[Concept]

cough or cough, Suwen. The Theory of Cough specifically discusses cough, and puts forward the statement that "Five zang-organs and six fu-organs all can lead to cough., not only the lung." Or called cough, it is often called together with abnormal rising of qi, such as Suwen. "Five zang-organs generation chapter" is called "cough abnormal rising of qi". In the book Jingui Yaolue, sometimes "cough abnormal rising of qi" is called together, and sometimes "phlegm-fluid retention cough" is called together. . Jingui Yaolue, "Wuwei Medical Slips of the Han Dynasty" is also called "cough", "cough abnormal rising of qi". It can be seen that before the Han Dynasty, cough, cough, and cough were synonymous, and cough was particularly closely related to abnormal rising of qi (breathing) and phlegm-fluid retention, so they were often referred to together.

Zhubing Yuanhou Lun clearly distinguishes cough, abnormal rising of qi, and phlegm-fluid retention, and discusses each in its own section. The "Fifteen Treatises on Cough Disease" points out "For cough, the lungs feel cold, and if it is mild, it becomes cough." If it is caused by warm and heat evil, separate "seasonal epidemic cough syndrome" and "warm disease cough syndrome" will be discussed separately. If it is caused by internal damage, there will be "consumptive disease cough syndrome". Suwen Bingji Qiyi Baomingji said: "Cough means no phlegm but has sound, lung qi means injury and unclearness. Cough means no sound but phlegm, and spleen dampness moves and makes phlegm. Cough means there is phlegm but sound , it is caused by injury to the lung qi, which is caused by dampness in the spleen, causing cough. "

There is no need to distinguish between cough, cough and cough in clinical practice, and they can be collectively called cough. Cough is a clinical manifestation of phlegm-fluid retention in the lungs. If cough is phlegm-fluid retention, it is mostly a lung and spleen disease syndrome. If cough is abnormal rising of qi, it is mostly a lung and kidney disease syndrome (abnormal rising of qi and phlegm-fluid retention can be See the discussion in panting and Sputum articles).

[Syndrome Analysis]

