and all bodily processes; is the home of the Po (Corporeal Soul); it relates to strength and sustainability; includes the throat and opens at the nose. » Healthy expressions are righteousness and courage. » Weakness, dysfunction, and illness associated with excessive grief, sadness, worry, and depression. » Lung Xu (Deficiency) signs include cold shoulder and back; changing complexion; and inability to sleep (Seem, p. 28); shortness of breath; changes in urine color; rumbling in the bowels with loose bowel movements; pallor; malar flush; chills; sniffles; sneezing; light cough; and sensitivity to cold. Chronic Lung Yin Xu (Deficiency) increases susceptibility to Heat rising and acute Shi (Excess) conditions such as Phlegm, Wind, Heat and Cold. » Lung Shi (Excess) signs include panting; yawning; sneezing (Seem, p. 28); pain in the upper back, shoulder, and chest; colds with stuffed nose; sore throat; hoarseness; wheezing respiration; frequent urination with small amounts; heavy chest; reduced lung capacity; coughing; and nasal discharge.
 * Chinese psychophysiology:**

• Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging; houses the Zhi (Will); expresses ambition and focus; governs Water to regulate body fluids; provides the "Fire of Life" through its Yang functions; provides the nourishing and stabilizing qualities of Yin and Water that balance the Yang and the Fiery qualities; facilitates inspiration by grasping and pulling down the Qi of the breath; and displays the effects of sexual dissipation, overwork, aging, chronic debilitation, and extreme stress. » Healthy expressions are gentleness, groundedness, and endurance. » Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); fearfulness; apathy; chronic fatigue; discouragement; scatteredness; lack of will; negativity; impatience; afternoon sore throats; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch. As always, chronic Yin Xu (Deficiency) predisposes to Empty Heat and/or acute inflammation. » Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency). » Mental signs of Kidney channel disorders include anxiety, fear in the pit of the stomach; sadness; mental and physical fatigue; antisocial tendencies; and laziness. (Seem, p. 28)

» Mental signs of Bladder channel disorders include changeable moods, over-enthusiasm, suspicion, jealousy, lack of confidence, and mental lassitude. (Seem, p. 28)

• Stomach ~ Wei is the Sea of Nourishment and origin of all fluids; transforms and digests food so that the Spleen can separate the distilled food essences; with the Spleen, is the root of post-natal Qi; and as Earth, relates to the ability to assimilate, stabilize, and feel centered and balanced. » Healthy expressions are fairness, openness, and nurturance. » Weakness, dysfunction, and illness associated with worry, anxiety, and overthinking. » Stomach Xu (Deficiency) signs include slow digestion; vomiting after meals; painful eyebrows; emotionality; teariness; sadness; cold feet (Seem, p. 28); cold and shivering in the abdominal area; abdomen swollen and full; gastritis; loss of appetite; diarrhea; nausea; and leg weakness. Stomach Yin Xu (Deficiency) increases the susceptibility to Stomach Fire. » Stomach Shi (Excess) signs include nightmares; acne; skin eruptions; excess stomach acid (Seem, p. 28); heat in the abdominal area; overactive digestive system causing hunger and thirst; dark yellow urine; gluttony; halitosis; swollen gums; red dry lips; pains and cramps in legs.

• Lung ~ Fei is the home of the Po (Corporeal Soul); governs the Qi; facilitates the immune function by assisting the dispersal of the Wei (Protective) Qi; regulates the rhythm of respiration, the pulse, and all bodily processes; relates to strength and sustainability; moves and adjusts fluid metabolism; includes the throat; and opens at the nose. » Healthy expressions are righteousness and courage. » Weakness, dysfunction, and illness are associated with excessive grief, sadness, worry, and depression. Worry depletes the Lung Qi. » Lung Xu (Deficiency) signs include cold shoulder and back; changing complexion; and inability to sleep (Seem, p. 28); shortness of breath; changes in urine color; rumbling in the bowels with loose bowel movements; pallor; malar flush; chills; sniffles; sneezing; light cough; and sensitivity to cold. Chronic Lung Yin Xu (Deficiency) increases susceptibility to acute Shi (Excess) conditions such as Phlegm, Wind, Heat and Cold. » Lung Shi (Excess) signs include panting; yawning; sneezing (Seem, p. 28); pain in the upper back, shoulder, and chest; colds with stuffed nose; hoarseness; wheezing respiration; frequent urination with small amounts; heavy chest; reduced lung capacity; coughing; and nasal discharge.
 * Chinese psychophysiology:**

• Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; maintains smooth flow of Qi and Xue (Blood); and reflects emotional harmony and movement. » Healthy expressions are kindness, spontaneity, and ease of movement. » Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry eyes, skin, and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down. Liver Yin Xu (Deficiency) predisposes to the Shi (Excess) conditions of Liver Fire Blazing. » Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216) » Liver Shi (Excess) signs include discontent; anger; pain in lumbar region and genitals (Seem, p. 28); muscular tension; excessive sex drive; insomnia; moodiness; excitability; genital diseases; red, tearing eyes; compulsive energy; and bitter taste in the mouth. Chronically suppressed anger can implode and give rise to Fire in the Liver and Gall Bladder with symptoms of sinusitis, irritability, bitter taste, headaches, etc.

