Plum+Pit+Qi+(Mei+He+Qi)

Refers to a subjective feeling of something stuck in the throat which can neither be swallowed down nor spit up. In the Chinese literature the something stuck in the throat is described as feeling similar to a piece of meat. This relatively commonly seen condition corresponds to both physiological and psychological conditions in terms of Western nosology.
 * Plum Pit Qi (Mei He Qi) **

Relevant Western Diseases: Hysteria, anxiety, depression, schizophrenia, psychoneurosis and possibly western medical conditions

Differential Diagnosis: Medical Disorders: A. Degenerative neurologic disorders, including multiple sclerosis (MS) and myasthenia gravis B. Seizure Disorders C. Cerebrovascular Accident (CVA) D. Myocardial Infarction Effects of Substances: A. Alcohol or illicit substance intoxication or withdrawal B. Side effects of nonprescription or prescription medications Psychiatric Disorders: A. Conversion Disorder B. Somatoform Disorder C. Somatic Delusion in Schizophrenia D. Hypochndriasis E. Disassociative Disorders F. Malingering G. Factitious Disorders
 * 1) Psychiatric Disorders

TCM Etiology & Pathogenesis: “The feeling of constriction or something stuck in the throat is believed to be due to phlegm blocking the orifice of the throat. This phlegm may be engendered by spleen vacuity or it may be brewed and transformed by some sort of evil heat. However, no matter where and how it is formed, it is rafted up to lodge up in the throat by either upwardly counterflowing Qi due to liver depression or some species of evil heat.” 1

“Emotional disorder is the primary etiological factor, such as prolonged anger, depression and anxiety which causes Qi and internal Zang Fu disharmony leading to Mei He Qi. Emotional disharmony causes confusion of the Qi mechanism and injures the internal organs generating the phlegm; the Qi and phlegm stagnate together and get stuck in the throat to cause this disease. Deviated Shen types or phlegm damp types can accelerate the pathology or can easily catch this disease”2

Prognosis: This disease will be resolved after roper treatment, the treatment may be short or long depending on the pathological situation. In general, Qi level pathology is much easier to resolve; sticky phlegm and blood level pathologies will last longer.

Diagnosis: A. Feeling of something stuck in the throat and difficulty cleaning it out B. History of depression, anxiety, anger, and moodiness C.<span style="font-family: "Times New Roman"; font-size-adjust: none; font-size: 7pt; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> Phlegm damp constitution D.<span style="font-family: "Times New Roman"; font-size-adjust: none; font-size: 7pt; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> No clear evidence in western medicine Should have A, then refer others

TCM Pattern Differentiation: Liver Qi and Phlegm Stagnation in the Throat, Shen Irritable 2 Feeling of something stuck in the throat and difficulty clearing it out by coughing or swallowing, depression, anxiety, easily angered and moody, chest pressure or abdominal distention [ Ban Xia, Hou Po, Fu Ling, Zi Su Ye, Sheng Jiang] More phlegm: + Xing Ren, Jie Gen Distention by Liver Qi : Chai Hu, Yu Jin Bloated Stomach: + Zhi Sih, Da Fu Pi, Su Gen Chong Qi rebellious: + Xiang Fu, Dan Shen Blood Stagnation: + San Leng, E Ju Heat: + Huang Qin, Zhu Ru
 * Tongue:** pink tongue, white coat
 * Pulse:** wiry
 * Acupuncture Treatment:** CV-17, CV-22, CV-23, LR-2, LR-3, PC-6, ST-36, ST-40, SP-9
 * Herbal Treatment:** Ban Xia Hou Po Tang Modification2
 * Modifications:**

Phlegm Qi Depression and Binding 1 Feeling of something caught in the back of the throat which can neither be spit up or swallowed down, chest and abdominal fullness and oppression, profuse phlegm, irritability, possible PMS, menstrual irregularity, or fibrocystic lumps in the breast in females. [ Ban Xia (10-12g.), Hou Po (10g.), Fu Ling (12g.), Chen Pi (6g.), Su Geng (10g.), Xi Ku Cao (15g.), Bei Mu (6g.), Chang Pu (6g.), Chai Hu (3-6g.), Sheng Jiang (6g.)] Severe Qi stagnation: + Yu Jin, Qing Pi Simultaneous abdominal distention: + Sha Ren, Mu Xiang Serious inhibition of throat: + Jie Geng, Xuan Shen
 * Tongue:** slimy white coat
 * Pulse:** slippery, bowstring
 * Treatment Principle:** Move the Qi and downbear counterflow, transform phlegm and disinhibit the throat
 * Acupuncture Treatment:** LR-3, PC-6, ST-40, ST-36, CV-17, CV-12, CV-22. Draining technique
 * Herbal Treatment:** Ban Xiao Hou Po Tang Jia Wei1
 * Modifications:**