1. Wind-heat Attacks the Lungs︰Symptoms include unpleasant cough and yellow or yellow-white phlegm that is thick and thick. Dry mouth, sore throat, headache, nasal congestion, body heat aversion to wind sweating, or slight aversion to wind cold, thin yellow tongue coating, floating pulse. Wind-heat pathogenic qi invades the lungs, lung qi fails in purification, and heat burns body fluids, so the cough is uncomfortable, the phlegm is thick and yellow, and it is thick and sore, and the throat is sore; wind-heat disturbs the clearing, and the blood counterflow in the head is disordered, causing headache. ; healthy qi and pathogenic qi are in conflict, and the function is excited, so the body temperature rises and fever is seen; pathogenic qi attacks the outside, and the function of the outside of the body is abnormal, then aversion to wind; wind-heat evil is responsible for the rise and release, causing striae and interstice opening and discharging and sweating. To treat dispersing wind, ventilating lung and relieving cough, choose Mulberry Leaf and Chrysanthemum Decoction plus or minus. Wind-heat attacks lung cough and cough may also appear to be superficially resolved or unresolved but the lung heat has become inflamed.
2. Wind-heat Attacks the Lungs︰Symptoms include unpleasant cough and yellow or yellow-white phlegm that is thick and thick. Dry mouth, sore throat, headache, nasal congestion, body heat aversion to wind sweating, or slight aversion to wind cold, thin yellow tongue coating, floating pulse. Wind-heat pathogenic qi invades the lungs, lung qi fails in purification, and heat burns body fluids, so the cough is uncomfortable, the phlegm is thick and yellow, and it is thick and sore, and the throat is sore; wind-heat disturbs the clearing, and the blood counterflow in the head is disordered, causing headache. ; healthy qi and pathogenic qi are in conflict, and the function is excited, so the body temperature rises and fever is seen; pathogenic qi attacks the outside, and the function of the outside of the body is abnormal, then aversion to wind; wind-heat evil is responsible for the rise and release, causing striae and interstice opening and discharging and sweating. To treat dispersing wind, ventilating lung and relieving cough, choose Mulberry Leaf and Chrysanthemum Decoction plus or minus. Wind-heat attacks lung cough and cough may also appear to be superficially resolved or unresolved but the lung heat has become inflamed.
3. Wind-heat Attacks the Lungs︰Symptoms include unpleasant cough and yellow or yellow-white phlegm that is thick and thick. Dry mouth, sore throat, headache, nasal congestion, body heat aversion to wind sweating, or slight aversion to wind cold, thin yellow tongue coating, floating pulse. Wind-heat pathogenic qi invades the lungs, lung qi fails in purification, and heat burns body fluids, so the cough is uncomfortable, the phlegm is thick and yellow, and it is thick and sore, and the throat is sore; wind-heat disturbs the clearing, and the blood counterflow in the head is disordered, causing headache. ; healthy qi and pathogenic qi are in conflict, and the function is excited, so the body temperature rises and fever is seen; pathogenic qi attacks the outside, and the function of the outside of the body is abnormal, then aversion to wind; wind-heat evil is responsible for the rise and release, causing striae and interstice opening and discharging and sweating. To treat dispersing wind, ventilating lung and relieving cough, choose Mulberry Leaf and Chrysanthemum Decoction plus or minus. Wind-heat attacks lung cough and cough may also appear to be superficially resolved or unresolved but the lung heat has become inflamed.
4. Wind-heat Attacks the Lungs︰Symptoms include unpleasant cough and yellow or yellow-white phlegm that is thick and thick. Dry mouth, sore throat, headache, nasal congestion, body heat aversion to wind sweating, or slight aversion to wind cold, thin yellow tongue coating, floating pulse. Wind-heat pathogenic qi invades the lungs, lung qi fails in purification, and heat burns body fluids, so the cough is uncomfortable, the phlegm is thick and yellow, and it is thick and sore, and the throat is sore; wind-heat disturbs the clearing, and the blood counterflow in the head is disordered, causing headache. ; healthy qi and pathogenic qi are in conflict, and the function is excited, so the body temperature rises and fever is seen; pathogenic qi attacks the outside, and the function of the outside of the body is abnormal, then aversion to wind; wind-heat evil is responsible for the rise and release, causing striae and interstice opening and discharging and sweating. To treat dispersing wind, ventilating lung and relieving cough, choose Mulberry Leaf and Chrysanthemum Decoction plus or minus. Wind-heat attacks lung cough and cough may also appear to be superficially resolved or unresolved but the lung heat has become inflamed.
