Throat Pain Like a Knife Cut, Can’t Even Swallow Saliva? Doctor Luo Dalun: First Tell the Difference Between “Pharynx” Pain and “Larynx” Pain

Opening: In this wave of infection, the most agonizing symptom is not the fever — it’s the sore throat

In the winter of 2022, epidemic-control measures were still tight, and many people were quietly panicking: what if I catch it once restrictions are lifted? Doctor Luo Dalun’s answer: you really don’t need to worry that much.

💬 Note from Doctor Luo: Some people demonized Omicron in the early days — “this is terrible” and so on. There’s really no need. Many experts have now spoken up: its harm is roughly comparable to the flu, maybe even slightly less. If you go into this anxious and terrified, that’s very bad for your recovery once you do get infected. People who have been studying traditional Chinese medicine feel much calmer at times like this — because you understand it, you know how to handle whatever comes up. Those who know nothing will panic after a few days of fever and all flood into the hospitals, putting enormous strain on the system. But honestly, who hasn’t had a fever in their life? Overall this is manageable. Today I’d like to share some more knowledge on preventing and treating colds and flu, so you can act with a clear plan.

He asked many patients and pieced together the pattern of this wave of infection: it starts with fever, then comes the sore throat and body aches — the throat pain is especially severe; some people describe it as “like being cut with a knife,” lasting for days. Then comes slow recovery, then coughing, and finally exhaustion. Most people gradually get better this way.

💬 Note from Doctor Luo: Today let’s talk about this “sore throat” business. What ordinary people call a sore throat is really pain in the throat region, and most of it is caused by heat — cold-type cases exist too, but they’re the minority.

Before you reach for medicine: is your “sore throat” actually a heat-type case?

For swollen, painful throat, the first thing is to tell cold from heat. What does a heat-type case look like? Doctor Luo gives four signals:

The throat is genuinely swollen
The tongue body is red — not that pale, whitish tongue
The pulse is rapid
If there’s phlegm it’s yellow, the nasal discharge is yellow too, and the tongue coating may be slightly yellow and greasy

💬 Note from Doctor Luo: See these signs, and you can judge it a heat-type case. Next step: you still have to distinguish the “pharynx” from the “larynx” — the treatment for these two places is actually different, and if you get it wrong you suffer for nothing.

The most important step: the pharynx and the larynx are not the same thing at all

Where is the pharynx? Up high. Open your mouth; where the oral cavity narrows like a funnel, the part you can see — that’s the pharynx.

💬 Note from Doctor Luo: The pharyngitis and tonsillitis we meet every day are all pharynx problems. Where are the tonsils? Under the two cheeks — when they swell up and you press there, it hurts badly under the jaw. Open your mouth and look in: everything at the back is red, sometimes even festering. Pharyngeal inflammation — especially when triggered by external pathogens — is often extremely painful.

What are the tonsils? They’re a defensive organ of the body, a lymphatic organ, extremely sensitive. When pathogens arrive, they organize resistance first — and resistance means swelling.

The larynx, by contrast, is down below: touch your Adam’s apple — that’s the larynx, and it’s tied to the vocal cords. When the larynx is diseased, the voice changes, and the pain is terrible — knife-cut pain; some patients say they can’t even swallow saliva.

💬 Note from Doctor Luo: The pharynx and larynx sit in different places and do different jobs, so they’re treated differently. For heat toxin in the pharynx, there’s a formula so classic it’s almost beyond belief; for laryngeal emergencies, there’s also a formula that proves itself the moment you try it. Let’s go through them one at a time.

Swollen painful pharynx: Li Dongyuan’s Pu Ji Xiao Du Yin — the formula the ancients carved onto stone tablets for people to copy

The representative formula for heat toxin in the pharynx is the Pu Ji Xiao Du Yin (Universal Salvation Toxin-Dispersing Decoction), created by Doctor Li Dongyuan in the Jin-Yuan era, specifically for swelling of the head and face caused by epidemic heat toxin.

