Cough
Cough is one of the most common symptoms presented and can be caused by numerous disorders.
In the Western Tradition, Cough is broadly differentiated into Hot, Cold, Dry or Moist:
- Heat-type Cough
- Cold-type Cough
- Dry-type Cough
- Moist-type Cough
Cough should firstly be classed as acute or chronic.
Acute cases are said to be initiated by Wind, and can come with Heat, Cold or Toxin:
- Acute Wind-Heat: itchy throat, irritable dry cough, yellow phlegm, red face, sweating, fever, fast pulse
- Acute Wind-Cold: feels cold, pale face, cough with white or clear mucus
- Acute Wind-Heat-Toxin: sore throat, feels unwell, harsh cough, yellow mucus, dirty yellow tongue coat
Examples:
Acute Wind-Heat:
- Plantain with Licorice
- Maidenhair, Hyssop and Licorice
- Thyme, Aniseed and Licorice;
- Cinnamon twig, Almond, Licorice
- Ephedra Ma Huang, Cinnamon twig, Licorice
- Violet with Licorice
- Forsythia Lian Qiao, Lonicera Jin Yin Hua, Licorice
- Thyme, Plantain, Violet, Licorice
Chronic Cases can come from various causes. Firstly, it can be differentiated into excess and deficient.
- Excess cases present with strong Cough, still with good energy, and the pulse is not weak
- Deficient cases the person is weak, the Cough is weak and voice usually low. There is a lack of energy, pale face, weak pulse
In Deficient cases, a nourishing diet along with a mix of Lung tonics and medicines to stop Cough are used.
Excess Cough is of various types:
- Wind: spasmodic or erratic dry Cough, nervous disposition, anxious
- Thyme, Aniseed
- Poppy seed, Almond, Licorice
- Valerian, Peony root, Licorice
- Cowlsip root, Peony
- Chebulic Myrobalan, Clove, Tabasheer
- Ephedra Ma Huang, Almond, Licorice
- Cold: Cough with thick white Phlegm, pale tongue with a thick white Coat
- Ginger, Licorice
- Cinnamon, Almond, Licorice
- Atractylodes Bai Zhu, Cinnamon, Ginger, Licorice
- Pinellia Ban Xia, Citrus Chen Pi, Ginger, Licorice
- Ephedra Ma Huang, Schisandra Wu Wei Zi, Ginger, Licorice
- Heat: Cough with yellow Phlegm, red tongue
- Plantain leaf, Violet
- Scutellaria Huang Qin, Platycodon Jie Geng, Licorice
- Tabasheer, Almond, Licorice
Deficient cases are caused by deficient Qi, Yin or Yang:
- Qi Deficient Cough: deficient or weak Cough, low energy, breathless, fatigue and poor digestion
- Coltsfoot, Date, Raisin, Almond, Licorice
- Elecampane, Raisin, Licorice
- Astragalus Huang Qi, Licorice
- Yin Deficient Cough: chronic dry Cough, no sputum, dry mouth and throat with a cracked tongue
- Marshmallow root, Asparagus root, Raisin
- Comfrey root, Plantain
- Ophiopogon Mai Men Dong, Lillium Bai He, Licorice
- Yang Deficient Cough: chronic Cough with white Phlegm, feels the Cold, copious pale urine, lower back pain
- Cinnamon, Walnut, Licorice
- Elecampane, Licorice, Cinnamon, Ginger
- Almond, Fennel seed, Cinnamon
- Walnut, Juniper
- Ginseng, Cinnamon, Licorice
Differential Diagnosis based on Humoral System
Heat-type Cough
Heat-type Cough typically comes with irritable Cough with yellow phlegm, burning sensation, sore throat, red tongue, thirst, and a fast or strong pulse, often with Fever. There maybe flushing of the cheeks, flaring of the nostrils, with high colored Urine. It is alleviated by Cool air but aggravated by Hot air.
