Cough

Cough , a main symptom of the lung problems , may result either from attack by exogenous pathogenic factors disturbing the dispersion of qi of the lung , or from disorders of the lung itself or other diseased zang - fu organs affecting the lung .

Etiology and Pathogenesis

Invasion by the exogenous pathogenic factors :

The lung dominates qi and is regarded as an umbrella protecting the five zang organs . Upward it connects the throat and has its opening in the nose , governing respiration . Externally it associates with the skin and hair . Once the lung is attacked by the exogenous pathogenic factors , the qi of the lung is blocked and fails to descend , thus resulting in cough .

Since the weather changes in different seasons , the exogenous pathogenic factors attacking the human body are various . Cough is therefore divided into two types : wind cold and wind heat .

Internal injury :

Cough resulted from functional impairment of the zang - fu organs falls into the category of cough due to internal injury , such as cough caused by dryness of the lung with deficiency of yin leading to failure of the qi of the lung to descend , or by disorders of the other organs affecting the lung . For example , in case of weakened spleen yang , the accumulated dampness may be turned into phlegm which goes upward to the lung , affecting the normal activities of qi and leading to cough . Stagnation of liver qi may be turned into fire , which flares up and injures the lung fluid , also resulting in cough . As said in Internal Classic : Cough can be caused by disturbance not only of the lung , but of any other zang - fu organs . No matter which zang - fu organ is dysfunctional , cough may result if the lung is affected . The commonly seen cough caused by internal injury in clinic results from dryness of the lung with deficiency of yin , and blockage of the lung by phlegm .

Differentiation

Invasion by the exogenous pathogenic factors :

• Wind - cold type :

  Main manifestations : Cough , itching of the throat , thin and white sputum , aversion to cold , fever , anhidrosis , headache , nasal obstruction and discharge , thin , white tongue coating and superficial pulse .

  Analysis : Cough , itching of the throat , thin and white sputum , nasal obstruction and discharge result from the attack of the lung by pathogenic wind cold , which is stagnated in the respiratory tract , affecting the dispersion of the qi of the lung . Headache , aversion to cold , fever and anhidrosis are due to wind cold affecting the skin and hair , and . residing on the body surface . Thin , white tongue coating and superficial pulse indicate the presence of the pathogenic factors staying in the lung and in the superficial part of the body .

• Wind - heat type :

  Main manifestations : Cough with yellow , thick sputum , choking cough , thirst , sore throat , fever , or headache , aversion to wind , sweating , thin , yellow tongue coating , superficial and rapid pulse .

  Analysis : In case of the attack of the lung by the pathogenic wind heat , the function of the lung in clarifying the passage and sending down the qi is impaired . The fluids are heated and turned into phlegm , and so cough with yellow , thick sputum or choking cough takes place . When the heat in the lung injures body fluid , thirst and sore throat occur . When the pathogenic factors stay in the skin and hair , their conflict with the body resistance gives rise to headache , aversion to wind , sweating and fever . Thin , yellow tongue coating , and superficial rapid pulse are the signs of wind heat staying in the lung and in the superficial part of the body .

Internal injury :

• Blockage of the lung by phlegm :

  Main manifestations : Cough with profuse , white and sticky sputum , stuffiness and depression of the chest , loss of appetite , white , sticky tongue coating and rolling pulse .

  Analysis : The spleen is considered as the source in the production of sputum and the lung as a container to store it . If the spleen fails in its transformation and transportation , the water dampness will no longer be transported and then gathered to form phlegm , which goes upward to the lung , affecting the qi of the lung and causing its failure in descending . The result is cough with profuse sputum or with white , sticky sputum . If water dampness stays in the middle jiao , impairing its activity , there may be stuffiness and depression of the chest and loss of appetite . White , sticky tongue coating and rolling pulse are due to internal obstruction by the phlegm .

• Dryness of the lung with deficiency of yin :

  Main manifestations : Dry cough without sputum or with scanty sputum , dryness of the nose and throat , sore throat , spitting blood or even coughing blood , afternoon fever , malar flush , red tongue , thin coating , thready and rapid pulse .

  Analysis : Dryness is easy to consume the body fluid . If the lung is injured by dryness , the function of the lung will be impaired , manifested by dry cough without sputum or with scanty sputum , dryness of the nose and throat , or sore throat . If the lung vessels are injured by dryness , blood in the sputum or hemoptysis results . If there is deficiency of yin of the lung with endogenous heat , afternoon fever and malar flush may be present . Red tongue , thin coating , and thready rapid pulse are the signs indicating deficiency of yin and dryness of the lung .

