Cough

Question 1

Describe a deficient cough

Answer 1

Lung Qi which is too weak to descend, and simply floats upward: DEFICIENCY

• Weakness of Lung Qi or Yin
  Deficient coughs are chronic, weak, worse with exertion, at night or when fatigued

Question 2

Describe an excess cough

Answer 2

A pathogen blocking the Lung Qi’s downward movement: EXCESS

• Wind, Cold, Heat or Phlegm, Dampness, Heat, pathological fluids or Qi stagnation
• Excess coughs are acute, loud and paroxysmal
• Excess with underlying deficiency

Question 3

What is the etiology of cough?

Answer 3

1. External pathogens (Entry into Lung through nose and mouth, skin)
2. Lung deficiency (Qi or Yin)
3. Spleen Qi deficiency, Phlegm
4. Liver invading the Lungs (Lungs should restrain Liver;
   Reverse controlling cycle, Liver rebels backwards)
5. Kidney deficiency (Grasps Qi, if not Lung Qi floats upward;
   KD & SP Yang fail to move fluids)

Question 4

Cough that is worse in the morning?

Answer 4

phlegm

Question 5

Cough that is worse with exertion or when tired?

Answer 5

Deficiency

Question 6

Cough that is worse in the afternoon or evening?

Answer 6

yin deficiency

Question 7

Cough that is worse with emotional upset?

Answer 7

LV qi invading LU

Question 8

What does copious mucus indication?

Answer 8

Copious indicates the presence of Phlegm

Question 9

What’s the difference between yellow/green, white, and thin/watery mucus?

Answer 9

Yellow or green: Phlegm Heat

White: Phlegm damp

Thin and watery: Cold fluids

Question 10

What does no mucus with cough indicate?

Answer 10

No mucous: Heat, dryness or Yin deficiency

Question 11

What does blood streaked mucus indicate?

Answer 11

Lung Heat, Fire or Yin deficiency

Question 12

Acute cough, frequent, loud, moderate thin clear or white mucous; initially non-productive Chills/fever; no sweating; occipital, frontal h/a; muscle aches, neck stiffness; nasal congestion or runny nose; wheezing, sneezing;

T: Normal, thin white coat
P: floating, tight
TX: Expel Wind and Cold, redirect Qi, stop cough
LI 4; LU 7; GB 20; BL 12, 13; LU 5; CV 17, 22; Ding Chuan; GV 23

Answer 12

Wind Cold

Enters through the pores, ‘tai yang’ channels, obstructing Lung Qi which ascends as cough

Question 13

Acute hacking, dry cough or sticky yellow; Fever/chills; thick yellow/green mucous; sore, dry scratchy throat; thirst; mild sweating; h/a;

T: normal, red tipped, thin white or yellow
P: Floating, rapid
TX: Expel Wind, Heat, Redirect Qi, Clear Phlegm
GV 14, BL12, 13; LI 11, 4; TW 5; LU 11; SI 17

Answer 13

Wind Heat

Invades the Lungs through the nose and mouth or Wind Cold now Heat, obstructing Qi

Question 14

Dry hacking cough, scant, sticky, thick mucous; dry throat, mouth, nose, lips; h/a; fever/chills;
T: normal, red tip, thin yellow coat;
P: thready, rapid
TX: Clear Heat, moisten Dryness, Redirect Qi
Sang Xing Tang

BL 12, 13; LU 5, 7, 9; KD 7, 6

Answer 14

Warm Dryness

Pathogenic Wind & Dryness, heat or cold, invades the Lungs; weather influence, A/C now a cause

Question 15

Cough, no mucous; itchy dry throat; dry nose, lips; h/a; Chills/fever; no sweat;

T: thin, dry white;
P: floating, tight
TX: Clear Lungs, moisten Dryness, redirect Qi
BL 12, 13; LU 5, 7, 9; KD 7, 6

Answer 15

Cool Dryness

Question 16

Dry hacking painful cough; little/no mucous; fever, sweat; chest tightness, pain; red complexion; chest heat sensation; dry mouth, thirst; SOB, wheezing;

T: red, red tip, yellow coat
P: flooding, rapid
TX: Clear Heat, redirect Qi, stop cough
LU 5, 6, 10; BL 13; CV 17; LI 4; GV 14; LU 1