Useful Foods include:
- Pumpkin, Amaranth, Purslane
- Poached Egg Yolk, Cow Trotters
Simples
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Date Raisins Almond Barley |
Plantain Poppy Violet Sugar Penids |
Four Cold Seeds Poppy seed Mallow seed Quince seed |
Tragacanth Gum Arabic Marshmallow root Tabasheer |
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1. For Cough with Fever, Barley Water (Avicenna) 2. Gruel of Barley with Sugar (Avicenna) 3. Licorice, Tragacanth, Starch, mixed with Lettuce juice and formed into pills. 4. Boil Dates in Pomegranate juice 5. Cough caused by Heat or Dryness, Cucumber kernel, Pumpkin kernel, Poppy seed, Tragacanth Starch, Licorice, Purslane seed 6. Diacodion, Diatragacanth Frigidum, Sugar Penids (2 drams each), Armenian Earth (1 dram) 7. Diapenidium, Lohoch Sanum & Expertum Compounds |
1. Peppermint, Licorice, Sugar. Used for Wind-Heat cough with sore throat. |
Cold-type Cough
Cold-type Cough is associated with excess clear or white phlegm (sometimes green), a pale face, feeling of cold, a slow pulse. There is no desire to drink and the person fears the Cold.
Useful food includes:
- Raisin, Figs, Dates, Pine nuts, Pitsachio, Almond
- Chicken broth, Meat Soups, Lamb, flesh of Young Birds
- Hydromel, Aged Aromatic Wine
Simples
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Elecampane Licorice Orris |
Myrrh Gum Ammoniac Storax |
Ginger Cinnamon Thyme |
Squill Arum Flowers of Sulphur |
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1. For Chronic Cough, hold a piece of Myrrh under the tongue. (Syrian “Book of Medicine“, trans. by Wallis Budge, 1913) 2. Boil Leek juice in oil and give it to drink when warm. This was said to help vehement Coughs greatly. (Secrets of Alexis) 3. Myrrh or Storax with Honey (Avicenna) 4. Boil Garlic and Dates 5. Mastic with Honey (Avicenna) 6. Sulphur taken in a poached Egg. This is said to be giid for severe Cough. (Avicenna) 7. Honey of Roses, Fig, Raisin, Licorice, Maidenhair (Avicenna) 8. Licorice, Tamarind, Saffron, Tragacanth, Pine nut, Cotton seed, Poppy seed, Dill seed, Aniseed, Myrrh, Saffron, Sugar |
1. Coltsfoot flower, Green tea 2. Apricot kernel (Xing Ren), Licorice, Ginger |
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Orris Powder (Diaireos Simplicis) Electuary of Orris root (Diaireos Salomonis) (Nicholas) Expert Pills for Cough from Cold and Dryness Pills of Black Pepper (Unani) |
Dry-type Cough
Cough with no sputum, dry mouth and throat, increases with hunger and movement but is alleviated by bathing, drinking moist drinks and rest. May come with or without Fever.
Useful Food includes:
Honey; Milk (as long as there is no Fever)
Barley Water (if there is Fever); Almond Soup, Pear soup
Simples
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Licorice Raisin Pear Marshmallow |
Hyssop Violet Sorrel Plantain |
Tragacanth Gum Arabaic Sugar Starch |
Asparagus root Comfrey |
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1. Dry Cough without Expectoration, use Electuaries (Avicenna) 2. Barley Water with White Poppy (seed) and Sugar 3. Cucumber kernel, Musk Melon kernel, Pumpkin kernel, Tragacanth, Bean Flour 4. Cassia Fistula, Almond, Violet |
1. One Pear cored and cubed, Apricot (or Almond) kernel, 10 grams. Boil together in water, sweeten with Sugar to taste. Good for dry Cough. 2. Honey and Egg tea. Put a tablespoon of Honey into a cup of water and bring to boil. Beat and egg in a separate bowl. Pour the Honey tea into the egg and mix well. Drink once or twice daily. This is for Dry or Yin deficienct Cough and Bronchitis. |
Moist-type Cough
Moist or wet cough has excess clear or whitish Phlegm, maybe runny nose and the sound of phlegm in the throat, more common in Moist constitutions, pale and wet or damp tongue coat, and a low, slippery pulse.