Treatment

Invasion by exogenous pathogenic factors :

Method : Select the points from the Taiyin and Yangming Meridians of Hand as the principal ones . Both acupuncture and moxibustion are applied in case of wind cold , while only acupuncture is used in case of wind heat to activate the dispersing function of the lung and to relieve the symptoms .

Prescription : Lieque ( L 7 ) , Hegu ( LI 4 ) , Feishu ( B 13 ) . Supplementary points : Pain and swelling of the throat : Shaoshang ( L II ) . Fever and aversion to cold : Dazhui ( Du 14 ) , Waiguan ( SJ 5 ) .

Explanation : The Taiyin and Yangming Meridians of Hand are exteriorly - interiorly related . Lieque ( L 7 ) , the Luo - ( Connecting ) point , and Hegu ( LI 4 ) , the Yuan - ( Primary ) point , are selected in combination with Feishu ( B 13 ) to strengthen the functional activities of the lung , to relieve symptoms and to eliminate the exogenous pathogenic factors , resulting in smooth flow ofqi of the lung and the normal dispersing function of the lung .

Internal injury :

• Blockage of the lung by phlegm : Method : Select the Back - Shu point and the points of the Yangming Meridian of Foot as the principal points . Both reinforcing and reducing methods should be considered in acupuncture treatment , or combined with moxibustion to strengthen the function of the spleen and to resolve phlegm .

  Prescription : Feishu ( B 13 ) , Zhongwan ( Ren 12 ) , Chize ( L 5 ) , Zusanii ( S 36 ) , Fenglong ( S 40 ) .

  Explanation : The Back - Shu point and the Front - Mil point are the points where qi of thezang - fu organs converges . Feishu ( B 13 ) and Zhongwan ( Ren 12 ) are selected in combination with Zusanii ( S 36 ) , the He - ( Sea ) point of Yangming Meridian of Foot , to strengthen the function of the spleen and harmonize the stomach , remove dampness and resolve phlegm . Chize ( L 5 ) , the He - ( Sea ) point of the Lung Meridian , is able to reduce the pathogenic factors from the lung and relieve cough . Fenglong ( S 40 ) , the Luo - ( Connecting ) point of the Yangming Meridian of Foot , is selected to strengthen smooth transport of qi in the spleen and stomach . Thus the body fluids are normally distributed following the free flow ofqi and phlegm is resolved .

• Deficiency of yin with dryness of the lung :

  Method : Select the Back - Shu point and Front - Mu point of the Lung Meridian as the principal points . Even - movement is applied in acupuncture treatment to nourish yin , eliminate dryness and descend lung qi .

  Prescription : Feishu ( B 13 ) , Zhongfu ( L 1 ) , Lieque ( L 7 ) , Zhaohai ( K 6 ) . Supplementary points : Kongzui ( L 6 ) and Geshu ( B 17 ) in case of coughing blood .

  Explanation : The selection of Feishu ( B 13 ) and Zhongfu ( L 1 ) is a method of combining Back - Shu point and Front - Mu point . It is used to regulate the lung passage and descend lung qi . Lieque ( L 7 ) , the Luo - ( Connecting ) point of the Lung Meridian of Hand - Taiyin , is connected with the Ren Meridian . Zhaohai ( K 6 ) is a point of the Kidney Meridian of Foot - Shaoyin - curving around the genital organ . The two points located up and down are selected as a combination of the Eight Confluent points to nourish yin , eliminate dryness , . clear the throat and descend the lung qi . Kongzui ( L 6 ) , the Xi - ( Cleft ) point of the lung , is indicated in acute cases of the lung . Geshu ( B 17 ) is a blood point of the Eight Influential Points . The two points are used in combination to stop bleeding .

Remarks

If cough is accompanied by fever and asthma , see Common Cold and Asthma .

Cough is often seen in common cold , acute and chronic bronchitis , pneumonia , bronchiectasis and pulmonary tuberculosis .

Cupping : Fengmen ( B 12 ) , Feishu ( B 13 ) .

Cutaneous needle : Tap along the Du Meridian and the Bladder Meridian on the upper part of the back till the skin becomes red or bleeds slightly .