• Gall Bladder ~ Dan is the source of courage and initiative, and is responsible for decision-making as the bodily Minister of Justice; controls circulation of the nourishing and protecting energies [Ying Qi and Wei (Protective) Qi]; and opens into the eyes. Its channel purifies Yang energy in the body. » Healthy expressions are kindness, decisiveness, control, and spirit of initiative. » Gall Bladder Shi (Excess) signs include tiredness; sighing; irritability; bitter taste in the mouth in the morning; pain in all joints; edematous knees and legs (Seem, p. 29); tinnitus; lateral headache; heaviness in head and stomach; muscular spasms; and limbs slightly cold. Chronically suppressed anger can implode and give rise to Fire in the Liver and Gall Bladder. » Anger, frustration, and resentment can cause Liver Qi Stagnation which, in turn, can produce Heat which affects the Gall Bladder.

• Spleen ~ Pi governs digestion; transforms food into Qi and Xue (Blood); governs the Xue (Blood); governs the Xue (Blood); ;resolves Dampness and Phlegm; maintains upbearing; and relates to the ability to assimilate, stabilize, and feel centered and balanced. » Healthy expressions are fairness, openness, deep thinking, and reminiscence. » The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen. This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise and excess consumption of sweet and Cold foods will also deplete the Spleen.

Integrative Therapies
A sore throat can occur with or without a cold. The throat is often red and swollen. The lymph glands in the neck can be easily felt and are tender. Like a cold, a sore throat can bring about symptoms of fever, tiredness, nausea, and headache. Sore throats are often viral in nature.

Symptoms can occur as the result of poor diet, stress, or lack of rest. Irregular or infrequent bowel movements can aggravate the problem by a buildup of waste materials that should be expelled from the body. A sore throat often requires that a culture be taken and tested for the possibility of strep throat. General measures for all sore throats are: • Rest • Plenty of fluids • Reduced sugar intake (such as candies and pastries) • Reduced intake of milk and dairy products

THE FOLLOWING SUPPLEMENTS ARE USED FOR SORE THROATS AND CAN BE TAKEN UNTIL SYMPTOMS IMPROVE: • Beta-carotene – 100,000 Units twice daily. Caution: Pregnant women (or women who may become pregnant) should not take more than 15,000 Units of Beta-carotene a day. • Vitamin C – For adults, 1,000 milligrams every 2 hours. For children, 250 milligrams every 2 hours. Cut back the dose if diarrhea occurs. • Bioflavonoids – These can be used to improve the action of Vitamin C. For children – 100 milligrams per day. For adults – 1,000 milligrams per day. • Zinc – 15 milligrams every 2 hours while symptoms are present for adults. For children – 2.5 milligrams times age per day. Zinc lozenges can also be used for their soothing effect. Zinc gluconate and zinc gluconate-glycine are the forms which have demonstrated the greatest effectiveness in studies. • Thymus – Take 1 tablet every 2 hours for adults, once a day for children. • Garlic – Take 2 capsules with each meal.

HERBS FOR THE SORE THROAT: • Gargle with salt water or diluted 3 percent hydrogen peroxide every 3 hours. You can also make a tea with 1 teaspoon of Golden Seal or 1 tablespoon of Calendula per cup of water. Simmer 1 minute. Steep 15 minutes. Gargle with it every 2 to 3 hours. » Take a mixture of the following herbs: 1 part Golden Seal 1 part Myrrh 2 parts Echinacea Also add 1 part Phytolacca or Poke Root if there are swollen tonsils or lymph glands.

If used as a tincture, which is a liquid herbal extract, take 1 teaspoon every 2 hours. Or, make a tea of the dried herbs in the same proportions. To do this, simmer 1 tablespoon of the mixture per cup of water for 5 minutes, steep for 15 minutes, and cool. Take 1 cup every 2 hours.

THE FOLLOWING PHYSICAL THERAPY MEASURES CAN ALSO BE USED: • Apply a steaming hot towel to the neck and throat for 5 minutes, followed by a cold wash cloth for 1 minute. Repeat this 2 more times, ending with cold. Do this twice a day. • You can also use a mustard plaster. Make a thick paste of dried mustard plus a little water. Smear onto a wash cloth and place over the skin of the neck for about 15 minutes. Remove sooner if there is a burning sensation or the skin turns red. The skin should turn pink but should not turn red or blister. Wash well afterwards. Repeat twice a day.

HOMEOPATHY From the following homeopathic medicines choose the one that best matches the symptoms. Dissolve 3 pellets under the tongue, 3 times a day. • Belladonna 12C: For a bright red sore throat with fever. • Mercurius sol. 12C: If the person perspires, drools, or salivates or has a salty or metallic taste in the mouth. The throat is painful, especially at night. • Phytolacca 12C: For a dark red colored throat and pain that shoots to the ears when swallowing. • Hepar sulph 12C: For whitish yellow spots on the throat and tonsils. The pain may feel like a splinter in the throat. • Lachesis 12C: When the left side of the throat is painful and swollen and hurts when swallowing.

Note: A wide range of homeopathic medicines can be helpful for individuals experiencing particularly severe or recurrent sore throats. Consultation with and examination by a qualified health care professional trained in homeopathic prescribing will usually be the best way to select the correct medicine.