Simples
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Honey water Thyme |
Ginger Cinnamon |
Orris juice Birthwort |
Bryony Sarcocolla |
2. Armenian Earth, Tragacanth, Gum Arabic, Peppermint, Hyssop, Thyme, Cinnamon, Maidenhair (Avicenna)
Decoction for Cough and Asthma
Decoction of Thyme (Mesue)
Electuarium Acahristum (Nicholas)
Diathamaron Magna (Nicholas)
Pectoral Powder
Powder for the Lungs
Pills for Difficulty Breathing and Asthma
Eight-Limbed Electuary (Ayurveda)
Pomegranate 9 Decoction (Se bru dgu thang) (Tibetan)
Rhododendron 16 (Dwa lis bcu drug) (Tibetan)
Settle the Lungs 8 (Glo man brgyad pa) (Tibetan)
Thin Phlegm
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Syrup of Poppy Mucilaginous Electuary |
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1. Mastic with Honey 2. Licorice with Tragacanth 3. Galbanum, Sweet Almond 4. Aloe, Honey, mixed and held in the mouth 5. Honey, Butter and Pepper powder, mixed well together 6. Fresh Riose, Pine Nut, Honey, Mastic, Raisin, as an Electuary |
1. Tangerine peel (Ju Hong), Green tea. Used for excess white, hard-to-clear Phlegm. 2. Daikon Radish, Green tea, Salt. Good for excess Phlegm, especially with Lung Heat. |
Other Causes of Cough
Avicenna mentioned various other cause of Cough including:
- Cough from the Stomach–Cough worsens during digestion or while filling the Stomach with digestive disturbance.
- Cough due to Liver disease–symptoms of Liver diseases in addition to Cough
- Cough caused by Suppuration–dryness (but maybe with a wet cough), pain, expectoration of foul sputum
- Cough from Abscess of the Chest–Cough with Chest pain; symptoms of Pleurisy or Pneumonia
Medicines for Cough
There are a number of different medicines that may be indicated in Cough:
- Medicines that directly Stop Cough (Anti-tussives): Coltsfoot, Bitter Almond, Poppy seed
- Medicines that Clears Phlegm (Expectorants): Agaric, Gum Ammoniac
- Open the Airways (Bronchodilators and Antispasmodics)
- Clear Heat and Inflammation (Anti-inflammatories)
- Clear Heat and Poison (Anti-bacterial)
- Relieve Heat and Spasms (Antihistamine)
- Stop Wheezing (Anti-asthmatic)
- Emetics (in low doses clear Phelgm)
- Soothe and nourish Yin (Emollient or Mucilaginous)
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Western Tradition Simples
Cough in General 1. Mint, Pine Nut, Linseed, Pepper, Honey 2. Licorice, Coltsfoot, Almond seed 3. Valerian Pepper, Horehound, Hyssop, Myrrh, Saffron, Honey (Avicenna) 4. Severe Cough, powdered Sulphur as much as you can pick with three fingers [1 gram], give it with a half-roasted Egg each morning for 5 mornings (3 mornings for a child). It will heal any vehement Cough. (The Secrets of Alexis, 1615) Infusion of Thyme Infusion of Mullein Decoction for Cough and Asthma Pectoral Infusion Pectoral Decoction Syrup of Licorice (Mesue) Syrup of Elecampane Syrup of Horehound Syrup of Hyssop of Amaron Syrup of Coltsfoot Compound Syrup of Sweet Pomegranate Conserve of Hyssop flower Sugar Penids (Diapenidion) Sugar Penids w Spices (Diapenidion cum Spicatum) Tragacanth Cooling Powder (Diatragacanth Frigidum) Pectoral Powder Powder for the Lungs Powder of Haly Troches for Cough (Andromachus) Pills of Almond (Unani) Pills to Cleanse the Chest Pills of Black Pepper (Unani) A Sound and Experienced Electuary (Mesue) Aurea Alexandrina Oil of Wax Acute Cough Infusion of Thyme Pectoral Decoction Theriac Chronic Cough 1. Costus, Dill Water, Vinegar (Avicenna) 2. Roasted Linseed, Pepper, Honey (Avicenna) 3. Storax, Honey, mix and lick often 4. Rue, Sage, Cumin (1 handful each), Black Pepper (0.5 oz.). Make a strong decoction, strain and make a syrup with Honey. Take a spoonful morning and night. 