Laryngitis

Western Diagnosis Inflammation of the larynx

Etiology -Viral URI most common -Bronchitis, influenza, pneumonia, pertussis, measles, diphtheria -Excess use of voice -Cigarette smoke or inhalation of irritants -Allergic Rx

Signs & Symptoms -Unnatural change of voice -Hoarseness -Aphonia -Tickling, rawness, urge to clear throat -Fever, malaise, pain, dyspnea if severe

Diagnosis Indirect laryngoscopy

Treatment

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Definition:
laryngitis: Inflammation of the larynx; hoarseness: roughness in the voice, often with decreased vocal power.

Etiology:
Most laryngitis is caused by microorganisms, viral and bacterial (especially streptococcus). It can also occur concurrently with other URIs and pulmonary infections. Other causes include voice overuse, allergic reactions, and inhaling irritating substances (e.g. smoking). Hoarseness is the most common symptom. In persistent hoarseness rule out neoplasm.

Nutrition:
eating principles: • eat as little as possible • increase Vitamin C foods, Vitamin A foods • avoid heavy protein foods, fats, meats, vinegars, shellfish, sugars • increase fluids • short fast (see Fasting in materia medica)

therapeutic foods: • steamed carrots, olives, daikon, celery, seaweed, licorice, cilantro (Ni, p. 157) • Horseradish or turnip syrup, propolis, raw cabbage juice.

fresh juices: • carrot (Walker, p. 144) • carrot and spinach (Walker, p. 144) • carrot, cucumber, and beet (Walker, p. 144) • orange (Yin-fang and Cheng-jun, p. 83)

specific remedies • tea from carrots, olives, drink three times daily for 1 week (Ni, p. 157) • tea from daikon radish and green apples, twice daily (Ni, p. 157) • tea from cilantro, 1 tbsp. green tea and salt, steep 5 minutes (Ni, p. 157) • honey in warm water for dry, sore throat (Shefi) • 8 oz. dried figs, 2 oz. molasses. Boil in 2 pt water until reduced by half. Eat and drink 5 oz at a time, per day- twice daily • 4 oz. peanuts minus their brown skins, a little salt. Boil in 1 1/4 pt water until reduced by half. Eat and drink. (Butt and Bloomfield, p. 124) • 5 oz. dried figs, 2 oz. raw brown sugar. Boil in 2 pt. water until reduced to half. Divide into 2 halves and eat and drink both in 1 day. (Butt and Bloomfield, p. 161) • 3 pears, 2 oz. of honey: blend the pears with the honey in 1 pt. water. Boil until reduced by half. Divide into 2 halves and eat and drink both in 1 day. (Butt and Bloomfield, p. 161)

avoid: • alcohol, stimulating foods, spicy, hot foods, fatty foods, fried foods

Botanicals
• Aconitum napellus (toxic): laryngitis: first stage, with fever, hot skin, extreme restlessness, dyspnea (Harper-Shove, p. 57) • Althea officinalis: demulcent • Arnica montana (toxic): hoarseness (NCNM Botanicals) • Capsicum frutescens: infusion for colds, catarrh, hoarseness (Felter and Lloyd, p. 435) • Collinsonia canadensis: chronic laryngitis, "minister's sore throat," hoarseness, sense of constriction (Felter and Lloyd, p. 581; Harper-Shove, p. 57) • Eryngium yuccaefolium: chronic pharyngitis associated with laryngeal irritation (Felter and Lloyd, p. 730) • Glycyrrhiza glabra: laryngitis (NCNM Botanicals) • Phytolacca decandra (toxic): chronic mucous affections (Felter and Lloyd, p. 1473) • Pilocarpus jaborandi (toxic): cough of, especially for stridulous laryngitis (Ellingwood, p. 464) • Populus gileadensis: laryngitis with aphonia (British Herbal Pharmacopoeia, p. 104) • Salvia officinalis: as a gargle • Serenoa serrulata: cough associated with laryngitis, aphonia (Ellingwood, p. 459) • Stillingia sylvatica (toxic): laryngeal irritation (Felter and Lloyd, p. 1837) • Oleum Terebinthinae: chronic affections of the mucous membranes of the air passages (Felter and Lloyd, p. 1921) • Tussilago farfara: (British Herbal Pharmacopoeia, p. 221)

