Note: if you are reading this page on cough, please realise that it is not yet finished! It’s been developing over the months and may take many more before I’m happy with it.
So it doesn’t yet cover all the descriptions I want to include. The finished article may look very different. But, this being the season for coughs, I was busy treating them (until where I worked had to close because of the coronavirus), and patients asked for a bit of theory.
Yes! Chinese medicine treats cough, and upper respiratory tract infections, asthma, bronchitis and so on. After all it’s only had 3000 years to think about them. Apparently it’s also been treating coronavirus, which doesn’t surprise me because its Four Levels theory was probably developed to deal with ‘flu.
I’ve also written a page specifically for this: ‘Cope with Fever‘.
But it doesn’t call them cough. First it works out which syndrome in Chinese medicine is the problem. Once it’s worked out the syndrome, it knows how to approach the problem. You’ll be amazed to find out that none of the syndromes is called ‘cough’!
Read on to discover how this is done. But do remember that coughing is your body’s attempt to make itself better. Suppressing your cough with powerful medication may be non-conducive to health. (Why is it not usually good to suppress symptoms? Read here)
Chinese medicine tries to understand the ‘energy imbalance’ behind your cough and, after diagnosing it, to heal the syndromes affected. Success means you feel better, and consequently your cough goes.
What a crazy question you may think! After all, with all the OTC (over-the-counter) medicines available, almost none of them talk about the kind of cough.
Instead they talk about ‘cough, cold and flu’; or cough suppressant (well, at least they’re being honest there!); sometimes you’ll see ‘baby cough’ or ‘adult chesty cough’ and very occasionally ‘tickly, chesty cough’.
But that’s about all. They don’t go into much more detail.
That’s not good enough for Chinese medicine. Let’s be more precise!
This makes a huge difference to how your cough will be treated.
Usually an acute cough is something that you didn’t have until a few days ago. It came on quickly, disrupting your life. Unless you’re unlucky, you expect to get rid of it in a few days.
An acute illness is one that attacks fast, produces immediate symptoms which clear soon: otherwise, it becomes chronic.
Acute coughs may come with sore throat and sudden, possibly high, measurable, fever. But not always. They can last a week or two.
There are two main ways disease – including cough – is considered to invade your body in Chinese medicine.
They are a bit technical so take a little while to get your head round. Not worth the bother if you’re interested in a chronic cough, but here they are for reference:
Acute coughs occur usually because of ‘invasion’ by
A chronic cough is one you’ve had for a while, and the symptoms of which are much the same all the time.
Any fever you get is fairly steady or predictable in its behaviour. In fact you may have no actual fever, but just feel as if you have – whereas with an acute disease you often do have a measurable fever.
Acute coughs usually have what is called Wind as part of their picture. ‘Wind‘ is shorthand, and describes something that, like the wind, is changeable and can be very destructive.
Actually, that’s not quite right. It might be hot, cold or neither, but it evokes in your body a reaction that is either Cold or Hot:
In other words, a cold draft that you think is the cause of your cough might produce in you a Wind-Heat reaction. And vice versa.
Which – you may wonder – is the more healthy reaction, Wind-Heat or Wind-Cold, and which is infectious?
Wind-Heat is more acute and generally quicker to appear. I think it usually shows more vigour in your reaction. A virus or bacteria often causes Wind-Heat. So frequently it’s infectious. And some doctors still give antibiotics for them. If it’s a virus, as in corona virus or ‘flu, learn how to cope with fever here.
Wind-Cold can come on fast too, and with it you may feel you’re going to die – yes really! it lasts longer and is more generally debilitating. I think it is a less healthy reaction. Wind-Cold reactions are not usually accompanied by a viral or bacterial agent, so aren’t usually infectious. However, they can lead to fever. Learn here how to cope with fever.
Chronic coughs continue indefinitely. You probably take something for them on an ongoing basis, even if it’s just boiled sweets. They probably aren’t infectious any longer, even if your phlegm is sometimes a bit green or yellow, which prompts you to visit your doctor for antibiotics.
Antibiotics will probably clear the colour from your phlegm for a while, but leave you open to acute infections again, because they kill off much of your immune system. Read the page on antibiotics.
This is the next important distinction to make. To understand this better, read the page on Excess and Deficiency, which means the same as ‘full or empty’.
It’s important because it tells the person treating you whether first to clear, dissipate your energy, or to support, tonify it. Many medics don’t fully understand this: to be fair, diagnosing it is not always easy, being often a combination of both as when someone has Phlegm-Fullness with underlying Kidney Yang deficiency.
Coughs ‘caught’ from the outside of your body are External, but many coughs arise from ongoing factors inside of your body.
Coughs from internal conditions (‘syndromes‘) may be with you for some time after an acute cough, if not indefinitely.
For example, you might find that after an acute cough, you are left with an occasional dry cough, perhaps with a little phlegm that may be quite deep and hard to raise.
Or, that you never got a cough in the first place, nor even an acute infection, but just found over time that you began to cough – for no apparent reason. What then?
Well, there are lots of possible reasons in Chinese medicine.
However, don’t assume your cough will go of its own accord.
Why? Because it has become chronic, meaning that your body doesn’t know how to throw it out. You’re stuck with it.
Of course, if it isn’t too bad, a change of environment – perhaps a good holiday and lots of sleep – might fix it.
Should that not work, don’t assume the worst and do seek professional help. Chinese medicine has lots of ways to treat syndromes that give rise to internally caused cough.
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Before proceeding, please do read my disclaimer!
It is possible to have more than one kind of a cough at the same time. This means you can have more than one syndrome at a time, eg both a Full and a Deficient syndrome.
NB: the syndromes I suggest below for each condition are only possible diagnoses. They are often the diagnosis, but not always. Don’t be surprised if a qualified practitioner comes to a different conclusion, or approaches treatment from a different perspective.
What about the corona virus cough, you ask. Well … I haven’t knowingly seen it so what follows is somewhat speculative. (And a South African patient tells me that out there the cough is less prevalent. More common there is diarrhoea and phlegm with fatigue.)
Over here, if it is a tickling, tiring cough, dry but with phlegm hard to raise, it may be a combination of Lung Qi deficiency, Lung Phlegm Heat and Lung Yin deficiency. If so, treatment would aim first to clear the phlegm, then boost Qi then, over time, reduce yin deficiency.
At least that’s the order in which I would probably do it.
I would expect acupuncture to ease the cough itself and boost Lung Qi deficiency. It would also help clear the phlegm. Herbs would back this up and deal with the yin deficiency.
But to back this up you’d need to look at your diet. There is more about this with foods to avoid and others to increase on my page Cope with Fever.
Most coughs occur because the Lung function’ of descending energy is blocked, leading to the energy ascending, as cough. Here is a list of Lung syndromes.
Full or Excess syndromes:
Interior syndromes of the Lungs
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