Phlegm Heat Harassing Above 1 Feeling of something caught in the back of the throat which can neither be spit up or swallowed down, chest and abdominal fullness and oppression, profuse phlegm, irritability, possible PMS, menstrual irregularity, or fibrocystic lumps in the breast in females. [Huang Lian (3-6g.), Huang Qin (10g.), Shi Chang Pu (6g.), Xia Ku Cao (15g.), Xuan Shen (15g.), Ban Xia (10g.), Zhu Ru (6-10g.), Zhi Shi (6g.), Chen Pi (6-10g.), Fu Shen (12g.), Gan Cao (3-6g.), Da Zao (3-5 pieces)]
 * Tongue:** red tongue, slimy yellow coat
 * Pulse:** slippery, bowstring, rapid
 * Treatment Principle:** Clear Heat and transform phlegm, resolve depression and disinhibit the throat
 * Acupuncture Treatment:** LR-2, ST-41, ST-40, CV-22, CV-17, CV-12. Draining technique
 * Herbal Treatment:** Huang Lian Wen Dan Tang Jia Wei1

Yin Vacuity-Liver Depression 1 Feeling of something caught in the back of the throat which can neither be coughed up or swallowed down, dry mouth and throat, 5-palm heat, lingering rib-side pain, possible menstrual pain or PMS, possible scanty, delayed, or blocked menstruation [Chuan Lian Zi (10g.), Sha Shen (12g.), Mai Dong (12g.), Sheng Di (12g.), Gou Qi Zi (10g.), Dang Gui (10g.), Xuan Shen (15g.), Yu Jin (10g.), Jie Geng (10g.), Bai Shao (10g.)]
 * Tongue:** red tongue, scanty coat
 * Pulse:** slippery, bowstring, rapid
 * Treatment Principle:** Enrich Yin and downbear fire, emolliate the liver and scatter nodulation
 * Acupuncture Treatment:** Tonify: LU-7, KI-6, SP-6; Even technique: LR-3, LR-14, CV-22, ST-40
 * Herbal Treatment:** Yi Guan Jian Jia Jian1

Lung-Kidney Yin Vacuity, Phlegm Fire Flaring Upward 1 Feeling of something caught in the back of the throat which can neither be spit up or swallowed down, dry mouth and throat, thirst but no great desire to drink, 5-palm heat, afternoon tidal heat, possible night sweats, possible palpitations, vexation and agitation, insomnia, tinnitus, dizziness [Chuan Lian Zi (6-10g.), Sha Shen (12g.), Mai Dong (12g.), Sheng Di (12g.), Gou Qi Zi (12g.), Dang Gui (10g.), Xuan Shen (10g.), Bei Mu (10g.), Xia Ku Cao (15g.), Mu Li (12g.), Zhi Mu (10g.), Huang Qin (10-12g.), Bai Shao (10g.)] Insomnia and pronounced disquietude of the heart spirit: + Suan Zao Ren, Bai Zi Ren
 * Tongue:** red tongue, dry and/or scanty, possibly yellow coat
 * Pulse:** bowstring, fine, rapid
 * Treatment Principle:** Nourish the lungs and enrich the kidneys, clear heat and disinhibit the throat
 * Acupuncture Treatment:** LU-7, KI-6, SP-6, ST-40, St-44, CV-22. Even technique
 * Herbal Treatment:** Yi Guan Jian Jia Wei1
 * Modifications:**

Blood Stasis Obstructing the Network Vessels 1 Feeling of something caught in the back of the throat which can neither be spit up or swallowed down, chest, rib-side, or abdominal fixed or piercing pain, possible menstrual irregularity and/or dysmenorrheal in females, enduring disease worse symptoms get worse in the afternoon or evening, spider nevi or varicosities, dark dusky complexion [Tao Ren (10g.), Hong Hua (10g.), Dang Gui (10g.), Chuan Xiong (10g.), Chi Shao (10g.), Chai Hu (10g.), Zhi Shi (6g.), Jie Geng (6g.), Chuan Niu Xi (10g.), Yu Jin (10g.), Xia Ku Cao (15g.), Dan Shen (10g.)] Dry & painful throat: + Xuan Shen, Tian Hua Fen
 * Tongue:** dark purplish tongue or possible static spots and macules
 * Pulse:** bowstring, choppy, possibly bound
 * Treatment Principle:** Quicken the Blood and transform stasis, free the flow of the network vessels and disinhibit the throat
 * Acupuncture Treatment:** LU-7, KI-6, SP-6, ST-40, St-44, CV-22. Even technique
 * Herbal Treatment:** Xue Fu Zhu Yu Tang Jia Jian1
 * Modifications:**