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Cough

Definition
 
Western
Cough is a sudden reflex which helps in the clearance of excess secretions, irritants, foreign particles and microbes out of the breathing passage. According to the duration, coughs can be classified as acute or chronic. Acute coughs generally last for 2-3 weeks whilst chronic coughs can persist for up to 8 weeks.
 
Traditional Chinese Medicine (TCM)
Cough is one of the most commonly seen symptoms in the Lung system. It occurs when the breathing mechanism and its related physiological functions of the Lung system become impaired. Phlegm may be present in some cases.
 
Classifications and Accompanying Symptoms Displayed in TCM Context
 
Acute Coughs
Can be present as clear, watery phlegm, scratchy throat, nasal congestion, runny nose, headaches, body aches; or viscous phlegm, hoarse coughing sound, sore throat, viscous nasal discharge, thirst, headache or the body constantly feeling hot.
 
Chronic Coughs
Primary symptoms of chronic coughs with large amount of phlegm are repeated occurrence of coughs with large amount of viscous and sticky phlegm (white or grey). Cough aggravates in the morning or after food consumption. Other accompanying symptoms include chest tightness, nausea or fatigue. Chronic dry coughs are often seen with symptoms such as short and rapid coughing sound, no or little white viscous phlegm, or phlegm with strains of blood. Other accompanying symptoms: Gradual hoarseness in voice, dryness in mouth cavity, hot flushes in the evenings, night sweats, gradual loss of weight or fatigue.
 
 
Causes
 
·          Cough is one of the common symptoms for respiratory tract infections such as the common cold, pneumonia, whooping coughs, or tuberculosis.
·          Exposure to air pollutants such as dust and smoke.
·          Irritations of airway by foreign bodies like recurrent incidental intrusion of food particles into windpipe due to difficulty in swallowing.
·          Diseases such as allergies and asthma.
·          Angiotensin-converting enzyme inhibitors.
 

Treatments
 
Herbs commonly used in prescriptions and acupuncture.
 
1.     Ku Xin Ren – 苦杏仁
 
English/ Common name
Almonds
Latin species
Prunus armeniaca L. var. ansu Maxim
Park of plant used
Seeds
Action/s
Helps to ease coughing [22] and ease bowel movements [18].
Precaution/s
Slightly toxic in properties. Do not consume in large quantities. Infants and people with watery stool or diarrhea should use with care [18].
               
2.     Chuan Bei Mu – 川贝母
 
English/ Common name
Fritillaria
Latin species
Fritillaria cirrhosa D. Don
Park of plant used
Bulbs
Action/s
Helps to reduce phlegm and ease coughs [4], especially chronic coughs with viscous phlegm [23].
Precaution/s
Should not be used together with Aconitum. People with digestive problems or watery phlegm should avoid using it [18].
 
3.     Kuan Dong Hua – 款冬花
 
English/ Common name
Flos Farfarae, Common Coltsfoot Flower
Latin species
Tussilago farlara L.
Park of plant used
Flower buds
Action/s
Helps to ease coughs, especially chronic coughs [24-25].
Precaution/s
No significant side effects.
               
4.     Bai Bu – 百部

English/ Common name
Radix Stemonae
Latin species
Stemona sessilifolia (Miq.) Miq., S. japonica (B1.) Miq., S. tuberosa Lour.
Park of plant used
Tubers
Action/s
Helps to ease coughs [7]. Also be used externally against certain bacteria, lice and parasites [27].
Precaution/s
No significant side effects.
 
5.     Pi Pa Ye – 枇杷叶

English/ Common name
Loquat Leaf
Latin species
Eriobotrya japonica (Thunb.) Lindl.
Park of plant used
Leaves
Action/s
Helps to ease coughs and vomiting [28]. Also possesses anti-parasitic effects [29].  
Precaution/s
Should be put in a cloth bag before cooking with other herbs to avoid irritations to the throat.
 
6.     Zi Su Zi – 紫苏子
 
English/ Common name
Semen Perillae
Latin species
Perilla frutescens (L.) Britt.
Park of plant used
Seeds
Action/s
Helps to reduce phlegm and ease coughs [30]. Also improves bowel movements [18].
Precaution/s
Avoid cooking for too long. People with watery stools or diarrhoea should use with care [24].
 
