Cough
Coughing is a natural reflex in which the body tries to keep the airways free. A cough can be dry and irritating, but also accompanied by mucus. Some cough symptoms suddenly occur with a cold or other respiratory infection and disappear within a short period of time. Others just stay there for weeks or return regularly.
The cause of cough can be very different. Think of an respiratory infection, asthma, allergies, mucus that runs from the nose to the throat, reflux, smoking or certain medications. Therefore, it is important to have the cause assessed in case of long-term cough.
Acupuncture and Chinese herbal medicine can be used in certain forms of cough. Within Chinese medicine, not only that you cough, but above all the type of cough, the presence and colour of mucus, additional symptoms and factors that affect the cough.
Possible Western disorders
Cough may occur, among other things:
- colds and other respiratory infections;
- acute or chronic bronchitis;
- pneumonia;
- asthma;
- COPD and emphysema;
- allergic rhinitis and postnasal drip;
- sinusitis;
- whooping cough;
- gastrooesophageal reflux;
- irritation from smoking, dust or other inhaled substances;
- certain medicines, including ACE inhibitors.
Less often, long-term cough may be associated with more severe lung or heart disease. Therefore, medical assessment is important in case of unexplained or prolonged coughing.
Possible causes
Acute cough is usually caused by irritation or inflammation of the airways, for example during a cold or other respiratory infection. Also allergens, smoke, dust, dry air and air pollution can stimulate the cough reflex.
During long-term coughs, different mechanisms may play a role. Phlegm can run down the throat from nose or sinuses, stomach contents may irritate the throat and airways in reflux, and some medicines may cause dry coughs. Smoking and prolonged exposure to irritating agents may also cause chronic stimulation of the airways.
Sometimes the initial respiratory infection has already disappeared while the cough remains for weeks. The airways can remain more sensitive after an infection.
How can acupuncture help with coughing?
Acupuncture treatment is tailored to the nature and cause of the cough. This includes checking whether the cough is dry or productive, which type of mucus is present and whether, for example, cold air, exercise, food or stress influence the symptoms.
Treatment may be directed at:
- reduce cough stimulation and frequency of coughing;
- reduce mucus and support coughing;
- treat dry or irritated throat and airways;
- treat additional complaints during or after respiratory infection;
- treat fatigue and reduced capacity for activity in chronic cough;
- reduce tension when stress or emotions clearly provoke or strengthen the cough.
In case of severe or unexplained respiratory complaints, acupuncture is additional to necessary regular diagnostics and treatment.
How can Chinese herbal medicine help with coughing?
Chinese herbal medicine offers many possibilities to adjust treatment to different types of cough. For example, a dry cough requires a different approach than a cough with lots of white mucus or thick yellow mucus.
The treatment may include:
- reduce cough stimulation;
- reduce mucus and support coughing;
- humidify dry and irritated airways;
- treat acute respiratory complaints when an infection is part of the image;
- in chronic weak cough, also treat the underlying pattern.
Herbs can give daily between treatments by support. Which herbs are used depends on the full grievance picture and can change during recovery.
Sustained cough after respiratory infection
A common situation is that colds, flu or other respiratory infection are largely over, but the cough persists. Within TCM there is no single fixed pattern for post-infectious cough.
Sometimes the airways are mainly irritated and a dry cough remains. In others, residual heat is present, for example with a dry nocturnal cough, thirst, warmth or mild sweating. According to TCM, a more severe thermal image can damage the liquids and Yin of the Lungs, thus maintaining dryness and persistent cough. Also left behind Phlegm can maintain the cough.
Therefore, a post-infectious cough is not automatically treated the same as the original cold.
How does Chinese medicine view coughing?
Within TCM, the Lung organ system plays the central role in coughing. According to this theory, Lung-Qi should mainly move down. When this movement is disturbed and Qi moves up, the cough reflex occurs.
In case of acute cough, the lung function can be temporarily disturbed by, for example, Wind-Cold, Wind-Heat or Wind-Dryness. In other people, the normal movement of Lung-Qi is hampered by Phlegm, the TCM term for an accumulation that often coincides with actual mucus in respiratory complaints.
In chronic cough, a shortage of Lung-Qi or Lung-Yin can play an important role. Other TCM organ systems can also have influence. The Spleen is involved in the processing of liquids and thus in the development of Dampness and Phlegm. According to TCM, the Kidneys support breathing and may become involved in long-term lung weakness. Liver-Qi can also affect lung function, which increases stress and emotions in some people.
