Acute Tonsillitis
Overview
Ru E (acute tonsillitis) is an acute throat disorder characterized by redness, swelling, and pain of the bilateral tonsils, which resemble silkworm moths. It corresponds to acute tonsillitis in modern medicine. The disease is commonly caused by externally invading wind-heat pathogenic toxin, or by accumulated heat in the lung and stomach that attacks the throat along the meridians and binds at the tonsils. Clinically, it presents with sore throat, difficulty swallowing, and swollen red tonsils with possible yellow-white purulent spots, often accompanied by fever, aversion to cold, headache, and cough. Pattern differentiation should distinguish wind-heat invading the exterior from excessive heat in the lung and stomach; the former is treated by dispersing wind and clearing heat, reducing swelling and benefiting the throat, while the latter is treated by draining heat and resolving toxin, benefiting the throat and reducing swelling. It is common in children and young adults, occurring in all seasons but more frequently in winter and spring.
Pattern differentiation (clinical patterns)
Wind-Heat Invading the Exterior
Sore throat, red and swollen tonsils, difficulty swallowing, fever with mild aversion to cold, headache, nasal congestion, cough with yellow sputum, red tongue tip and edges with thin white or thin yellow coating, and a floating rapid pulse.
Disperse wind and clear heat, reduce swelling and benefit the throat.
Excessive Heat in the Lung and Stomach
Severe sore throat, marked redness and swelling of the tonsils with possible yellow-white purulent spots, difficulty swallowing, high fever, thirst with preference for cold drinks, bad breath, constipation, red tongue with yellow coating, and a surging rapid pulse.
Drain heat and resolve toxin, benefit the throat and reduce swelling.
Yin Deficiency with Lung Dryness
Dry throat with mild pain, dark red and slightly swollen tonsils, afternoon tidal fever, heat in the palms and soles, dry cough with little sputum, red tongue with scanty coating, and a thin rapid pulse.
Nourish yin and moisten the lung, clear and benefit the throat.
Connections
Daily care & prevention
During illness, patients should rest in bed, drink plenty of warm water, and consume a light, easily digestible diet, avoiding spicy, greasy, fried foods, alcohol, and smoking. Rinse the mouth with dilute salt water or a decoction of honeysuckle and licorice to maintain oral hygiene. Take isolation precautions to avoid infecting others. Closely monitor body temperature and throat changes; if high fever persists or breathing difficulty occurs, seek medical attention promptly. Usually strengthen exercise to enhance constitution and prevent external contraction.
When to seek medical care
If there is persistent high fever, severe sore throat, difficulty swallowing, labored breathing, difficulty opening the mouth, neck swelling and tenderness, or palpitations, chest tightness, joint pain, or hematuria, it indicates worsening condition or complications, and immediate medical attention is required. In children, restlessness, refusal to eat, drooling, or breathing difficulty warrants particular vigilance.