Pharyngeal swelling refers to the symptom of redness and swelling in the pharynx. Historical medical literature has referred to it with terms such as "pharyngitis," "嗌腫," "throat wind," "tonsillitis," and "throat abscess."

White putrefaction in the throat can also cause pharyngeal swelling; see the separate entry for more details.

bubble_chart Pattern Analysis

1. Wind-heat Invading the Lung︰Sore and swollen throat, dry and burning sensation accompanied by fever, sweating, headache, nasal congestion with runny nose, cough, red tongue with thin white or slightly yellow coating, and floating rapid pulse. This is caused by wind-heat pathogens invading the lung-defense system, leading to impaired lung qi circulation and meridian stagnation. Symptoms include fever, nasal congestion with clear discharge, swollen throat, cough, headache, floating pulse, and thin white tongue coating, indicating an exterior pattern. Since the condition involves wind-heat pathogens, the fever is relatively high without aversion to cold, sweating is present, and the throat pain, burning sensation, and swelling are more severe, with redness and swelling of the tonsils and uvula, as well as a rapid pulse. Treatment should focus on dispersing wind and clearing heat to reduce swelling. The recommended formula is Lonicera and Forsythia Powder with the addition of Stiff Silkworm and Achyranthes Root.
2. Lung-stomach Heat Exuberance︰The throat is red, swollen, burning, and painful, with a sensation of obstruction, and there is pain in the subcutaneous node, accompanied by high fever, thirst with a desire to drink, cough with yellow phlegm, fetid mouth odor, a red tongue with yellow coating, and a surging, rapid pulse. This is an interior heat excess pattern, often caused by excessive consumption of spicy and fried foods, leading to accumulated heat in the lung and stomach that ascends along the meridians to disturb the throat, resulting in qi and blood stagnation. Hence, symptoms such as high fever, thirst, cough with yellow phlegm, fetid mouth odor, and a surging pulse are observed. Treatment should focus on clearing heat, benefiting the pharynx, and reducing swelling, using a modified Jin Deng Root of Nose Decoction.
3. Heat Toxin Stagnation and Obstruction︰Swelling and severe pain in the throat, difficulty speaking and swallowing, pain in the subcutaneous nodes under the jaw; phlegm rattling and rapid breathing, lockjaw—if the swelling is hard and diffuse, there is no pus; if the swelling is raised with a tight root and a soft top, there is pus. Accompanied by fever, thirst, headache, rapid pulse, yellow tongue coating, and red tongue. Caused by accumulated heat in the spleen and stomach transforming into fire, which disturbs the throat, steaming and scorching the membranes, leading to congestion and decay of flesh and blood. Symptoms include severe swelling, obstruction, and pain in the throat, difficulty swallowing and breathing, phlegm rattling and rapid breathing, and in severe cases, the flesh and membranes are damaged by heat toxin, leading to pus formation. If the swelling occurs in the isthmus of fauces, tonsils, or soft palate, the redness and swelling are prominent, and symptoms are relatively mild. If it occurs under the jaw, the tonsils are not red or swollen, but the swelling in the jaw area is obvious. If it occurs on the posterior laryngeal wall, the symptoms are most severe, easily obstructing the pharyngeal isthmus and causing difficulty breathing, commonly seen in children. Treatment should focus on clearing heat and removing toxin to reduce swelling. Depending on whether the swelling is with or without pus, select Five-Ingredient Toxin-Eliminating Decoction, Throat-Clearing and Diaphragm-Disinhibiting Decoction, or Immortal Formula Life-Saving Decoction with modifications.
4. Lung-kidney Yin Deficiency︰Swelling of the tonsils in the throat, with bean-curd-like discharge upon pressure, slight redness and pain, and a sensation of throat obstruction; dry cough with little or sticky phlegm; accompanied by thirst, vexing heat in the chest, palms, and soles, afternoon facial flushing, shortness of breath and reluctance to speak, mental fatigue and lack of strength, a red tongue with scant coating, and a thin, rapid pulse. It is caused by constitutional yin deficiency and deficiency fire flaming upward to the throat, known as "deficiency-fire tonsillitis." The main manifestations include tonsil swelling resembling silkworm moths, persistent and non-resolving, with bean-curd-like discharge upon pressure. Symptoms come and go, recurring repeatedly. As it belongs to deficiency-heat, the redness, swelling, heat, and pain are mild, while signs such as a red tongue with scant coating, thin and rapid pulse, dry mouth and thirst, afternoon malar flushing, and vexing heat in the chest, palms, and soles are observed. It can be differentiated from the aforementioned excess patterns. In cases biased toward lung yin deficiency, symptoms include dry cough with little or sticky phlegm, shortness of breath, and reluctance to speak. Treatment should focus on enriching yin and clearing the lung, using the formula Sweet Dew Decoction. In cases biased toward kidney yin deficiency, symptoms include soreness in the lower back and weak knees, deficiency-induced vexation and insomnia, vertigo, and tinnitus. Treatment should focus on nourishing the kidney and reducing fire, using the formula Anemarrhena, Phellodendron, and Rehmannia Decoction.

bubble_chart Documentation

1. Jingyue Quanshu．Throat: "Repelling yang pharyngitis: It is caused by fire not returning to its origin, then the rootless fire lodges in the throat, its symptoms are upper heat and lower cold, completely not fire pattern. Anyone examining this should diagnose that the six pulse conditions are faint, with no sign of smoothness or largeness, and the lower body has absolutely no fire pattern, the abdomen does not like cold, these are its signs. This condition must be caused by damage to essence due to lust or diarrhea damaging the kidneys, or originally having no real fire but continuously taking cold and cool substances that damage yang qi, all can have this condition. It is best to quickly use Zhenyin Decoction, followed by Eight-Ingredient Rehmannia Pill, or using honey with Aconite Lateral Root to hold in the throat is also excellent, if cold and cool substances are used again, it will certainly lead to no cure."