Chronic Cough is definitely an Internal Injury Disease. During this pandemic, the most feared illnesses are probably cough and fever, as there is a concern about being infected by a virus. In daily life, aside from the so-called chronic bronchitis cough, there are many patients with chronic cough who endure it without seeking treatment, thinking it is not serious. However, this chronic cough is certainly an internal injury disease that, if not thoroughly treated, can lead to significant problems.
On April 19, 2020, a 38-year-old female patient sought treatment, expressing her frustration with a chronic cough that had lasted over a year and had not improved despite various treatments. She had even experienced low-grade fevers and was worried about being infected with the COVID-19 virus. After testing negative, she felt somewhat relieved but remained anxious, often questioning whether she had been infected. Her cough had started at the end of 2018, initially accompanied by fever, but after recovering, it returned about a week later. The cough was not severe, with less coughing in the morning, more in the afternoon, and frequent coughing at night, especially after lying down, which disturbed her sleep and made her feel uncomfortable. Eventually, she developed pharyngitis, with a persistent itchy throat and occasional throat pain. Hospital examinations diagnosed her with pharyngitis and prescribed cough suppressants and sprays, but they were largely ineffective. The sprays sometimes alleviated throat discomfort, but overuse seemed to diminish their effectiveness. Hospital tests showed no abnormal indicators. She also sought treatment at a TCM hospital for cough and phlegm, but it was ineffective. Frustrated, she purchased various cough and phlegm medications on her own, but none worked, leading to significant distress. This condition severely impacted her life and work; there was even an instance where she could not control her cough during intimate moments with her husband, which was quite embarrassing.
The patient had a good appetite but was prone to internal heat, with a sensitive and painful throat. She sometimes felt hungry, experienced intermittent abdominal cramping, and occasionally had acid reflux. Her bowel movements were daily but not abundant, somewhat dry, and slightly difficult to pass. Urination was short and yellow, with occasional sensations of heat. She fell asleep relatively well but often woke up sweating and coughing, feeling unrefreshed in the morning with dry mouth and thirst. She also experienced calf cramps. Her menstrual cycle was generally regular, but over the past year, the flow had decreased, and dysmenorrhea had intensified, with a tendency for prolonged periods and occasional lower abdominal pain. She felt easily irritable. Examination revealed a shiny, dry tongue with no coating, a deep tongue body, and prominent veins on the underside. The pulse was thin, rapid, and slightly choppy, with almost no kidney pulse. The diagnosis was Yin Deficiency, Blood Deficiency, and Blood Stasis. A prescription was made for 5 doses: Zhi Gan Cao (Honey-fried Licorice), Huang Qin (Scutellaria), Dang Gui (Angelica Sinensis), Sheng Di (Rehmannia), Bai Shao (White Peony), Chuan Xiong (Ligusticum), Ze Xie (Alisma), Dan Pi (Moutan), Bai Zhu (White Atractylodes), Fu Ling (Poria), Zhi Mu (Anemarrhena), Huang Bai (Phellodendron), Bai Wei (Cynanchum), and Qing Hao (Artemisia Annua).
On April 26, 2020, during a follow-up visit, the patient happily reported that after taking the medicine, she felt refreshed and less anxious, with a significant reduction in coughing—she hardly coughed in the morning and only occasionally at night, without the previous severity. She felt much more comfortable, with improved sleep quality and less sweating at night. Mornings were better, with less dry mouth. Recently, she had no abdominal or lower abdominal pain, and her acid reflux was manageable. There were no calf cramps. Bowel movements had become smoother. Urination remained yellow but without the sensation of heat. The pulse was still thin and slightly rapid, with no significant changes otherwise. The tongue was still without coating but less shiny, with a small amount of saliva, a slightly deep tongue body, and prominent veins underneath. The prescription was adjusted to include: Sheng Di (Rehmannia), Dan Pi (Moutan), Chi Shao (Red Peony), Dang Gui (Angelica Sinensis), Chuan Xiong (Ligusticum), Tao Ren (Peach Kernel), Hong Hua (Safflower), Da Zao (Jujube), Ze Xie (Alisma), Bai Zhu (White Atractylodes), Fu Ling (Poria), and Dan Shen (Salvia).
A few days ago, she informed me that after taking the medicine, she traveled out of town and did not have time for an in-person consultation, but she had not coughed for a long time and felt her cough had improved, with some improvement in her menstrual symptoms, particularly in dysmenorrhea. She felt there were still some other health issues to address and would schedule another appointment upon her return.
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