Caution for Those Who Cough Daily: Potential Internal Injuries
Many patients cough a few times every day, both adults and children. Some have become accustomed to this daily cough and do not realize they are unwell. While this cough may resolve on its own, it is not necessarily a good sign; it could develop into other illnesses. Even if the cough is treated, it is essential to regulate the body, not just to prevent recurrence, but to ensure complete recovery.
On October 27, 2017, a mother brought her 11-year-old son for a consultation. She reported that the child had been coughing for almost a year, but it was not severe. He would cough a few times every morning, rarely coughing at other times, and occasionally coughing during the night. This situation arose after a cold and cough treatment, and despite visiting several hospitals, there was no improvement, so it was left untreated. The child had a good appetite and was not picky with food, though he did not eat much. The family felt the child was energetic, but I observed that he was just active and easily fatigued. He fell asleep relatively easily but did not sleep soundly, occasionally waking up. The child mentioned that sometimes he would wake up due to a full bladder, and he even experienced bedwetting. In the morning, he felt lethargic and had difficulty concentrating on tasks, especially in class, where he struggled to pay attention to the teacher. He had daily bowel movements, but they started hard and became softer, making them difficult to pass. The child also ground his teeth and drooled during sleep. The abdomen was tender to touch. The tongue showed a yellow coating in the center, and the tongue body was slightly dark. The pulse was thin and rapid, with a small heart pulse, a strong and tense cold pulse, a weak and thin kidney pulse, a small and slippery lung pulse, a strong and thin spleen pulse, and a decent life pulse. The diagnosis indicated the child had spleen deficiency with stomach heat and food stagnation, yin deficiency with blood heat, and disharmony between the heart and kidneys. I prescribed a formula of 5 doses: Sheng Di (Rehmannia Root), Shu Di (Prepared Rehmannia), Mai Dong (Ophiopogon), Gan Cao (Licorice), Shan Yao (Chinese Yam), Shan Zha (Hawthorn), Shen Qu (Fermented Barley), Ji Nei Jin (Chicken Gizzard Lining), Bai He (Lily Bulb), Xuan Shen (Scrophularia), Jie Geng (Platycodon), Dang Gui (Angelica), and Bei Mu (Fritillaria).
I informed the child’s mother that even if the cough improved after taking the medicine, it was crucial to continue treatment; otherwise, the child might develop more severe conditions, such as rhinitis and nasal congestion. The mother seemed unconvinced. Sure enough, after returning home, they did not continue treatment.
On May 29, 2018, she brought the child back for a follow-up. She reported that after taking 5 doses of medicine last year, the coughing had significantly reduced, and the child’s overall health improved, leading them to believe he was fully recovered. However, before the Spring Festival, he began experiencing nasal congestion, which they thought was just a cold, but it worsened, leading to daily runny nose and severe congestion. A hospital visit revealed sinusitis, with some swelling in the sinuses, and treatment with nebulizers provided only temporary relief. This prompted them to return for a consultation. The child’s appetite was decent, but he frequently had bad breath and mouth ulcers, and sometimes experienced abdominal pain, which was tender to touch. Bowel movements were irregular, occurring every 2 to 3 days, sometimes even 5 days apart, indicating clear constipation. He also sweated easily, felt heat in the afternoons, and often sweated profusely while eating. His throat frequently felt dry and painful. Urination was scant and dark. Sleep was poor, and he struggled to wake up in the morning. The tongue coating was thick and yellow in the center, the tongue body was dark, and the tongue surface was dry. The pulse was rapid and solid. This was a typical case of Yangming bowel excess syndrome. I explained to the child’s mother that the spleen and stomach issues had not been addressed in a timely manner. She seemed a bit upset and asked why I couldn’t treat it all at once. I replied that I wished I had that ability, but building a house requires starting with a solid foundation. She realized her mistake and said she would ensure proper treatment this time. I prescribed 3 doses: Hou Po (Magnolia Bark), Da Huang (Rhubarb), Zhi Shi (Bitter Orange), Mang Xiao (Mirabilite), Sheng Di (Rehmannia), Xuan Shen (Scrophularia), and Mai Dong (Ophiopogon). I instructed her to allow the child to have a significant bowel movement after taking the first dose and then to stop the medication, observe for a few days, and ensure to return for follow-up.
On June 5, 2018, they returned for a follow-up. The mother reported that after the first dose, the child experienced abdominal pain, and after the second dose, the pain intensified, leading to many dark, foul-smelling stools. They stopped the medication. In the following days, the child had daily bowel movements, though they were somewhat unformed and sticky, and most of the mouth ulcers had healed. The nasal passages felt clearer, sweating had decreased significantly, and sleep had improved. Urination had increased. The tongue coating began to show white, and the tongue body had lightened. The pulse was slightly rapid and thin, with a weak heart pulse, thin liver pulse, and weak and thin kidney pulse, while the lung pulse was slightly thin, and the spleen pulse was thin and slippery. The diagnosis indicated spleen deficiency with stomach heat. I prescribed 7 doses: Jin Yin Hua (Honeysuckle), Lian Qiao (Forsythia), Niu Bang Zi (Burdock Seed), Xin Yi Hua (Magnolia Flower), Shan Zha (Hawthorn), Shen Qu (Fermented Barley), Ji Nei Jin (Chicken Gizzard Lining), Chen Pi (Aged Tangerine Peel), Ban Xia (Pinellia), Fu Ling (Poria), Gan Jiang (Dried Ginger), and Huang Lian (Coptis), and Lai Fu Zi (Radish Seed).
They returned for another follow-up, reporting significant improvement in nasal congestion, with the sinuses having shrunk, and the child’s overall energy had improved. When he came for a follow-up a few days ago, he had virtually no nasal discharge or congestion. However, I informed them that he was not fully recovered yet and needed to continue treatment.
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