Chinese Formulae
• Hou Yan Wan (patent); Ilex 15 (patent); Liu Shen Wan (patent): Fire Toxin (Hou Yan: Zhu, p. 182; Ilex: Dharmananda, 1990, p. 70; Liu Shen Wan: Fratkin, p. 81) • Gasping F.; Qing Yin Wan (patent); San She Dan Chuan Bei Extract (patent): Lung Yin Xu (Deficiency), including overuse of the voice. (Gasping F.: Hsu, 1980, p. 552; Qing Yin: Zhu, p. 165; San She Dan: Fratkin, p. 73) • Lily 14 (patent); Yang Yin Qing Fei Tang Jiang (patent): Lung Yin Xu (Deficiency) (Lily 14: Dharmananda, 1990, p. 20; Yang Yin: Zhu, p. 84) • Rehmannia and Lonicera C.: Xue (Blood) Heat (Hsu, 1980, p. 188; Dharmananda, 1986, p. 369) • Arctium C.; Forsythia 18 (patent): Wind-Heat (Arctium: Hsu, 1980, p. 169; Forsythia: Dharmananda, 1990, p. 67)

Acupuncture
after assessing the person and palpating, consider these patterns: perverse Wind or direct attack of toxic or endemic origin; » acute: Wind-Cold; Wind-Heat; Lung Heat; » chronic: Lung and/or Kidney Yin Xu (Deficiency)

» therapeutic note: in Traditional Chinese Medicine the voice is produced by the Lung, rooted in the Kidney

» illustrative combinations: • Lu-9, Lu-7, Lu-10, Kd-6, Kd-7, Kd-3, CV-22 and UB-13 for hoarseness due to Lung and Kidney Yin Xu (Deficiency) with Heat in the Lung (Jirui and Wang, p. 212) • LI-10, LI-7, LI-11, TW-3, St-40, Ht-7, LI-4 and GB-20 for laryngitis (Lee and Cheung, p. 355) • SI-17, St-12, UB-11, UB-17, Lu-2, Lu-5, LI-2, St-45, Kd-1 and Kd-2 for laryngitis with cold and fever (Lee and Cheung, p. 355) • UB-10, CV-23, CV-22, SI-5, LI-4, SI-3, LI-3, Lu-11, TW-1, St-36, St-40, Sp-6 and Lv-2 for laryngitis (Lee and Cheung, p. 355) • LI-4, Kd-1, CV-22 and St-40 for laryngitis (Lee and Cheung, p. 355) • Kd-7 and Kd-3; CV-23, CV-22 and CV-18; GB-20 and UB-10; UB-11, UB-12 and UB-13 for laryngitis (Mann, p. 91) • LI-4 and GV-14: allay inflammation and relax the throat (Finkelstein, p. 7) • CV-22, LI-4 and GV-15: treat vocal cord problems (Finkelstein, p. 93) • CV-22 and Kd-6: loosen the throat (Finkelstein, p. 93) • GV-15 and CV-23: strengthen speaking ability (Finkelstein, p. 80) • CV-22, LI-18 and LI-4 for hoarse voice and/or congested throat (Shanghai, p. 165; p. 557); • PC-5, LI-18 and LI-4 for hoarse voice (Shanghai, p. 556) • LI-18 and Kd-3: treat the throat (Finkelstein, p. 11) • LI-18, CV-22 and Kd-3 for sounds in the throat (Shanghai, p. 165) • Lu-9 and CV-17: tonify the Zhong (Ancestral) Qi of the chest, esp. the Heart and Lung, in Qi Xu (Deficient) individuals with cold hands and weak voice (Maciocia, p. 373) • Lu-9 and Lu-10 for dry throat (Shanghai, p. 244) • CV-22 and CV-23: regulate Lung; diffuse Lung Qi