5. Sulphur, mixed with animal fat or honey into Pills. Principle compounds for Chronic Coughs are: –Powder of Anise –Athanasia Magna Chronic Cough with Phlegm: –Antipatri –Pills of Agaric –Pills of Almond (Unani) –Pills of Shafa (Unani) –Lohoch of Pine nuts –Sound and Experienced Electuary Chronic Cough with Yin Deficiency: Syrup Against Consumption Syrup of Violet Lohoch of Pine nuts Other: Infusion of Mullein Pectoral Decoction Anti-Asthmatic Syrup (D’Aquin) Syrup of Coltsfoot Compound Syrup of Hyssop (Mesue) Syrup of Hyssop of Amaron Syrup of Licorice (Mesue) Syrup of Horehound Compound Syrup of Calamint Lohoch for Asthma Lohoch of Poppy Lohoch of Raisin Pectoral Powder Powder of Anise (Dianisum) Haly’s Powder Black Troches for Cough (Troch. Bechici Nigra) Troches for Cough (Andromachus) Athanasia Magna Esdra Pills of Agaric (Mesue) Sea Buckthorn 5 (Star bu 5) (Tibetan Medicine) Chronic Cough, with purulent matter / Pus Principle formulas –Diasulphur –Lohoch of Pine nut –Sound and Experienced Electuary Syrup of Horehound Compound Syrup of Calamint Syrup of Jujube (Mesue) Syrup of Hyssop (Mesue) Syrup of Prune Diasulphur Lohoch of Pine nut Copper 25 (Zangs thal nyer lnga) (Tibetan) Death Healing Nectar (Tibetan) Rhinoceros Horn 25 (Bse ru nyer lnga) (Tibetan) Sandalwood 8 (Tsan dan brgyad pa) (Tibetan) Cough with Thick Phlegm Lohoch of Squill Syrup of Hyssop (Mesue) Syrup of Horehound of Hamech Pectoral Powder Pills for Asthma and Shortness of Breath (Unani) Pills of Agaric (Mesue) Pills of Almond (Unani) Er Chen Tang (TCM) Tussi diuturnae–Persistent cough Hyssop Colocynth Athanasia Powder of Anise Compound (Dianisum) (Mesue) Sugar Penids (Diapenidion) (Nicholas) Expert Pills for Cough from Cold and Dryness Pills of Almond (Unani) Pills of Shafa (Unani) To Purge In Cough Note purging is not generally indictaed in acute cough. Indian Electuary Greater (Mesue) Electuary of Dates (Diaphoenicum) (Mesue) Holy Bitters (Hiera Picra) Aloephangine Pills (Mesue) Golden Pills (Nicholas) Pills of Mastic (Mesue) Pills of Agaric (Mesue) To Strengthen after Pectoral Decoction Electuary of Pine Nuts (Looch de Pino) (Mesue) Electuary of Orris Root (Diaireos Salomonis) (Nicholas) Tragacanth Warming Powder (Diatragacanth Calidii) Powder of Calamint Compound (Diacalamint) (Nicholas) Powder of Galangal Compound (Diagalanga) (Mesue) Powder of Cinnamon Compound (Diacinnamonum) |
TCM Classification Wind Cold acute cough with clear mucus, sneezing, runny or blocked nose, no sweating, light fever, headache, muscle aches, feels cold, pale face Gui Zhi Tang Xiao Qing Long Tang Da Qing Long Tang Zhi Sou San Wind Heat acute cough with whitish or yellowish mucus, blocked nose, fever, headache, feels hot Sang Ju Yin Yin Qiao Jie Du Pian Lung Heat dry hacking cough with yellow mucus, fever, red cheeks, chest tightness and pain, feels heat in the chest, dry mouth, thirst, shortness of breath, wheezing. Ma Xing Shi Gan Tang Sang Ju Yin Cold Phlegm chronic cough with excess white or clear mucus, heaviness in the chest, poor appetite, nausea, vomiting, lethargy, thick tongue coat. Er Chen Tang Gan Cao Gan Jiang Tang Ling Gan Wu Wei Jiang Xin Tang Ling Gui Zhu Gan Tang Fu Ling Gui Zhi Gan Cao Da Zao Tang San Zi Yang Qin Tang Hot Phlegm hacking cough, thick yellow, mucus that is hard to clear, sore throat, fullness of the chest, poor