When the throat burns like fire, the voice becomes hoarse and low, even normal speech becomes difficult, and the rhythm of life seems disrupted. Why do sore throat and hoarseness occur? What medicine works well?
What causes sore throat and hoarseness?
Dr. Que Poh Yuen Albert , a TCM expert at Singapore Gong Fang Tang TCM, states that throat problems are not always simply "excessive heat" (上火); finding the root cause is key to precise resolution. TCM views the throat as the "gateway of the lung and stomach," and its discomfort often arises from the interplay of multiple complex factors:
External Contraction of Wind-Heat/Wind with Heat: One of the most common causes. Wind-heat pathogens invade the throat like a raging fire, scorching body fluids, leading to redness, swelling, heat, and pain in the throat, hoarseness, often accompanied by fever, headache, and yellow phlegm.
External Contraction of Wind-Cold: Cold pathogens bind the exterior, stagnating lung qi; cold congeals in the throat like frost covering the throat. Manifestations include itchy, sore throat, muffled or hoarse voice, aversion to cold, and clear, thin phlegm.
Yin Deficiency with Fire Flaring: After prolonged late nights, excessive voice use, or fluid damage from febrile diseases, the body's fluids become depleted, allowing deficient fire to flare upward and scorch the throat. Characteristics include dry, sore throat with a burning sensation, hoarseness worsening in the afternoon or evening, and dry mouth.
Congestion of Phlegm-Dampness (or Phlegm-Heat): Spleen deficiency impairs transportation and transformation, leading to dampness accumulating into phlegm; or prolonged stagnation transforms into heat. Phlegm-dampness or phlegm-heat pathogens obstruct the throat and airways. Symptoms may include a blocked sensation or foreign body feeling in the throat, copious sticky phlegm, a muffled or hoarse voice, and difficulty speaking.
How does TCM treat sore throat and hoarseness?
Facing complex throat ailments, Dr. Que shares a simple yet powerfully focused ancient classic formula: Ban Xia San Ji Tang (Pinellia Powder and Decoction). Although this formula contains only three herbs, it directly targets the core pathological mechanism of cold pathogens and phlegm-dampness obstructing the throat.
Ban Xia San Ji Tang consists of Ban Xia (Pinellia), Gui Zhi (Cinnamon Twig), and Gan Cao (Licorice).
Ban Xia (Pinellia) (Main Commander): A master at drying dampness, transforming phlegm, directing rebellious qi downward, and dissipating nodules. It powerfully clears phlegm-dampness turbidity blocking the throat, unblocking this "strategic pass."
Gui Zhi (Cinnamon Twig) (Surprise Troop): Warms and unblocks the channels, dispels cold, and releases the muscles. Although warm in nature, its clever use in this formula lies in diffusing the qi mechanism constrained by cold pathogens, driving away congealed cold, and assisting Ban Xia in opening blockages and dissipating nodules.
Zhi Gan Cao (Prepared Licorice) (Harmonizer): Sweet and moderating, harmonizes the middle jiao. It moderates the harsh nature of Ban Xia and Gui Zhi, preventing damage to healthy qi, while also supplementing the spleen and stomach, fortifying the earth (spleen) to control water (dampness), reducing phlegm-dampness generation at its source.
This formula appears simple, but its combination is extremely precise. The key lies in accurate pattern differentiation, grasping the core mechanism of 'cold invasion with phlegm obstruction' – meaning local phlegm-dampness congealing in the throat, accompanied by cold pathogen constraint. Mistakenly using cold, clearing herbs at this stage would instead freeze the pathogens, worsening the congestion. Ban Xia San Ji Tang warms and dissipates simultaneously, transforms phlegm and opens blockages, like the spring sun melting icy frost, dispersing stagnation and constraint."
Medical Case
Patient: Ms. Wang, 36 years old.
Chief Complaint: Hoarseness and swollen, sore throat for 2 weeks, accompanied by a stuffy sensation in the throat. Bowel movements slightly dry, urination normal.
Initial Consultation: Tongue coating thin, white, and moist; pulse floating.
Pattern Differentiation: Cold constraint with yang stagnation, disharmony of the channels and collaterals.
Treatment Principle: Dispel cold and open blockages.
Prescription: Ban Xia San Ji Tang.
Formula: Ban Xia (Pinellia) 15g, Gui Zhi (Cinnamon Twig) 12g, Gan Cao (Licorice) 6g. Decocted in water, 1 dose daily, taken morning and evening.
Second Consultation: After taking 5 doses, swollen throat pain and stuffy sensation significantly reduced, able to produce sound but not clearly. Added Zhu Ru (Bamboo Shavings) 6g to the above formula, took another 5 doses.
Result: All symptoms were cured. Throat no longer painful, speech voice returned to normal.