Answer 16

LU Heat

Pathogen into Lungs, no exterior Sx remain;

Question 17

Chronic cough, profuse thin or thick white, or clear mucous; rattle in chest, worse in AM, after eating; chest, epigastric fullness; poor appetite; nausea, vomiting; loose stools; lethargy, weakness;

P: Soft and slippery
T: pale and swollen, scalloped, greasy, white coat
TX: Tonify Spleen, dry Damp, transform Phlegm
BL 13, 43, 20; LU 5, 7, 9; LIV 13; SP 3, 6; ST 36 Ding Chuan

Answer 17

Phlegm Damp

Causes chronic cough…the result of poor diet or recurrent URIs treated with antibiotics; common in children with dairy rich diet; a mixed pattern of Excess and Deficiency

Question 18

Hacking cough, profuse, thick yellow/green mucous; chest/epigastric fullness; wheezing worse at night, in morning; poor appetite, nausea; lethargy, weak; sore throat; bitter taste;
T: thick, greasy yellow coat
P: slippery, rapid
TX: Expel Phlegm, Clear Heat; redirect Lung Qi
LU 5, 6, 7, 1, 10; ST 40; LI 11; BL 13; CV 17

Answer 18

Phlegm Heat

Lung Heat congeals fluids into Phlegm Heat following EPI; flare up of chronic Phlegm Damp in Lung from alcohol, spicy foods, tobacco; mostly Acute

Question 19

Paroxysmal, severe cough; chest hypochondrial pain; exacerbated by emotions; persists for several weeks, subsides, returns; red face, eyes; bitter taste; irritable; dizziness, h/a; LIV 14, 3 very tender on palpation;

T: red, dry, yellow coat
P: wiry, slippery
TX: Clear Liver Fire, moisten LU, transform Phlegm
BL 13, 18; LU 5; LIV 2, 3, 14; GB 34; PC 6

Answer 19

LV Fire invading LUs

Question 20

Chronic, weak, dry cough, little mucous and hard to expectorate, sticky, blood streaked; dry mouth, throat; low grade fever rises in afternoon/evening; malar flush; night sweat; ‘five hearts heat’; emaciation, fatigue

T: red, dry little or no coat, peeled (mirror) coat
P: thready, rapid
TX: Nourish Lung Yin, moisten Lung, transform Phlegm
BL 13, 43, 23; LU 9, 5, 7; KD 6, 3; LU 10 for severe heat

Answer 20

LU yin deficiency

Yin is damaged by chronic, severe disease, febrile diseases, smoking, bronchodilators, prolonged exposure to hot, dry environments; can follow KD Yin def.; failure of weak Lung Qi to descend or deficient heat rising cause cough

Question 21

Chronic, weak, tiring cough; exacerbated by exertion, fatigue, wind exposure; thin clear frothy white mucous; SOB; spontaneous sweating; aversion to Wind; frequent colds; weak, low voice; fatigue

T: pale, thin white coat
P: weak
TX: Tonify Lung Qi, calm cough, transform Phlegm
BL 13, 43, 20; LU 9, 7; GV 14; ST 36; SP 6; CV 12;

Answer 21

LU qi deficiency

If weak Lung Qi, with impaired descending, then chronic cough

Question 22

Chronic cough, thin watery mucous; worse with exertion; edema; cold, heavy limbs, spontaneous sweating; nocturia or difficult urination; dizziness, palpitations;

T: pale, swollen
P: deep, slippery
TX: Warm Yang, disperse Cold; move fluids
BL 20, 23; CV 9, 6; KD 7, 3; SP 9, 6; ST 36

Answer 22

SP & KD Yang deficiency

Failure to process fluids, accumulating in Lung, obstruct Lung Qi; diuresis to drain fluids, then strengthening SP/KD Yang.

Question 23

Chronic cough, worse at night; scanty mucous, bloody; pain upon coughing; cold extremities, a frequent sign of Blood stasis in chronic Lung disease. Following trauma to the chest, contusion, rib fracture; late stage of serious disease, cancer.

T: pale, or purples, stasis spots
P: wiry, thready, weak
TX: Resolve Blood stasis, stop cough
BL 17, 13; LU 5; LI 4; LIV 3; PC 6, SP 10; hemoptysis LU 6

Answer 23

Blood Stagnation