5. Wind-heat Attacks the Lungs︰Symptoms include unpleasant cough and yellow or yellow-white phlegm that is thick and thick. Dry mouth, sore throat, headache, nasal congestion, body heat aversion to wind sweating, or slight aversion to wind cold, thin yellow tongue coating, floating pulse. Wind-heat pathogenic qi invades the lungs, lung qi fails in purification, and heat burns body fluids, so the cough is uncomfortable, the phlegm is thick and yellow, and it is thick and sore, and the throat is sore; wind-heat disturbs the clearing, and the blood counterflow in the head is disordered, causing headache. ; healthy qi and pathogenic qi are in conflict, and the function is excited, so the body temperature rises and fever is seen; pathogenic qi attacks the outside, and the function of the outside of the body is abnormal, then aversion to wind; wind-heat evil is responsible for the rise and release, causing striae and interstice opening and discharging and sweating. To treat dispersing wind, ventilating lung and relieving cough, choose Mulberry Leaf and Chrysanthemum Decoction plus or minus. Wind-heat attacks lung cough and cough may also appear to be superficially resolved or unresolved but the lung heat has become inflamed.
6. Wind-heat Attacks the Lungs︰Symptoms include unpleasant cough and yellow or yellow-white phlegm that is thick and thick. Dry mouth, sore throat, headache, nasal congestion, body heat aversion to wind sweating, or slight aversion to wind cold, thin yellow tongue coating, floating pulse. Wind-heat pathogenic qi invades the lungs, lung qi fails in purification, and heat burns body fluids, so the cough is uncomfortable, the phlegm is thick and yellow, and it is thick and sore, and the throat is sore; wind-heat disturbs the clearing, and the blood counterflow in the head is disordered, causing headache. ; healthy qi and pathogenic qi are in conflict, and the function is excited, so the body temperature rises and fever is seen; pathogenic qi attacks the outside, and the function of the outside of the body is abnormal, then aversion to wind; wind-heat evil is responsible for the rise and release, causing striae and interstice opening and discharging and sweating. To treat dispersing wind, ventilating lung and relieving cough, choose Mulberry Leaf and Chrysanthemum Decoction plus or minus. Wind-heat attacks lung cough and cough may also appear to be superficially resolved or unresolved but the lung heat has become inflamed.
7. Phlegm Drink︰Symptoms include cough, white sputum, coughing that stops immediately after the phlegm comes out, accompanied by chest and epigastrium swelling and tightness, decreased diet; or nausea, vomiting, or facial swelling. The tongue coating is white and greasy, and the pulse is moist and slippery. phlegm-dampness means that the cough is caused by phlegm, so it has the characteristic that the cough stops immediately after the phlegm comes out. It is a comprehensive manifestation of phlegm-dampness and dysfunction of spleen in transportation (reduced diet, chest distension, or vomiting). To treat invigorating spleen and drying dampness, resolving phlegm and relieving cough, choose Two Old Ingredients Decoction combined with Stomach-Calming Powder addition and subtraction. If phlegm-dampness accumulates and turns into heat, you will see yellow and thick phlegm, yellow and greasy fur, slippery and rapid pulse, etc. This is phlegm-heat cough. To treat it, clearing heat and resolving phlegm should be treated with Phragmites Stem Decoction TogetherMinor Chest Bind Decoction adds and subtracts. If there is phlegm-fluid retention or internal accumulation of water and vapor, combined with cold evil, resulting in internal stasis of cold drinks, or cough with external evils that have not been purified, coughing up white thin phlegm, fullness and tightness in the chest and diaphragm, and even vomiting Cold shape etc. To treat with warming lung and resolving fluid retention, choose Minor Green-Blue Dragon Decoction plus or minus.
8. Spleen Qi Deficiency︰Symptoms include cough, multi-colored white phlegm that is easy to cough up, black end swallowwort root swelling, shortage of qi, physical fatigue, cold sensitivity, abdominal distention, loss of appetite, and bland taste in mouth. The tongue coating is thin and white, and the pulse is thin. Mainly due to weak spleen qi deficiency, lack of power in transportation and transformation, accumulation of dampness and phlegm, phlegm-dampness blocking the lungs and cough, so the phlegm is white and multi-colored and easy to be coughed up. This disease also has the symptoms of weak spleen qi deficiency (shortage of qi, face and face). blackend swallowwort root swelling, lack of food, loose stool, etc.). To treat the spleen and replenishing qi, drying dampness and resolving phlegm, choose Six Gentlemen Decoction addition and subtraction.
