🌿 Folk Prescriptions

Cough is an important defensive mechanism of the respiratory system, clearing mucous secretions, harmful substances, and foreign bodies from the throat and entire airway. From a physiological perspective, cough serves a protective function. However, when cough becomes frequent and severe—especially chronic or recurrent—it significantly impacts quality of life, turning cough into a symptom.
Cough is one of the most common chief complaints in respiratory diseases. Statistics show that in the U.S., cough ranks second among reasons for outpatient visits, with annual treatment costs exceeding $1.2 billion. Cough is categorized as acute or chronic. With rising public health awareness and knowledge levels, most acute coughs are self-managed. In clinical practice, we frequently encounter patients with chronic cough, accounting for about two-thirds of all patients.
Chronic cough is generally defined as: 1) lasting at least three weeks; 2) being the sole current symptom; 3) no hemoptysis; 4) no history of chronic respiratory diseases related to cough; 5) recent X-ray examination unable to confirm diagnosis. These conditions have unclear etiology, non-specific symptoms, require exclusion of many factors, complex diagnostic procedures, and are time-consuming and costly, hindering effective diagnosis and treatment. Common causes of chronic cough include: 1) cough variant asthma; 2) postnasal drip syndrome; 3) gastroesophageal reflux disease, etc.
TCM has long recognized cough, generally dividing it into external pathogenic cough and internal injury cough. Cough primarily involves lung disorders, caused by impaired normal functions of lung dispersion and descent. However, the cause is not solely confined to the lungs—“Five Zang and Six Fu organs can all cause cough, not just the lung.”
External pathogenic cough, being newly onset and short in duration, is easier to treat and corresponds to acute cough. Internal injury cough is longer in duration, recurrent, and often involves damage to other organs. Management of chronic cough in TCM follows principles for internal injury cough. Clinical observation reveals that chronic cough mainly falls into two categories: phlegm-heat stagnation and yin deficiency with heat accumulation. These arise from failure to resolve exterior pathogens initially, leading to internal transformation into heat, phlegm-heat stagnating in the throat or trachea (airway), disrupting lung qi dispersion and descent, thus triggering cough. Alternatively, pre-existing yin deficiency allows external pathogens to directly attack the airway, forming yin deficiency with heat accumulation, causing cough. Such coughs typically present as dry cough, throat itching, sensation of a lump in the throat, dry burning or stabbing chest pain, and worsening with exposure to irritants. Treatment focuses on clearing and dispersing, clearing phlegm-heat, resolving nodules, and soothing the throat, with adjunctive cough suppression. For yin deficiency, nourishing yin and moistening the lungs are added. Excellent results are achieved using formulas like Yangyin Qingfei Wan, which nourishes yin, moistens the lungs, clears heat, and soothes the throat—particularly suitable for yin deficiency with heat accumulation. When using commercially available TCM preparations, despite ease of access and convenience, strict adherence to indications and understanding of individual disease characteristics are essential for optimal therapeutic outcomes.
Moreover, it is crucial to recognize that numerous serious conditions can cause cough, including lung tumors, severe infections, and increasingly recognized interstitial lung diseases. These must be taken seriously, with accurate diagnosis and targeted treatment for effective management.