Cough

By Jiang Liu, Diplomate of Oriental Medicine
 AR Licensed Acupuncturist and Herbalist
Acupuncture & Chinese Medicine Clinic
2024 Arkansas Valley Dr., Suite 402
Little Rock, AR 72212

 

Coughing is a reflex that keeps your throat and airways clear. Therefore, coughing helps heal your body or protect yourself. However, having a persistent cough can be exhausting. The physical action of coughing depletes your energy reserves and disrupts your sleep. A chronic cough can also cause headache, dizziness, excessive sweating, urinary incontinence, or fractured ribs, especially in women with fragile bones. Coughs can be either acute or chronic. Acute coughs begin suddenly and usually last no more than 2 to 3 weeks and chronic coughs last longer than 2 to 3 weeks.

Causes

An occasional cough is normal. But a cough that persists for long periods of time may signal an underlying problem. Some causes of coughs include:

  • Respiratory infections: cold, influenza, sinusitis, bronchitis, croup, pneumonia or tuberculosis
  • Respiratory disorders: asthma, emphysema, cystic fibrosis, bronchiectasis, cystic fibrosis, interstitial lung diseases, sarcoidosis, chronic obstructive pulmonary disease, or lung tumors
  • Argies
  • Cardiovascular diseases: heart failure, pulmonary infarction or aortic aneurysm
  • Stomach acid backs up into the esophagus: Gastroesophageal reflux disease
  • Conditions affecting the lung tissue: mediastinal masses
  • Environmental pollutants: smoking, dust or smog
  • A foreign body can sometimes be suspect
  • Some medications: ACE inhibitors

Conventional treatment

The treatment of cough is determined by the cause. However, patients may get symptomatic relief from expectorants which help thin the mucus and make it easier to cough mucus up when you have a productive cough, and from suppressants which control or suppress the cough reflex and work best for a dry, hacking cough that keeps you awake.

Chinese medicine

In Chinese medicine, cough can be caused by either exogenous pathogenic factors or endogenous origins (the impairment of internal organs). The exogenous pathogenic factors include wind, cold, heat and dryness; the endogenous factors may originate lung or other related organs such as liver, spleen or kidney, which eventually lead to the dysfunction of lung, causing cough. Exogenous cough arises as a new illness, with abrupt onset flowing exposure to cold, and is accompanied by nasal mucosal congestion and discharge, sneezing, an itchy throat, distending headache, generalized body aches, aversion to wind or cold, and fever. Endogenous cough is generally chronic, with slow onset. There usually are symptoms of other visceral organs, such as fatigue and weakness, chest distention, flank pain, anorexia, diarrhea, or other symptoms.

Cough can be treated by acupuncture, herbals or some other modalities of Chinese medicine, alone or combination of different modalities, depending on individual situation.

Clinical classifications and treatment principles

A. Exogenous pathogenic factors

Wind-Cold

  • Symptoms and signs: Cough with a heavy sound and thin, white sputum, fever, headache, stuffy and runny nose, anhidrosis
  • Tongue: Thin white coating
  • Pulse: Floating and tight
  • Treatment principle:
    • Disperse the wind
    • Dispel the coldness
    • Clear lung
    • Suppress cough

Wind-Heat

  • Symptoms and signs: Cough with a high husky sound and thick white or yellow sputum, fever, chilliness, headache, sore throat, thirst, yellow nasal discharge
  • Tongue: Thin, yellow coating
  • Pulse: Floating and fast
  • Treatment principle:
    • Disperse the wind
    • Eliminate the heat
    • Clear lung
    • Dissolve sputum

Wind-Damp

  • Symptoms and signs: Profuse mucus, heavy/loose/thick cough, feelings of heaviness in the body
  • Tongue: Greasy, thick coating
  • Pulse: Floating and slippery
  • Treatment principle:
    • Disperse the wind
    • Eliminate Dampness
    • Dissolve sputum

Wind-Dry

  • Symptoms and signs: Dry choking cough with a husky sound and thick or blood-tinged sputum, itching and dryness of throat, sore throat, dryness of nose and lips, headache, stuffy nose, fever, aversion to wind
  • Tongue: Red tip, dry
  • Pulse: Floating
  • Treatment principle:
    • Disperse the wind
    • Moisten the lung

B. Impairment of internal organs

Live-fire attacking the lung

  • Symptoms and signs: Coughing possibly blood-tinged, costal pain, irritability
  • Tongue: Red with yellow coating
  • Pulse: Wiry and rapid
  • Treatment principle:
    • Eliminate liver fire
    • Smooth qi
    • Suppress ascended qi

Phlegm-dampness accumulating in the lungs

  • Symptoms and signs: Cough with a heavy sound and profuse white sputum, fullness and oppressive sensation over the chest and epigastrium, fatigue, poor appetite, nausea, vomiting, diarrhea
  • Tongue: White and greasy tongue coating
  • Pulse: Soft-floating and smooth
  • Treatment principle:
    • Tonify the spleen
    • Dry dampness
    • Eliminate sputum
    • Relieve cough

Phlegm-heat stagnation in the lungs

  • Symptoms and signs: Rapid breathing with harsh voice, cough with difficult expectoration of thick yellow sputum, or odorous or bloody sputum, chest pain, dry mouth, constipation
  • Tongue: red tongue with yellow or yellow and greasy coating
  • Pulse: rapid and smooth
  • Treatment principle:
    • Eliminate the heat
    • Dissolve sputum
    • Peace the lug
    • Relieve cough

Lung-yin deficiency

  • Symptoms and signs: Longstanding cough with a little amount of white mucous or blood-streaked sputum, dry throat, hoarseness, flushed cheeks, afternoon fever, feverish sensation over the palms, soles and the chest, insomnia, night sweating, fatigue, emaciation
  • Tongue: red tongue with scant coating
  • Pulse: Thready and rapid
  • Treatment principle:
    • Nourish yin
    • Moisturize the lungs
    • Dissolve sputum
    • Suppress cough

Lung-qi deficiency

  • Symptoms and signs: Longstanding cough with very low sound, cough accompanied by asthma, thin, clear and white sputum, poor appetite, shortness of breath and oppressive sensation over the chest, low spirit, tiredness, spontaneous sweating, aversion to coldness
  • Tongue: light color and white coating
  • Pulse: weak
  • Treatment principle:
    • Nourish qi
    • Warm the lung
    • Dissolve sputum
    • Suppress cough