9. Wind-heat Attacks the Lungs︰Symptoms include unpleasant cough and yellow or yellow-white phlegm that is thick and thick. Dry mouth, sore throat, headache, nasal congestion, body heat aversion to wind sweating, or slight aversion to wind cold, thin yellow tongue coating, floating pulse. Wind-heat pathogenic qi invades the lungs, lung qi fails in purification, and heat burns body fluids, so the cough is uncomfortable, the phlegm is thick and yellow, and it is thick and sore, and the throat is sore; wind-heat disturbs the clearing, and the blood counterflow in the head is disordered, causing headache. ; healthy qi and pathogenic qi are in conflict, and the function is excited, so the body temperature rises and fever is seen; pathogenic qi attacks the outside, and the function of the outside of the body is abnormal, then aversion to wind; wind-heat evil is responsible for the rise and release, causing striae and interstice opening and discharging and sweating. To treat dispersing wind, ventilating lung and relieving cough, choose Mulberry Leaf and Chrysanthemum Decoction plus or minus. Wind-heat attacks lung cough and cough may also appear to be superficially resolved or unresolved but the lung heat has become inflamed.
10. Wind-heat Attacks the Lungs︰Symptoms include unpleasant cough and yellow or yellow-white phlegm that is thick and thick. Dry mouth, sore throat, headache, nasal congestion, body heat aversion to wind sweating, or slight aversion to wind cold, thin yellow tongue coating, floating pulse. Wind-heat pathogenic qi invades the lungs, lung qi fails in purification, and heat burns body fluids, so the cough is uncomfortable, the phlegm is thick and yellow, and it is thick and sore, and the throat is sore; wind-heat disturbs the clearing, and the blood counterflow in the head is disordered, causing headache. ; healthy qi and pathogenic qi are in conflict, and the function is excited, so the body temperature rises and fever is seen; pathogenic qi attacks the outside, and the function of the outside of the body is abnormal, then aversion to wind; wind-heat evil is responsible for the rise and release, causing striae and interstice opening and discharging and sweating. To treat dispersing wind, ventilating lung and relieving cough, choose Mulberry Leaf and Chrysanthemum Decoction plus or minus. Wind-heat attacks lung cough and cough may also appear to be superficially resolved or unresolved but the lung heat has become inflamed.
11. Kidney Yang Deficiency︰Symptoms include cough, with clear and thin phlegm in a foamy state. If the cough is severe, there will be nausea and shortness of breath, which will be aggravated by exertion. blackend swallowwort root swelling, or swelling of the limbs. The fur is white and light, and the pulse is heavy and thin. It is caused by multifactorial body yang deficiency or old age and frailty, persistent cough, and kidney disease. The kidney governs the bones, stores essence and receives qi. If kidney yang deficiency is insufficient, it will not be able to receive qi, so there will be frequent coughing and wheezing, or it may often cause cough and difficulty breathing, or even feeling that the qi rushes up from under the navel. After exertion, All symptoms will be aggravated; the kidney governs water, and if kidney yang deficiency occurs, the water and dampness will turn into phlegm, and the phlegm will have a salty taste. There is insecurity of kidney qi, so if the cough is severe, there will be drowning. To treat warming and tonifying kidney yang, choose Kidney Qi Pill plus Schisandra Fruit, Psoralea, etc. If you have severe cough and asthma, and the phlegm is heavy and salty, you should nourish the kidneys and resolving phlegm, then choose Jian Six Gentiemen Metal and Water Decoction.
12. Liver Fire Invading Lung︰Symptoms include cough qi counterflow, where the phlegm is not clear, either like plum cores, or like broken flocculation, which is difficult to cough up. Coughing may cause flushing and hypochondriac pain. Dry throat, dysphoria and irritability. The tip of the tongue is red, the fur is thin, yellow and dry, and the pulse is stringy and rapid. This syndrome is mostly caused by stagnation of anger damaging the liver, failure of the liver to relieve diarrhea, excessive liver damage to the lungs, and lung qi ascending counterflow. The symptoms are characterized by symptoms of liver depression (suffocation or gushing in the chest and ribs, depressed mood, dysphoria, irritability, etc.) and ascending counterflow symptoms (cough counterflow or wheezing due to coughing, etc.), as well as phlegm accumulation in qi depression. The symptoms (unpleasant discharge of phlegm, or phlegm such as plum cores, loose flocculation, etc.) are common. To treat soothing the liver and resolving phlegm, regulating qi and resolving phlegm, choose Peripatetic Powder combined with Pinellia and Magnolia Bark Decoction plus or minus. If the fire turns into depression, bitter taste in the mouth, yellow phlegm, red tongue, stringy and rapid pulse, it is advisable to clear the liver and draining fire, moistening dryness and resolving phlegm, and then choose clearing the lung and resolving phlegm decoction combined with Dai Ha powder.