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed; others are possible. Also, multiple patterns can occur at the same time, allowing you to recognize yourself in different descriptions. Not everyone with the same pattern has all the symptoms mentioned. The pattern is determined based on the overall picture.
Most common TCM patterns
Wind-Cold
Brief explanation
Wind-Cold is especially relevant in the event of a sudden cough during a cold. According to TCM, Wind-Cold temporarily obstructs the normal spreading and descending function of the Lungs. The complaint image is characterized by clear or white mucus.
Common symptoms
- sudden, heavy cough;
- thin, clear or white mucus;
- sometimes initially a dry cough;
- chills and crookedness;
- little or no sweating;
- runny nose with clear, watery mucus;
- nose congestion and sneezing;
- stiff neck and muscle pain;
- tickle or irritation in the throat;
- sometimes breathlessness or wheezing.
Examples of Western disorders
This pattern can be recognised in colds, influenza and other acute respiratory infections.
Wind-Heat
Brief explanation
Wind-Heat has a warmer and more irritated airway image on the foreground. The cough can start dry, but also accompanied by yellow, sticky and difficult to cough up mucus.
Common symptoms
- acute dry or hard cough;
- yellow or greenish, sticky mucus;
- dry, tickling or sore throat;
- fever or feeling warm;
- low chills;
- mild to moderate sweating;
- thirst;
- yellow or green nasal fluid;
- headache.
Examples of Western disorders
This pattern can be recognised in colds, throat and respiratory infections, acute bronchitis and other infections involving cough and heat symptoms.
Wind-Dryness
Brief explanation
Wind-Dryness focuses on dryness irritation. According to TCM, the Lungs are particularly sensitive to dehydration of their mucous membranes. Dry outdoor air can play a role, but also long-term stay in highly heated, refrigerated or dehumidified rooms.
Common symptoms
- dry, hard stimulant;
- little or no mucus;
- where appropriate, a small amount of sticky mucus that is difficult to release;
- dry or painful throat;
- dry mouth and nose;
- dry or cracked lips;
- dry skin;
- sometimes mild fever or chills.
Wind-Dryness can have a warmer or cooler character. In the warm form thirst and warmth are more in the foreground; in the cool form more crunchiness.
Examples of Western disorders
This pattern can be recognised in case of dry cough during or after respiratory infection and in case of respiratory irritation due to a dry environment.
Heat in the Lungs
Brief explanation
At Heat in the Lungs, the thermal image is deeper than at Wind-Heat. It can occur when an acute respiratory infection pulls further in. The cough is often powerful and painful and is accompanied by obvious heat and dryness symptoms.
Common symptoms
- hard, loud or painful cough;
- little or no mucus;
- any sticky mucus that is difficult to loosen;
- heat, pressure or chest pain;
- fever;
- red or warm face;
- dry mouth;
- thirsty;
- sometimes breathlessness or wheezing;
- constipation.
Examples of Western disorders
This pattern can be recognized in acute bronchitis, respiratory infections and pneumonia. In case of high fever, breathlessness or severe feeling sick medical assessment is necessary.
Phlegm-Dampness
Brief explanation
Phlegm-Dampness is an important pattern for long or regular productive coughs. According to TCM, liquids are not sufficiently processed and a build-up of Dampness and Phlegm hinders lung function. De Spleen often plays an important role in this.
Common symptoms
- chronic or recurrent cough;
- a lot of white, clear or sometimes thick mucus;
- mucus usually relatively easy to cough up;
- squirming or slimy sound on the chest;
- chest pressure or feeling heavy;
- symptoms often get worse in the morning;
- cough may get worse after certain diets;
- fatigue and sluggishness;
- feeling heavy in the body;
- low appetite;
- bloated abdomen;
- sometimes nausea or loose stools.
Examples of Western disorders
This pattern can be recognised in chronic bronchitis, COPD, bronchiectasia and asthma with high mucus.
Phlegm-Heat
Brief explanation
Phlegm-Heat combines mucus accumulation and Heat, which makes the mucus thicker and stickier according to TCM. This can occur acutely during an infection, but also when an existing Phlegm-Dampness pattern gets warmer.
Common symptoms
- firm, productive cough;
- a lot of thick yellow or green mucus;
- mucus that is difficult to cough up;
- cough often worse at night or early in the morning;
- pressure, tightness or warmth on the chest;
- dry mouth and throat;
- thirst;
- possible fever;
- irritability or restlessness;
- sometimes breathlessness or wheezing.