appetite, nausea, constipation, fatigue, bitter taste in the mouth, yellow tongue coating Ding Chuan Tang Qing Qi Hua Tan Wan Gun Tan Wan Rhodiola Four Decoction (Sro lo bzhi thang) (Tibetan) Sandalwood 8 (Tsan dan brgyad pa) (Tibetan) Sea Buckthorn 5 (Star bu 5) (Tibetan Medicine) Gentiana algida 15 (Spang rgyan dkar po 15) (Tibet.) Qi deficiency Chronic, weak cough, short of breath, spontaneous Sweating, fatigue, breathless quickly, frequent colds Bu Fei Tang Jiu Xian San Liu Jun Zi Tang Sheng Mai San Shi Quan Da Bu Tang Ren Shen Hu Tao Tang Qi and Yin deficiency Weak cough, dry cough, dry throat, no energy, worse at night; as above but with signs of Yin deficiency Sheng Mai San Lung Yin Deficiency chronic dry cough, dry throat, afternoon or tidal fever, malar flushing, night sweats, heat in soles and palms, fatigue, emaciation Bu Fei E Jiao Tang Mai Men Dong Tang Sha Shen Mai Dong Tang Bai He Gu Jin Tang Mai Wei Di Huang Wan Kidney Yang Deficiency Chronic cough, chronic edema or fluid retention, cold intolerance, heavy limbs, feels the cold, spontaneous sweating, difficult urination, dizziness, palpitations. Zhen Wu Tang |
Special Formulas
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1. Take the fruiting pod of Datura, split, fill with salt, smear with dung, and bake in a fire. When cool, powder and take some with sugar. (Ayurveda) 2. Adhatoda, Ginger, Pepper (equal parts), powder and form pills with Honey. (Ayurveda) PILLS FOR COUGH Storax Myrrh Frankincense Saffron Licorice juice equal parts Form pills the size of a Chickpea. TROCHES OF ANDROMACHUS FOR COUGH Pine nuts 5 drams Starch Gum Arabic Tragacanth White Poppy seed 2 aureos Form pills to be held in the mouth PILLS FOR HOT COUGH OF ZACHARIA Licorice juice Starch Tragacanth Gum Arabic Bitter Almond 1 dram ea. Sugar Candy 3 drams Form Pills with mucilage of Quince seed EXPERT PILLS FOR COUGH Storax Myrrh Opium Form pills with Honey. (Poppy seed can replace Opium) PILLS FOR COUGH Agaric 2 drams Frankincense 1 dram Mix with Hyssop juice and form 10 pills. ELECTUARY FOR COUGH Linseed, dried Raisins, stoned 4 oz. ea. Sweet Almonds Bitter Almonds Pine nuts Orris root Resin 2 drams ea. Frankincense Myrrh Mastic Saffron 1 dram ea. Powder the Linseed, mix with the Raisin pulp, add the rest in powder and mix with Asses Milk, form into rolls and dry. Then powder, and with three times their weight of clarified Honey, form an Electuary. Dose: 1 dram morning and night with wine. A piece may also be held under the tongue to stop Cough. (Secrets of Alexis) |
ELECTUARY OF BUTTER Honey clarified Butter 4 oz. ea. Cumin Annis ½ oz. ea. Licorice 1 oz. Form an Electuary (Lohoch) Used for Cough. It is licked or held in the mouth. (Nicholas Florentini) TROCHES OF POPPY SEED White Poppy seed 30 drams Cucurbita seed Citrul seed Henbane seed 20 drams Starch Tragacanth Gum Arabic 15 drams Form Troches with mucilage of Psyllium Dose: 3 drams with syrup of Poppy or Barley water. For Cough and Catarrh EXPERT PILLS FOR COUGH FROM COLD AND DRYNESS OF PAULUS Myrrh Saffron Pine nut Quince seed Fennel seed Aniseed Sweet Almond Bitter Almond White Poppy seed Licorice juice equal parts Mix with Penid three times the weight, and Fennel juice, and form pills DIAPAPAVER White Poppy seed 30 drams Licorice Tragacanth Sugar Penids 20 drams Gum Arabic Licorice juice Bean meal Fennel seed Aniseed Lettuce seed Starch Purslane seed Mallow seed 10 drams Cucumber seed Melon seed Cucurbit seed 5 drams Confect with clarified Honey, or with Penids and Honey together |