 
Home Remedies
 
Fritillaria + Chinese Pear + Rock sugar
a)     Remove core, put fritillaria and rock sugar into the hole of pear.
b)     Steam the stuffed pear in a double boiler at high heat for 40 minutes.
a)     Remove from heat. Serve warm.
 
 
References
 
1.      Pratter MR. Cough and the common cold: ACCP evidence-based clinical practice guidelines.Chest. 2006 Jan;129(1 Suppl):72S-74S.
2.      Peter V Dicpinigaitis, Gene L Colice, Mary Jo Goolsby, Gary I Rogg, Sheldon L Spector, and Birgit Winther. Acute cough: a diagnostic and therapeutic challenge. Cough. 2009; 5: 11.
3.      Katzer, Gernot (2005-09-11). Almond (Prunus dulcis).http://www.uni-graz.at/~katzer/engl/Prun_dul.html. Retrieved 2008-07-18.
4.      Wang SJ, Yu JL, Gao WY. Use of X-Ray Diffractometry (XRD) for Identification of Fritillaria According to Geographical Origin. American Journal of Biochemistry and Biotechnology 1(4): 199-203, 2005
5.      Chisholm, Hugh.The Encyclopaedia Britannica : a dictionary of arts, sciences, literature and general information 11th edition Volume 1. New York : Encyclopaedia Britannica. 1910-1922
7.      Xu YT, Shaw PC, Jiang RW, Hon PM, Chan YM, But PP.Antitussive and central respiratory depressant effects of Stemona tuberose. J Ethnopharmacol. 2010 Apr 21;128(3):679-84. Epub 2010 Feb 26
8.      Li SL, Jiang RW, Hon PM, Cheng L, Xu HX, Greger H, But PP, Shaw PC. Quality evaluation of Radix Stemonae through simultaneous quantification of bioactive alkaloids by high-performance liquid chromatography coupled with diode array and evaporative light scattering detectors. Biomed Chromatogr. 2007 Oct;21(10):1088-94.
9.      Xu YT, Hon PM, Jiang RW, Cheng L, Li SH, Chan YP, Xu HX, Shaw PC, But PP. Antitussive effects of Stemona tuberosa with different chemical profiles. J Ethnopharmacol. 2006 Nov 3;108(1):46-53. Epub 2006 May 4
10.    Lin LG, Zhong QX, Cheng TY, Tang CP, Ke CQ, Lin G, Ye Y. Stemoninines from the roots of Stemona tuberosa. J Nat Prod. 2006 Jul;69(7):1051-4.
11.    Huang Y, Li J, Meng XM, Jiang GL, Li H, Cao Q, Yu SC, Lv XW, Cheng WM.Effects of triterpene acids of Eriobotyra japonica (Thunb.) Lindl. Leaf and MAPK signal transduction pathway on inducible nitric oxide synthase expression in alveolar macrophage of chronic bronchitis rats. Am J Chin Med. 2009;37(6):1099-111.
12.    Huang Y, Li J, Cao Q, Yu SC, Lv XW, Jin Y, Zhang L, Zou YH and Ge FJ. Anti-oxidative effect of triterpene acids of Eriobotrya japonica (Thunb.) Lindl. leaf in chronic bronchitis rats.Life Sci. 2006 May 1;78(23):2749-57. Epub 2005 Dec 13.
14.    Chen GG, Zhang JY, Guo YL. Analysis of Volatile Components of Fresh Perilla frutescens (L.) Britt. Var. acuta (Thunb.) Kudo by Headspace GC/MS. Journal of Essential Oil Research Sep/Oct 2004
17.    中医药-中医中药大全-中国医药网 http://www.pharmnet.com.cn/tcm/
18.    Gao XM. 中药学. 中国中医药出版社. 2006
19.    Zhou ZY. 中医内科学. 中国中医药出版社. 2007
21.    Chen CQ. 本草拾遗
22.    Ni ZM.本草汇言：明代本草名著校注. 中医古籍出版社.2005
23.    Wang J.本草会编. 1463-1539
24.    Zhang L.本经逢原. 中国中医药出版社. 1996
25.    Miao XY.本经疏证.1652
26.    日华子本草. 安徽科学技术出版社. 2005
27.    Li SZ. 本草纲目.1977
28.    中医研究，1989，2：32
29.    JiaSX.药品化义