💬 Note from Doctor Luo: Back then patients would feel cold and feverish, with badly swollen tonsils — sometimes the whole face swelled and the eyes couldn’t open; they were thirsty and wanted cold drinks, the tongue felt parched, the tongue body was red, and the pulse was floating, rapid and forceful. That’s when Pu Ji Xiao Du Yin is used to resolve heat toxin in the upper burner and the head and face — and it works remarkably well. I’ve seen extremely severe tonsillitis — cases where antibiotics did nothing and the usual detoxifying medicines did nothing. Pu Ji Xiao Du Yin went down and worked instantly: the heat toxin was dissolved on the spot, recovery within a day. It’s basically miraculous.

How much did the ancients trust this formula? Doctor Luo shares a telling detail: ordinary people carved it onto wooden boards and stone tablets, set them at crossroads, and let passersby copy it down — to use whenever an epidemic struck.

How is the formula put together? Doctor Luo takes it apart piece by piece:

Huang qin (baical skullcap root) and huang lian (coptis): the commanding generals of detoxification, best stir-fried with yellow rice wine — the pharmacy’s wine-fried huang lian and wine-fried huang qin are even better
Xuan shen (figwort root): draws the kidney water and kidney essence up to the throat to quench the fire above — it both detoxifies and nourishes yin
Lian qiao (forsythia) and ban lan gen (isatis root): detoxify
Ma bo (puffball): a fungus, mushroom-like, like a little sack filled with powder and spores — touch it and a puff of “smoke” flies out; it detoxifies powerfully and is especially effective against heat toxin in the throat
Niu bang zi (burdock seed): detoxifies, strongly clears the throat and benefits the larynx, acting on the oral-pharyngeal region
Bo he (mint): lifts and disperses outward
White stiff silkworm (jiang can): detoxifies and also lifts and disperses
Sheng ma (cimicifuga) and chai hu (bupleurum): lift the medicine upward
Jie geng (platycodon): opens the lungs and also carries medicine upward
Chen pi (tangerine peel): regulates qi

💬 Note from Doctor Luo: The whole formula lifts the medicine upward so it acts on the pharynx — which is why it’s so effective for pharyngeal infection. Remember: when tonsils are really swollen and painful, you can go to the pharmacy and get this formula.

Dosage: In the original formula, huang qin and huang lian were 15 g each, and everything else was very light — ma bo, niu bang zi, bo he, ban lan gen and lian qiao only 3 g each; white stiff silkworm and sheng ma 2 g; jie geng, chai hu and xuan shen 6 g.

💬 Note from Doctor Luo: I feel those doses are on the small side. When I prescribe it as a decoction I raise everything: huang qin and huang lian 12 g each is enough; lian qiao, ban lan gen, ma bo and niu bang zi around 9 g; chai hu and jie geng 6 g, sheng ma 2–3 g; xuan shen can go up to 9 g. Drink this as a decoction — I’ve used it for years, it works instantly, the problem dissolves right away.

The method of taking it also matters: In Li Dongyuan’s day, the herbs were ground into powder, steeped in boiling water, and sipped slowly — a mouthful now and then, working through the whole day; or mixed with honey into pills and held in the mouth, letting them dissolve slowly in saliva.

💬 Note from Doctor Luo: A couple of days ago I saw a netizen mention that colleagues in Taiwan brew the formula and turn it into a spray — you spray it into the throat, swallow, and that’s it. That’s a wonderful development of Li Dongyuan’s method, very well done. What’s a pity is that a classic formula like this for treating epidemic heat disease still hasn’t been approved as a manufactured medicine here — the drug authorities haven’t paid enough attention to classical formulas. They’ve sent their spray all over the world, saying “this is something Chinese.” We really should be doing the same on our side.

Doctor Luo also has a remarkable piece of experience: people who get tonsillitis regularly often find that after one course of this treatment, the tonsillitis stays away for a very long time — some are even cured for good.

💬 Note from Doctor Luo: I’ve genuinely met such patients. Years later I’d ask: “Still getting swollen?” “I used to get it all the time; now it hasn’t flared up in ages.” — That’s what Pu Ji Xiao Du Yin does.

