TCM and Chronic Cough

 

By Dr. Hong-Yen Hsu

 

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The most pervasive symptom of respiratory disease (e.g. bronchitis, pneumonia) is coughing. Such diseases are customarily treated with antibiotics. In Traditional Chinese Medicine, on the other hand, treatment is tailored to the conformation of the sufferer, the stage of the disease, the pattern of symptoms manifested, and the etiology of those symptoms.

 

For example, the initial stage of most respiratory diseases is marked by any or all of the following symptoms:

• Fever
• Headache
• Chills
• Fatigue
• Cough
• Nasal and/or sinus congestion
• Ear and/or throat discomfort
• Disruption of normal activity of sweat glands (i.e excessive or deficient perspiration)

In cases of Excess conformation, herbal formulas containing Ma-huang (Ephedra) are administered; if the conformation is one of Deficiency, herbal formulas containing Cinnamon or Aconite are preferred.

 

If coughing is the most prominent symptom in the initial stage of respiratory disease, the etiology of the disease in Traditional Chinese medicine terminology is determined by accompanying factors. The cough is said to be attributable to Wind Chill if there is also expectoration of loose sputum and thin white tongue fur; severe Wind Chill is treated with Ma-huang Combination, while mild chilling indicates that Apricot Seed and Perilla Formula will provide relief. If the throat is sore and expectoration difficult, tongue fur thin and white or yellow in color, and the pulse slippery, the condition is said to be due to Wind Heat. Mild symptoms of Wind Heat are treated with Morus and Chrysanthemum Combination, severe cases with Ma-huang and Apricot Seed Combination. Finally, a hacking, unproductive cough and a dry mouth and throat, with an unnaturally red tip of the tongue, are indications of a Dry Heat condition, to be alleviated with Eriobotrya and Ophiopogon Combination.

 

Chronic coughing which persists after the initial or acute stage of a respiratory disease has passed may be even more troublesome, especially for the person of Average or Deficiency conformation. The accompanying table distinguishes the main types of chronic cough due to respiratory disease, the symptoms characteristic of each type, and the herbal formula best suited to such type.

 

“Dry” Cough

Characteristic Symptoms	Formulas
Palpitations, dry mouth, night sweating	Bupleurum, Cinnamon & Ginger Combination
Dry mouth and throat, "flushing up," small amount of sticky phlegm	Ophiopogon Combination
1. Accompanied by lack of vitality 2. Accompanied by sore throat 3. Especialy troublesome at night; accompanied by hard stool	Pinellia & Magnolia Combination Coptis & Scute Combination Phellodendron Combination

 

“Moist” Cough

Characteristic Symptoms	Formulas
Little or no expectoration
Palpitations, chest distress, insomnia, protracted coughing with copious phlegm	Bamboo & Ginseng Combination
Wheezing, persistent mild fever and headache, productive cough; gastro-intestinal dysfunction	Ginseng & Perilla Combination
Wheezing, difficulty in breathing, lack of vitality, moderately productive cough; no gastro-intestinal problems	Ma-huang & Magnolia Combination
Expectoration of watery sputum
Wheezing, difficulty in breathing, sneezing, profuse nasal discharge, edema, urinary disturbance; no gastro-intestinal problems	Minor Blue Dragon Combination Hoelen & Schizandra Combination
Expectoration of pus-laden sputum
Chronic cough, large amounts of pus-laden sputum	Trichosanthes & Chih-shih Combination
Chronic cough, dry mouth, "flushing-up," sore throat	Bupleurum & Scute Combination
Chronic cough, shortness of breath, large amounts of pus-laden sputum	Platycodon & Fritillaria Combination
Persistent fever, chills, anorexia, nausea, vomiting, chest and abdominal distress, violent coughing	Minor Bupleurum Combination (or suitable modification)