Wind-cold fettering exterior and wind-heat attacking the lungs are both caused by feeling external evils, so both have exterior syndrome/pattern. The two syndromes should be distinguished by the characteristics of cough, the nature of phlegm, and the combined exterior syndrome/pattern. , which is the key point for identification.

The two syndromes of dryness damage to the lungs and summerheat dampness are also caused by external evils, so exterior syndrome/pattern can also be seen. However, its onset is seasonal. Because the nature of the pathogenic factors is different, the clinical manifestations are also different. This can be distinguished from wind-cold fettering exterior and wind-heat attacking the lungs.

Lung heat and dryness of the lungs, heat is the gradual progression of fire, and fire does not have dryness. Therefore, although the disease cause of these two syndromes is heat evil and the other is dryness, their symptoms are similar (such as Coughing causes pain in the chest and hypochondrium), which should be differentiated based on the different symptoms and symptoms.

Phlegm-fluid retention and spleen deficiency both suffer from phlegm-dampness, but their disease cause mechanisms of disease are different.

Cough is a symptom. The first step is to identify whether it is cough due to external contraction or cough due to internal damage. Generally speaking, cough due to external contraction often has obvious causes, has a rapid onset, and has a short course. It is characterized by exterior syndrome/pattern and mostly excess syndrome/pattern. Cough due to internal damage often has no obvious cause, has a slow onset and a long course, especially lung yin deficiency and kidney yang deficiency cough, which does not heal for a long time or recurs repeatedly. This is mostly due to deficiency syndrome/pattern.

To differentiate the syndrome of cough, we must grasp the characteristics of cough and phlegm. For example, if the cough is severe during the day, it is often hot and dry, and if the cough is severe at night, it is often kidney deficiency, spleen deficiency or phlegm-dampness. In terms of phlegm differentiation, those with clear and thin phlegm belong to dampness, those with thick phlegm belong to heat and dryness; those with white phlegm belong to wind, cold, and dampness, and those with yellow color belong to heat; those with excessive phlegm belong to phlegm-dampness and kidney deficiency, and those with less phlegm are mostly wind-cold fettering exterior or yin deficiency, etc. Dry cough with little or no phlegm is difficult to come out.

[Documentation]

1. Danxi Xinfa ． "Cough": "If you cough a lot in the first half of the day, you have stomach fire. Use Fritillaria Bulb and Gypsum to reduce stomach fire; if you cough a lot in the afternoon, you have yin deficiency. , must use Four Ingredients Decoction, add fried cypress, Anemarrhena to reduce fire; those who cough at dusk have fire floating in the lungs, so it should not be used For cooling medicine, Schisandra Fruit and Chinese Gall should be collected and lowered; for those who have a lot of cough at midnight, there is food accumulation in the stomach. At this time, the fire energy flows into the lungs, Use Anemarrhena and Chinese Wolfberry Root-bark to reduce lung fire."
2. Jingyue Quanshu. "Cough": "Cough, if it occurs in autumn or winter, it is cold and hot. But to relieve the cold, the heat will dissipate on its own. It is suitable to Liu'an Jian, Two Old Ingredients Decoction , Jian Six Gentiemen Metal and Water Decoction, check the deficiency and excess. It should be used by the elderly. If the internal heat is severe, it may be supplemented by Skullcap Root, Anemarrhena and so on."
3. Zabing Yuanliu Xizhu. Origin of Cough Asthma: "A cough without phlegm is called a cough. It is not without phlegm. The phlegm is not easy to come out. The disease is in the lungs. The lungs dominate the sound, so the sound comes first and then the phlegm. A cough without phlegm is called a cough. It is not silent because the phlegm comes out with coughing. The sound is not very loud, the disease is in the spleen, and the spleen stores phlegm, so the phlegm comes out and the cough stops."