Agonizing laryngeal pain: Doctor Geng Jianting’s Dan Zhi She Yu Tang

If the pain is in the larynx — at the Adam’s apple, at the vocal cords — knife-cut pain, unable even to swallow saliva, Doctor Luo recommends a formula he has tried and found remarkably effective: Dan Zhi She Yu Tang (Moutan-Gardenia Belamcanda-Yujin Decoction).

This formula comes from the great throat specialist Doctor Geng Jianting, whose family was a six-generation laryngeal medicine dynasty.

💬 Note from Doctor Luo: Doctor Geng’s ancestors lived in Dong’e, Shandong, working as gardeners. An old physician used to come by regularly to buy flowers — gardenia, belamcanda, peony, flowers that could be used as medicine — and the two families became close. In the end the old doctor passed his books and formulas to the gardener’s family: the man was buying flowers to treat illnesses. The Geng family later moved to Yangzhou and practiced medicine there, specializing in throat disease, using flower-type herbs — they also had all sorts of special tricks like radish-leaf remedies.

By the sixth generation, Doctor Geng Jianting was already a master of laryngeal medicine from a famous lineage, with enormously rich clinical experience. He took part in founding the China Academy of Chinese Medical Sciences (formerly the Institute of Chinese Medicine), was a master of medical literature, and wrote many books on the subject.

💬 Note from Doctor Luo: The old master specialized in laryngeal emergencies — acute epiglottitis. The epiglottis suddenly becomes acutely inflamed, often triggered by a gust of winter wind; sometimes before it even swells much it can block the airway — and people die. So in ancient times this was a true laryngeal emergency: if you didn’t treat it properly, the patient died.

How is Dan Zhi She Yu Tang put together?

Peony flower petals — you can’t get the flowers now, so use dan pi (moutan bark) 6 g
Zhi zi (gardenia fruit) 6–9 g
She gan (belamcanda) 9 g
Yu jin (curcuma) 9 g
Pi pa ye (loquat leaf) 9 g
Fu ling (poria) 9 g
Raw gan cao (licorice) 3 g

💬 Note from Doctor Luo: The old master said cold and heat are locked in combat here, giving rise to this illness, so the formula frees the qi and adds just a little heat-clearing — and that cures it. I’ve used it for years: basically one dose brings obvious relief, and if a little tail end remains, two or three doses finish it for sure. For acute laryngeal swelling and pain brought on by external pathogens, this formula works instantly.

Doctor Luo’s modifications:

💬 Note from Doctor Luo: With COVID patients — many of them had that knife-cut pain, couldn’t swallow saliva, and this was often exactly the problem. Using Dan Zhi She Yu Tang, I sometimes add fang feng and jing jie to disperse wind pathogen, and pair it with Sheng Jiang San — cicada slough, jiang huang, white stiff silkworm; if the stool is dry, add a little da huang. Basically, patients report their throat is essentially fine by the next morning — while everyone else was in agony, this person drank the decoction and never really hurt, and the fever came down too.

One-sentence summary: tell the pharynx from the larynx, and confirm the heat-type diagnosis

💬 Note from Doctor Luo: The pharynx is up above — it includes the tonsils; the larynx is down below, at the Adam’s apple. If you can tell these two apart, and you’ve confirmed it’s a heat-type case — yellow phlegm, rapid pulse, red tongue body — then the formula will work instantly. Our formulas get more and more precise, more and more focused; whatever the problem is, we solve it the right way, and people are spared the suffering. Otherwise you lie there for days, unable to drink water, hurting like you’ve been cut with a knife — try a week of that, and most people find it unbearable.

One final reminder from Doctor Luo: this is the treatment for heat-type cases. A minority of people have cold-type sore throats — and those need a different approach.

💬 Note from Doctor Luo: What I’ve seen so far is still mostly heat-type — pathogens invade, the body starts resisting, and heat is generated. For heat-type cases, these formulas work. Tomorrow we’ll continue talking about how to face colds and flu. See you tomorrow!

Compiled from Doctor Luo Dalun’s health lectures (cold and flu prevention series: the pharynx and the larynx).