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
These are dealt with in detail below.
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
In these cases, Cough medicines (Anti-tussives) are combined with Diaphoretics (medicines to promote Sweat):
Examples:
Acute Wind-Heat:
- Plantain with Licorice
- Maidenhair, Hyssop and Licorice
Acute Wind-Cold:
- Thyme, Aniseed and Licorice;
- Cinnamon twig, Almond, Licorice
- Ephedra Ma Huang, Cinnamon twig, Licorice
Acute Heat-Toxin:
- 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 excess conditions, Purging, Fasting, Bloodletting and cleansing medicines are used.
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
| Date Raisins Almond Barley | Plantain Poppy Violet Sugar Penids | Four Cold Seeds Poppy seed Mallow seed Quince seed | Tragacanth Gum Arabic Marshmallow root Tabasheer |
| 1. For Cough with Fever, Barley Water (Avicenna) | 1. Peppermint, Licorice, Sugar. Used for Wind-Heat cough with sore throat. |
| 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 |
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
| Elecampane Licorice Orris | Myrrh Gum Ammoniac Storax | Ginger Cinnamon Thyme | Squill Arum Flowers of Sulphur |
| 1. For Chronic Cough, hold a piece of Myrrh under the tongue. (Syrian “Book of Medicine”, trans. by Wallis Budge, 1913) | 1. Coltsfoot flower, Green tea |
| 2. Boil Leek juice in oil and give it to drink when warm. This was said to help vehement Coughs greatly. (Secrets of Alexis) | 2. Apricot kernel (Xing Ren), Licorice, Ginger |
| 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 |
Cold & Dry Cough
| 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
| Licorice Raisin Pear Marshmallow | Hyssop Violet Sorrel Plantain | Tragacanth Gum Arabaic Sugar Starch | Asparagus root Comfrey |
Compounds
| 1. Dry Cough without Expectoration, use Electuaries (Avicenna) | 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. Barley Water with White Poppy (seed) and Sugar | 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. |
| 3. Cucumber kernel, Musk Melon kernel, Pumpkin kernel, Tragacanth, Bean Flour | |
| 4. Cassia Fistula, Almond, Violet |
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
| Honey water Thyme | Ginger Cinnamon | Orris juice Birthwort | Bryony Sarcocolla |
1. Almond, Pistachio, Sugar. Mix and eat
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
| Syrup of Poppy | |
| Mucilaginous Electuary |
Thick, hard-to-clear Phlegm
| 1. Mastic with Honey | 1. Tangerine peel (Ju Hong), Green tea. Used for excess white, hard-to-clear Phlegm. |
| 2. Licorice with Tragacanth | 2. Daikon Radish, Green tea, Salt. Good for excess Phlegm, especially with Lung Heat. |
| 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 |
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)
| Figs | Jujubes |
| Almonds | Pine nuts |
| Thyme | Hyssop |
| Tragacanth | Gum Arabic |
| Licorice | Sugar Penids |
| Poppy seed | Opium |
| Agaric | Turbith |
| Sulphur |
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
| 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) | ELECTUARY OF BUTTER |
| 2. Adhatoda, Ginger, Pepper (equal parts), powder and form pills with Honey. (Ayurveda) | Honey clarified |
| PILLS FOR COUGH | Butter 4 oz. ea. |
| Storax | Cumin |
| Myrrh | Annis ½ oz. ea. |
| Frankincense | Licorice 1 oz. |
| Saffron | Form an Electuary (Lohoch) |
| Licorice juice equal parts | Used for Cough. It is licked or held in the mouth. (Nicholas Florentini) |
| Form pills the size of a Chickpea. | TROCHES OF POPPY SEED |
| TROCHES OF ANDROMACHUS FOR COUGH | White Poppy seed 30 drams |
| Pine nuts 5 drams | Cucurbita seed |
| Starch | Citrul seed |
| Gum Arabic | Henbane seed 20 drams |
| Tragacanth | Starch |
| White Poppy seed 2 aureos | Tragacanth |
| Form pills to be held in the mouth | Gum Arabic 15 drams |
| PILLS FOR HOT COUGH OF ZACHARIA | Form Troches with mucilage of Psyllium |
| Licorice juice | Dose: 3 drams with syrup of Poppy or Barley water. |
| Starch | For Cough and Catarrh |
| Tragacanth | EXPERT PILLS FOR COUGH FROM COLD AND DRYNESS OF PAULUS |
| Gum Arabic | Myrrh |
| Bitter Almond 1 dram ea. | Saffron |
| Sugar Candy 3 drams | Pine nut |
| Form Pills with mucilage of Quince seed | Quince seed |
| EXPERT PILLS FOR COUGH | Fennel seed |
| Storax | Aniseed |
| Myrrh | Sweet Almond |
| Opium | Bitter Almond |
| Form pills with Honey. (Poppy seed can replace Opium) | White Poppy seed |
| PILLS FOR COUGH | Licorice juice equal parts |
| Agaric 2 drams | Mix with Penid three times the weight, and Fennel juice, and form pills |
| Frankincense 1 dram | DIAPAPAVER |
| Mix with Hyssop juice and form 10 pills. | White Poppy seed 30 drams |
| ELECTUARY FOR COUGH | Licorice |
| Linseed, dried | Tragacanth |
| Raisins, stoned 4 oz. ea. | Sugar Penids 20 drams |
| Sweet Almonds | Gum Arabic |
| Bitter Almonds | Licorice juice |
| Pine nuts | Bean meal |
| Orris root | Fennel seed |
| Resin 2 drams ea. | Aniseed |
| Frankincense | Lettuce seed |
| Myrrh | Starch |
| Mastic | Purslane seed |
| Saffron 1 dram ea. | Mallow seed 10 drams |
| 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. | Cucumber seed |
| Dose: 1 dram morning and night with wine. A piece may also be held under the tongue to stop Cough. (Secrets of Alexis) | Melon seed |
| Cucurbit seed 5 drams | |
| Confect with clarified Honey, or with Penids and Honey together |
