Traditional Chinese Medicine (TCM) is a complete system of medicine. It has a
history that has been evolving for over 4,000 years and its approach to health
is much more holistic than Western medicine, where health problems are dealt
with in isolation.

There are many organs that are responsible for voice health. The lungs, liver,
spleen and kidney are key in this function. Each organ has a physical,
spiritual, emotional role in maintaining good health and a deep understanding
of their interrelationship is important to affect a good treatment.

Below you will find a list of ailments that affect the voice. This will help
you to identify your ailment and seek appropriate treatment.

Good hunting!

Hoarse Voice (sheng yin si ya) or Loss of Voice (shi yin)
A hoarse voice can be identified as having a relatively low, harsh or husky,
often muffled or laboriously forced quality that has little or no resonance.

Causes of hoarseness
Hoarseness can be broken down into three categories.

1. Excess: Quick onset with acute, severe and pronounced symptoms. Quick to
resolve.
2. Deficiency: Slow onset with chronic (ongoing) less pronounced symptoms.
Slow to resolve.
3. Stagnation: Quick or slow onset caused by trauma, overuse, singing damage,
nodule growth on larynx or emotions. Can have post-viral complications.

1. Excess
This is where an external evil (bacteria or a virus) enters the lungs and
lodges in the throat and leads to the inhibition of lung chi (energy of the lung),
which then impedes the voice.

A. Wind cold (Common cold 1)
Wind cold invades the lungs and lodges in the throat, obstructing the free
movement of the lung chi and preventing full expression of the voice.

Symptoms
Symptoms are sore throat or loss of voice; itchy throat; hoarse voice; fever;
aversion to cold; headache; body aches; nasal congestion; runny nose with
clear mucus; no sweating; thirst and a cough. The tongue has a white fur. The
pulse is floating and tight.

Treatment
Disperse wind cold with warming and acrid herbs. Promote circulation of lung
chi, promote sweat and restore the voice. This is supplemented with
acupuncture.

B. Wind heat (Common cold 2)
Wind heat (or wind cold which turns hot), penetrates and lodges in the throat
and larynx causing redness, swelling, inflammation and makes speaking
difficult.

Symptoms
Hoarse voice which starts with discomfort in the throat; a dry, painful, itchy
throat followed by a red, sore, swollen throat. Other symptoms may occur such
as a cough with yellow sputum, fever, sweat, headaches, fatigue and loss of
appetite. The tongue has slightly red edges and yellow fur. The pulse is
rapid and floating.

Treatment
Using cooling and clearing herbs will disperse wind heat, cool and moisten the
lungs, and restore the voice. This is supplemented with acupuncture.

Notes on above
Wind cold can quite quickly turn to wind heat as it has a tendency to
stagnate. Mucous will turn yellow and throat will become red and swollen.
A responsible practitioner will be fully aware of these possible problems and
will want you to keep in touch over this acute phase.
For acute throat problems caused by either wind cold or heat, I find both
acupuncture and Chinese herbs very effective and, if administered early
enough, will resolve the attack completely.

2. Deficiency
These patterns are due to a weakness of the lungs, kidneys and/or spleen. It
is important to quantify at this point that when we refer to the above organs,
we are looking at this from a TCM perspective.

Lung dryness
Lung dryness is due to wind and dryness (with either heat or cold, depending
on the season) invading the lungs.. It usually occurs during dry seasons but
it can also be provoked by air conditioning and, as a result, can occur at any
time of the year. This damages lung fluids, which are then unable to moisten
the larynx and throat.

Symptoms
A hoarse, husky voice or raspy voice; sore, dry, ticklish throat; dry mouth,
nose and lips; dry hacking; non-productive cough.

Treatment
Clear and moisten the lungs with sweet, slightly bitter and cool herbs to
benefit the throat.