Examples of Western disorders
This pattern can be recognized in acute and chronic bronchitis, bronchiectasies and other respiratory infections with highly coloured sputum.
Liver-Fire disturbs the Lungs
Brief explanation
In this pattern there is a clear relationship between cough and emotional tension. Long-term stagnation of Liver-Qi can develop according to TCM Heat and then disrupt the normal decreasing movement of Lung-Qi.
The cough can therefore occur in seizures and clearly worsen during stress, frustration, anger or emotional restlessness.
Common symptoms
- sudden or seizureal hard cough;
- clear worsening due to stress or emotions;
- pressure or chest pain or flanking;
- difficult to cough up mucus;
- yellow mucus, if any;
- continuous need to scrape the throat;
- dry mouth and throat;
- thirst;
- bitter taste;
- irritability or rapid anger;
- headache;
- Sometimes sleep worse.
Examples of Western disorders
A similar sign of complaints may occur with stress-related cough and respiratory disorders where tension is a clear triggering or worsening factor. Reflux may also be part of a related grievance image according to the source.
Lung-Qi-deficiency
Brief explanation
With Lung-Qi deficiency, TCM's lung function is not sufficiently powerful to support Qi's breathing and normal decline in movement. Therefore, coughing is usually less potent than excessive patterns and easily gets worse when someone is tired.
Common symptoms
- chronic, weak cough;
- coughing costs energy and makes tired;
- symptoms worse with exercise or fatigue;
- low mucus or thin, clear/white mucus;
- shortness of breath;
- soft or weak voice;
- little need to talk;
- easy sweating;
- sensitivity to wind and cold;
- regular colds or other respiratory infections;
- pale radiating pain;
- general fatigue.
If the Spleen is also weakened, little appetite, bloated abdomen, loose stools and more mucus can be avoided.
Examples of Western disorders
This pattern can be recognised in chronic bronchitis, asthma, COPD or emphysema, especially when fatigue, low capacity for activity and recurrent respiratory infections are present.
Lung-Yin-deficiency
Brief explanation
Lung-Yin deficiency is a more chronic dryness pattern. According to TCM, sufficient Yin and moisture are lacking to moisten the Lungs and airways. This creates a dry, weak and often persistent cough. Long-term illness, recurrent airway problems or previous Heat in the Lungs may precede it.
Common symptoms
- chronic dry cough;
- little or no mucus;
- any sticky mucus that is difficult to loosen;
- dry mouth and throat;
- dry or hoarse voice;
- cough often worse at night or at night;
- fatigue;
- feeling warm in the chest, hands or feet;
- night sweats;
- sometimes mild warmth or hotness later in the day;
- restlessness or poor sleep.
In deeper Yin deficiency, according to TCM, the kidneys may also be involved, for example with low-back symptoms, dizziness or nocturnal urination.
Examples of Western disorders
This pattern can be recognised in long-term dry cough and chronic pulmonary diseases such as COPD, chronic bronchitis or bronchiectasia when dryness and low sputum are at the forefront.
When do you get a cough assessment?
An acute cough with an uncomplicated cold usually resolves on its own. Have a cough assessed by a doctor if it persists, keeps returning, clearly worsens or has an unknown cause.
Talk to a doctor more quickly, including breathlessness, high or persistent fever, clear chest pain, severe illness or marked deterioration.
Coughing up blood should be medically assessed. This also applies to unexplained weight loss, persistent hoarseness or swallowing problems and a new or changing long-lasting cough in someone who smokes or has smoked for a long time.
Outlook
The course of treatment depends on the cause, duration and severity of the cough and on the underlying TCM pattern. A recent cough may react relatively quickly, while a cough that has been present for weeks or months usually requires more time.
The type of cough also plays a role. In the case of persistent post-infectious cough, for example, irritation, residual Heat, Phlegm or Dryness may be present. In chronic patterns such as Lung-Qi or Lung-Yin deficiency, a longer treatment course is usually required.
In the initial phase, one treatment per week is common. For acute or severe symptoms can be treated temporarily two to three times a week. As soon as the cough decreases clearly, the frequency can be reduced. These are guidelines; the treatment plan is always adapted to the individual situation.
Contact
Do you have cough and want to know if acupuncture or Chinese herbal medicine can help with your complaints? Please feel free to contact us to discuss your situation or make an appointment.