Dysphonia & Hoarseness

WESTERN MEDICINE: Dysphonia and hoarseness are changes in the quality of the voice due to interference with vibration, approximation, or tension of the vocal cords. 

SYMPTOMS AND SIGNS: Dysphonia and hoarseness are two symptoms indicating that one has lost their voice, or speaking in a deep or harsh unnatural voice. It is often seen at acute and chronic laryngitis, nodule of the vocal cords, neoplasms, and hysterical dysphonia. 

ETIOLOGY AND PATHOLOGY: The causative factors and pathological changes of dysphonia and hoarseness are as follows: 

(1). Exogenous wind cold or wind heat attack lung, and cause lung Qi stagnation. Lung is supposed to control the movement of the epiglottis and vocal cords. So the stagnated lung Qi will lead to the abnormal epiglottis and vocal cords movement which cause difficulty speaking or changes of voice with hoarseness. 

(2). Chronic diseases or elderly due to the lung and kidney Qi and Yin deficiency. 

(3).Unstable and prolonged emotions cause the Qi stagnation, so as to affect the normal function of lung Qi. 

(4). Excessive use of voice, or too strong use of voice. 

DIFFERENTIATIONS: 

1. Dysphonia and Hoarseness due to Wind Cold:

Indications: Sudden loss of voice, or hoarse voice, accompanied with itching throat, cough, fullness of chest, nasal congestion, fever and aversion to cold, headache, thin and white coating, floating pulse. 

Treatment & Formulas: Dispel wind cold and open the lung Qi.

Products:

    • Xing Su San (Apricot and Perilla Combination, Item No. 2104): It clears and opens the stagnated lung Qi and dispel wind cold factors. It is also applied for the common cold, bronchitis, bronchiectasis, and pulmonary emphysema.
    • Shi Shen Tang (Ma-huang and Cimicifuga Combination, Item No. 2014): This is a very good formula for wind cold symptoms, so it is often applied for common cold due to the wind cold factors. 

2. Dysphonia and Hoarseness due to Phlegm Heat:

Indications: Hoarse voice, cough with sticky yellow sputum, dry or pain throat, dry and bitter mouth, fever, yellow greasy tongue coating, slippery and rapid pulse. 

Treatment & Formulas: Clear the lung heat and resolve the phlegm so as to regulate the lung Qi. 

Products

    • Qin Yan Li Ge Tang (Arctium Combination, Item No. 2185): A strong formula for lung heat symptoms plus constipation due to strong interior heat. 
    • Tie Di Wan (Gasping Formula, Item No. 2285): This is a typical formula to treat hoarseness and sore throat due to the lung heat and lung Qi  stagnation, or due to excessive talking and singing. 

3. Dysphonia and Hoarseness due to Qi Stagnation: 

Indications: Sudden loss of voice, usually ha after any strong emotions, accompanied restlessness, easy to get anger, chest fullness blocking sensation of throat, thin tongue wiry and small, or wiry and uneven pulse. 

Treatment & Formulas: Regulates the liver Qi and harmonizes the stagnated lung Qi. 

Products:

    • Xiao Chai Hu Tang (Minor Bupleurum Combination  Item No. 2029): This is a formula that regulates the stagnated liver Qi
    • Xiao Yao San (Tang - kuei and Bupleurum Formula, Item No: 2195): It regulates the liver Qi harmonizes the spleen and stomach.
    • Jia Wei Xiao Yao San (Bupleurum and Paenia Formula, Item No. 2068): Same function as Xiao Yao San, use for liver stagnation plus the symptoms of deficient fire.
    • Gan Mai Da Zao Tang (Licorice and Jujube Combination, Item No. 2294): This is for dysphonia and hoarseness due hysterical reasons.
    • The above formula can combine with Tie Di Wan (Item No. 2285) so as to help the lung Qi.

4. Dysphonia and Hoarseness due to the Dryness of bung: 

Indications: Deep and harsh quality of voice, sore, pain and dry throat, dry mouth, or accompanied with cough, scanty and sticky sputum, red and dry tongue, thin coating, slightly rapid pulse. 

Treatment & Formulas: Tonify and moisten lung, so to open the lung Qi

Products:

    • Qing Zao Jiu Fei Tang (Eriobotrya and Ophiopogon Combination, Item No. 2186): This is a very effective formula to moisten lung dryness. It is especially popular during the autumn time. 
    • Sha Sheng Mai Dong Tang (Adenophora and Ophiopogon Combination, Item No. 2107): It is a very good Yin tonic formula for the lung. 
    • Mai Men Dong Tang (Ophiopogon Combination, Item No. 2196): It also treats hoarseness and dysphonia by its Yin tonic function. 

5. Dysphonia and Hoarseness due to the Lung and Kidney Yin Deficiency:

Indications: The deep and harsh voice gradually becomes serious, or to dysphonia, dry cough with scanty sputum, or tidal fever (fever at afternoon or evening), night sweating, tinnitus, sore and weak sensation at lumbar region, thin body type. Red tongue, scanty tongue coating, thready and rapid pulse. 

Treatment & formulas: Tonify the lung and kidney, clear the deficient fire so to moisten and open the lung Qi. 

Products:

    • Bai He Gu Jin Tang (Lily Combination, Item No. 2092): A Yin tonic for both the lung and kidney.
    • Ji Ju Di Huang Wan (Lycium, Chrysanthemum and Rehmannia Six Formula, Item No. 2290): This is a Yin tonic for kidney. 
    • Zhi Po Ba Wei Wan (Anemarrhena, Phellodendron, and Rehmannia Formula, Item No. 2123): This treats dysphonia and hoarseness due to kidney Yin deficiency plus the symptoms of deficient fire, such as tidal fever, night sweating, and etc.

COMMENTS: 

1. Dysphonia and hoarseness due to wind cold or phlegm heat are easy to cure. If they last a long period of time, then moisture or Yin of lung and kidney will be consumed and affected, making recovery of the voice more difficult.

2. The patients of dysphonia and hoarseness, they needs to avoid the spicy, hot, or fatty food; alcohol drink and smoking are forbidden; warm clothes are advised so to avoid to catch cold.

3. For the patients of dysphonia and hoarseness due to emotional reasons, a peaceful and quiet environment need to be created for them, and talking therapy is highly advised.

4. For the patients of dysphonia and hoarseness due to vocal cords' problem, loud talking, laughing and singing are restricted.


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