Phlegm Heat
There two causes of phlegm heat voice disorders. The first is triggered by a
wind heat invasion in a person with pre-existing phlegm. This will combine
with the wind heat and block the channels of the throat, obstructing the lung
chi and larynx. The second pattern is often found in heavy smokers with
persistent low-grade symptoms.

Symptoms
Husky, raspy or hoarse voice; throat clearing and expectoration of thick
yellow mucous - possibly worse in the morning; worse through smoking; dry,
sore, red or congested throat; dry mouth with bitter taste; possible low
fever.. The tongue will be greasy with a yellow coat. The pulse will be
slippery and rapid.

Treatment
Clear heat and resolve phlegm using moist, cold and bitter herbs, supported
with acupuncture.

Lung and kidney yin deficiency
Yin deficiency may have many causes such as constitution, ageing, over
taxation or consumption of drying substances (such as food, drink and drugs).
The above is also heightened at menopause as the yin (water) is naturally in
decline. When the yang (fire) is not checked by yin, heat will rise, drying
the voice box.

Symptoms
Chronic hoarse voice; laboured voice; can't speak for long; slight sore
throat; discomfort in throat; dry cough; red throat; scant production of
phlegm; poor sleep; lower back and knee pain; tinnitus; hot hands, feet and
chest. The tongue is red, maybe some peeled patches, and very little or no
coating. The pulse is rapid and fine.

Treatment
Nourish yin using with sweet, slightly bitter and cool herbs to benefit the
throat.

Lung and spleen chi (energy) deficiency
This may be caused by overworking of the body or voice, long-term illness,
poor diet or irregular eating patterns. Persistent worry, great loss, living
in a damp environment for a sustained period of time also may affect the lungs
and/or spleen.

Symptoms
Chronic hoarseness, worse in afternoon; easily tired; speaking is an effort;
there may be shortness of breath; fatigue, or lack of energy; loose bowels.

Treatment
Supplement and boost the lungs and spleen. Raise energy and restore the voice
using warm and tonifying herbs and acupuncture. Suggest lifestyle changes to
diet, mental outlook and living environment.

3. Stagnation
If stagnant chi blood or phlegm block the voice box this will lead to nodules.

Stagnation of liver chi
Liver chi stagnation is caused by emotional distress and can cause voice
inhibition.

Symptoms
Congested feeling in the throat (feeling of stone in throat - globus
hystericus); sudden loss of voice brought on by emotional problems,
depression, anger, great emotional upset; fullness or tightness in the chest;
difficulty in taking a large breath. Women may experience pre-menstrual
tension and breast tenderness. The tongue can be normal or dark/purple in
colour. The pulse may be wiry, choppy - possibly rapid.

Treatment
Sooth and regulate liver chi using bitter, slightly acrid and cool herbs.
Regular acupuncture treatments and counselling are recommended.

Note on above
Liver chi stagnating is often the result of long-term resentment and anger and
counselling can be very beneficial part of treatment.

Chi, blood and phlegm stagnation
This may be due to lingering infection - either bacterial or viral - that
binds in the throat after an acute disease. It may also arise after severe
overuse of voice, which may damage the network of vessels in throat. Stubborn
phlegm may block the smooth flow of chi and blood in the voice box causing the
voice to be hoarse and laboured.

Symptoms
Chronic hoarseness; effort when speaking; discomfort and a feeling of
something in throat; on inspection of vocal cords the colour is dull and there
may be nodules or polyps. The tongue is purple with a coating. The pulse is
choppy.

Treatment principles
Move the chi and quicken the blood; transform the phlegm.. Clear nodules and
restore voice using acrid, bitter and cool herbs and/or slightly warm and
aromatic herbs. Both herbs and acupuncture work well in this condition but
regular acupuncture and herbs must be administered and consistency with
treatment is very important. In addition, total rest of the voice is strongly
recommended.

For more information please contact Martin Silliton:

Mobile: 07931 598 346
Email: martin@silliton.flyer.co.uk