Homeopathy
acute: • Aconitum napellus: burning, dry, constricted, stinging; agitation, anxiety; in dry cold weather; hoarse, dry, croupy cough < 12 a.m. and after • Ammonium causticum: acute or subacute; sensation of rawness and burning very intense; persistent cough, almost no voice left; tendency to ulceration • Arum triphyllum: frequent, recurrent; burning and dry sensation in pharynx; voice breaks down when attempting to speak or sing high pitch; voice uncertain, uncontrollable. • Belladonna: sore, painful as if foreign body were in it; may be painless, hoarseness, loss of voice; high piping voice, moaning at every breath < touch, draught • Causticum: aphonia; sensation of painful wound in larynx, burning, very sensitive; voice low pitch, difficulty speaking loudly • Ferrum phosphoricum: first stage of inflammation; dry cough due to laryngotracheal tickling < night and 4-6 a.m., touch, right side, > cold application • Hepar sulphur: loss of voice and cough after midnight; after exposure to dry, cold air; dry, hoarse cough < dry cold air, > dampness • Phosphorus: very painful, very sensitive to touch; clergyman's sore throat; violent tickling in throat when speaking; aphonia < evenings; can't speak because of pain < cold air, talking, evening and drinking cold • Spongia tosta: great dryness, burning, constricted, sensitive to touch; feeling of a plug in larynx; pain talking and swallowing; cough dry, burning with sensation of tearing in throat < any nervous excitation, talking, lying with head low > cold drink, eating a lot

chronic: • Argentum metallicum: chronic hoarseness; sensation of scraping, rawness < using voice; cough from laughing • Argentum nitricum: sensation of a splinter in throat on swallowing; chronic hoarseness; high notes cause cough; swelling around vocal cords with tendency to ulceration; hoarseness < a.m., warm room, smoke, speaking or singing, > fresh air, cold • Calcarea phosphorica: difficult breathing < dampness, getting feet wet > lying • Calcarea sulphurica: last stage of ulcerated sore throat with yellow discharge; chronic hoarseness, < dampness, draughts, warm room > open air, dry warm air • Causticum: aphonia, larynx sore, hoarseness > cold air, cold water, < external warmth, dampness; own voice roars in ears and distresses; difficulty of voice of singers and public speakers • Chlorum: stridulous laryngitis, sudden spasm of the glottis; constriction with suffocation; loss of voice from damp air; sudden dyspnea from spasm of vocal cords • Kali muriaticum: whitish mucus hard to expel; dry cough < cold air, dampness > dry heat • Kali phosphoricum: paralysis of vocal cords; hoarseness < cold, eating, early morning > warmth • Manganum: laryngitis and cough in damp weather, often followed by bronchitis or vice versa; hoarseness < am, open air, > smoking • Silicea: chronic cough and sore throat; suppurative stage, heat • Stannum: throat dry and stings; sensation of erosion in larynx; hoarseness, < cold, talking, singing; causing weakness in chest, temporarily > after cough and spit; very weak person

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

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

Mind/Body
• The inability to speak up for one's self; swallowing anger; stifled creativity; refusal to change. The throat is an avenue of expression and a channel of creativity. (Hay, 1984, p. 186) • So mad you can't speak; fear of speaking up; resentment of authority. (Hay, 1984, p. 172) • 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; extends through the skin, controls the pores, and manifests through the body hair. » 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, Cold, and Heat. » 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:**

• 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; facilitates inspiration by grasping and pulling down the Qi of the breath; and displays the effects of sexual dissipation, overwork, chronic debilitation, or 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; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch. As always, Yin Xu (Deficiency) predisposes to Empty Fire 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).