Cough

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

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.

Invasion by the exogenous pathogenic factors

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.

P/T – expel Wind Cold, disperse LU Qi, relieve cough

Acupuncture

[LU7 - LI 4 - BL13 ]

• superficial symptoms: BL11, BL12 (moxa and cupping)
• headache: GB20, DU23
• body and limbs aching: BL60, LI7
• Phlegm: ST40
• Pain and swelling of the throat: LU11.
• Fever and aversion to cold: [DU14 – TH5].
   

Explanation:  

Method: Select the points from  Taiyin LU and Yangming LI 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.

Explanation:  [LU7 - LI4 - BL13] disperse Lung Qi, relieve cough.  Taiyin LU and Yangming LI are exteriorly - interiorly related. LU7, the luo-connecting point, and LI4, the yuan-primary point, are selected in combination with BL13 to strengthen the functional activities of the lung, to relieve symptoms and to eliminate the exogenous pathogenic factors, resulting in smooth flow of qi of the lung and the normal dispersing function of the lung.

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.  

P/T – expel Wind Heat, relieve cough

Acupuncture

 
[LI11 - BL13 - LU5 - DU14]

• sore throat: bleed LU11, LI1
• copious cough: [RN22, ST40]

Explanation:  induce sweat, LI11 (expel Wind Heat), bleed LU5

P/T – moisten Lung, clear Heat, relieve cough

Acupuncture

 
[KI3 - BL13 - KI6 - LU7]

• blood in Phlegm:  [LU6 - SP10]

Explanation:  neutral stimulation, KI 3 (moisten LU), BL13, KI6, LU7 (all for throat/chest/Lung disorders)

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.

P/T – clear Heat, transform Phlegm, descend Lung Qi to relieve cough

Acupuncture

 

[LU5 - LU7 - BL13 - ST40 - LI11]

Explanation:  ST40 for phlegm and LI11 for heat

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.

Acupuncture

Method: Select the metameric shu and mu points of taiyin LU as the principal points. Even - movement is applied to nourish yin, eliminate dryness and descend lung qi.

 
[LU1 - BL13 - BL23 - LU5 - KI6 - KI3 - LU9] or,

• [LU1 - BL13 - LU7 – KI6].
• night sweats:  SI3
• tidal fever:  LI11
• 5 centre heat:  MH8 - KI1 - BL43
• coughing blood: LU6 and BL17

Explanation:  The metameric shu and mu points BL13 and LU1 regulates the lung passage and descend lung qi. LU7, the luo-connecting point of taiyin LU, is connected with Ren.  KI6 is a point of shaoyin KI used for Yin deficient heat.  Compared to LU7, it is located below. 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. LU6, the xi-cleft point of the lung, is indicated in acute cases of the lung. BL17 is a blood point of the Eight Influential Points. The two points are used in combination to stop bleeding. LU9 nourishes LU KI.

P/T – invigorate and strengthen Spleen, transform Damp, eliminate Phlegm, relieve cough

Acupuncture

Method: Select the metameric shu point and the points of yangming ST 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:

 
[LU9 - BL13 - BL20 - SP3 - ST40] or,

• [BL13 – RN12 – LU5 – ST36 – ST40].
• poor appetite: MH 6 - ST 36

Explanation:  [LU9 - BL13] regulate LU Qi, [BL20 - SP3] relieve cough. The metameric shu and mu points are the points where qi of the zang - fu organs converges. BL13 and RN12 are selected in combination with ST36, the he-Sea point of yangming ST, to strengthen the function of the spleen and harmonize the stomach, remove dampness and resolve phlegm. LU5, the he-sea point of taiyin LU, is able to reduce the pathogenic factors from the lung and relieve cough. ST40, the luo-connecting point of the yangming ST, is selected to strengthen smooth transport of qi in the spleen and stomach. Thus the body fluids are normally distributed following the free flow of qi and phlegm is resolved.

P/T – tonify Lung Qi, relieve cough

Acupuncture

 
[LU 9 - BL 13 - LU 7 - ST 36 - RN 6]

• fullness, shortness of breath:  RN17, MH6
• wheezing:  ding chuan

Explanation:  

 
Auricular –LU, trachea, bronchi, shenmen, *medium stimulation

• 7 star – Du & Lung meridian, upper chest
• Injection – RN 17, LU 1, LR 2, BL 11, 12, 13, GB 21, ding chuan, ST 36, ST 40
• Chronic cough should be treated in mid summer with 16 % Bai Fu Zi, 48 % Yang Jin Hya Ye
• 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: [BL12 – BL13].
• Cutaneous needle: Tap along  Du  and taiyang BL on the upper part of the back untill the skin becomes red or bleeds slightly.