A cough is a cough is a cough… right?
Well, not really. Coughs are funny in that they seem to have their own unique personality. You can have a chronic dry cough, a loud hacking cough, or an annoying tickle in your throat.
In Chinese medicine, the characteristics and quality of your cough give up clues as to the underlying pattern to be treated — essentially what’s causing your cough. Things like how your cough sounds, how long you’ve had it, and the color and quantity of the phlegm (I know, gross) associated with your cough are all signs as to what’s going on in your body that’s behind your cough.
Diagnosing Your Cough
Before treating your cough, a practitioner of Chinese medicine would need to make a diagnosis, and to do so, her or she would take a number of things into consideration. One common way of making a diagnosis is called the Eight Principle Pattern Diagnosis (for more on this check out Simple Steps, pp 133-140), which is really a series of four dichotomies:
Is your cough internal or external?
Basically, where did that hack come from? If it’s an offshoot from a cold or the flu, it’s considered external. That means it’s pretty superficial and came from some outside factor like your co-worker sneezing on your computer keyboard. An internal cough means that it’s the product of some kind of dysfunction of your internal organs.
For example, in some cases people with poor digestion can build up a lot of phlegm that clogs up their lungs and causes a cough.
Does your cough come from an excess or a depletion?
An excess is essentially stuff that you have to move or get rid of for your cough to go away. Excess coughs are loud with a lot of phlegm rattling around. A depletion means that some kind of weakness is causing your cough, and in order for you to heal, you’ll need to beef up your health.
In most cases a cough caused by a depletion is quiet, sounds weak and forceless, and is not so productive and phlegmmy.
Is there heat or cold involved with your cough?
A cough with heat will often produce yellow phlegm, may smell bad, and may come with a fever, thirst, or constipation. This kind of cough is often associated with the flu, pneumonia, or a lung infection. The heat involved may also dry out your lungs and cause a loud cough with little phlegm.
If cold is involved, then the phlegm you cough up will be white or clear, you may feel chilled and even achy.
Is your cough Yin or Yang in nature?
In Chinese medicine, Yang is considered warm, active, bright, and moving, so a Yang cough is loud, hot, and excess, with yellow phlegm. In contrast, Yin is considered to be cool, dark, moist, and quiet, so a Yin cough is cooler and wetter. There may be lots of phlegm with a Yin pattern, but it will be clear or white, and generally you won’t feel hot or run much of a fever.
Treating Your Cough
Once your cough has been diagnosed, your practitioner will settle on a course of treatment which is aimed at resolving the source of your cough.
If it’s an external cough from a cold or the flu, then your practitioner will generally use acupuncture and an herbal formula short term to speed the course of your cold/flu, resolve the phlegm, and stop your cough.
If your cough is caused by internal factors, like an imbalance of your internal organs, then your road to recovery will also involve acupuncture and likely an herbal formula for a longer period of time. In many cases, some dietary changes, as well as lifestyle tweaks may be in order.
Certainly, if you’re a smoker, quitting will be the first order of business in resolving your cough–and the best thing you can do for yourself to improve your health.
So, are all coughs created equal?
Not really, in Chinese medicine.