The symptoms of wind-heat cough include nasal congestion and runny nose, initially with clear nasal discharge, later turning into yellow, thick mucus, with a sensation of heat in the nose, sneezing, a heavy voice, fever, aversion to wind, sweating, dry or bitter mouth, cough with thick phlegm, and in severe cases, dry throat pain, hoarseness, flushed face, red eyes, and epistaxis. If heat injures the lung collaterals, the phlegm may be blood-streaked, the tongue coating may be thick and white or slightly yellow, and the pulse may be floating, surging, or slippery and rapid. The treatment should focus on spicy-cool methods to release the exterior.
1. Mild Wind-Heat Cough
The clinical presentation includes mild fever and aversion to wind, slight sweating, nasal congestion, heavy voice, initially clear nasal discharge, sneezing, and later yellow, thick nasal discharge, cough with thin phlegm, dry throat, pale yellow urine, thin white or yellowish tongue coating, and a pulse that is floating and slightly rapid or slightly surging and rapid. Treatment should use spicy-cool light formulas to release the exterior, such as Sang Ju Yin (Mulberry Leaf and Chrysanthemum Decoction) or Yin Qiao San (Honeysuckle and Forsythia Powder).
Sang Ju Yin (Mulberry Leaf and Chrysanthemum Decoction) is indicated for wind-heat cough, mild fever, slight thirst, thin yellow tongue coating, and a floating, rapid pulse.
Prescription:10g of Sang Ye (Mulberry Leaf), 12g of Ju Hua (Chrysanthemum), 10g of Xing Ren (Apricot Kernel), 10g of Jie Geng (Platycodon), 12g of Lian Qiao (Forsythia), 6g of Bo He (Mint), 6g of Gan Cao (Licorice), and 15g of Wei Jing (Reed Rhizome), decocted in water.
Modification:If there is a sensation of breathlessness, thirst, and a surging pulse, add 15g of Sheng Shi Gao (Gypsum) and 10g of Zhi Mu (Anemarrhena); if the tongue is crimson and there is night fever, remove mint and add 12g of Xuan Shen (Scrophularia) and 12g of Mai Dong (Ophiopogon).
Yin Qiao San (Honeysuckle and Forsythia Powder) is indicated for headache, body heat, sweating, slight aversion to wind-cold, or just heat without cold and thirst, with a floating, slightly rapid pulse and cough with sticky phlegm.
Prescription:15g of Yin Hua (Honeysuckle), 15g of Lian Qiao (Forsythia), 10g of Jie Geng (Platycodon), 10g of Niubangzi (Burdock Fruit), 10g of Bo He (Mint), 6g of Jing Jie (Schizonepeta), 10g of Dan Zhu Ye (Lophatherum), 12g of Dan Dou Chi (Fermented Soybean), 6g of Gan Cao (Licorice), decocted in water, taking it when the aroma is strong, do not decoct for too long.
Modification:If there is chest tightness, add 10g of Huo Xiang (Agastache) and 10g of Yu Jin (Curcuma); if thirsty, add 10g of Hua Fen (Pollen); if there is swelling and pain in the throat, add 10g of Ma Bo (Fungus), 12g of Xuan Shen (Scrophularia), and for epistaxis, remove Jing Jie and Dan Dou Chi, and add 30g of Bai Mao Gen (Imperata) and 30g of Ce Bai Ye (Platycladus); for cough and wheezing, add 10g of Xing Ren (Apricot Kernel) and 10g of Hou Po (Magnolia Bark).
For wind-heat cough, in the early stage of mild illness, it is advisable to use Yin Qiao San or Sang Ju Yin for spicy-cool exterior release. If the heat is constrained in the upper jiao and the exterior wind-heat has not resolved, use Yin Qiao San or Sang Ju Yin. If the illness is severe and the medication is light, it is necessary to clear and cool, and Qing Xin Liang Ge San (Clear Heart and Cool Diaphragm Powder) can be used.
Qing Xin Liang Ge San (Clear Heart and Cool Diaphragm Powder) is indicated for dizziness, fever, irritability, slight aversion to wind, dry or bitter mouth, or thirst, with a white greasy or slightly yellow tongue coating, and a floating, rapid or slippery pulse, cough with difficulty in expectoration.
Prescription:12g of Lian Qiao (Forsythia), 10g of Huang Lian (Coptis), 10g of Shan Zhi Zi (Gardenia), 10g of Bo He (Mint), 10g of Jie Geng (Platycodon), 10g of Dan Zhu Ye (Lophatherum), 6g of Gan Cao (Licorice), and one spoon of honey, decocted in water.
2. Severe Wind-Heat Cough
The clinical presentation includes heat emanating from the nose, fever, sweating, aversion to wind but not cold, dry or bitter mouth or thirst, cough with thick phlegm, severe throat pain, flushed face, dry eyes, hoarse voice, and epistaxis. If heat injures the lung collaterals, the phlegm may be blood-streaked, the tongue may have a thick white coating or slight yellow, and the pulse may be floating, surging, slippery, and rapid. Treatment should focus on clearing and cooling, using Zhi Ling Qing Fei Yin (Gardenia and Forsythia Clear Lung Decoction) or Qing Fei Jie Du Tang (Clear Lung and Detoxify Decoction); if there is internal fire causing hemoptysis, treatment should cool the blood and clear the fire, using Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) or Dan Xi Ke Xue Fang (Dan Xi’s Hemoptysis Formula).
Zhi Ling Qing Fei Yin (Gardenia and Forsythia Clear Lung Decoction) is indicated for wind-heat cough, flushed face, body heat, irritability, and rapid pulse with a thick white or yellow tongue coating.
Prescription:10g of Shan Zhi Zi (Gardenia), 10g of Huang Lian (Coptis), 10g of Jie Geng (Platycodon), 10g of Bo He (Mint), 6g of Gan Cao (Licorice), 10g of Xing Ren (Apricot Kernel), and 10g of Hua Fen (Pollen), decocted in water.
Qing Fei Jie Du Tang (Clear Lung and Detoxify Decoction) is a self-formulated prescription indicated for lung system affected by wind-heat, cough with yellow-green thick phlegm, or chest and rib pain, with blood in the phlegm.
Prescription:15g of Ye Ju Hua (Wild Chrysanthemum), 12g of Huang Lian (Coptis), 1.5g of Zhu Shao Hu (Bupleurum), 30g of Zihua Diding (Viola), 10g of Bo He (Mint), 30g of Da Qing Ye (Isatis), 6g of Gan Cao (Licorice), and 30g of Yin Hua Teng (Honeysuckle Vine), decocted in water.
Modification:If there is blood in the phlegm, remove Chai Hu and Huang Lian, and add 10g of Jiao Shan Zhi (Burnt Gardenia), 15g of Da Xia Ji (Cirsium), and 30g of Bai Mao Gen (Imperata).
Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) is indicated for heat cough, body heat, flushed face, irritability, thirst, and blood in the phlegm, with a rapid and strong pulse.
Prescription:1g of Wu Xi Jiao (Black Rhinoceros Horn) (ground into powder, or use 30g of water buffalo horn, or 15g of tortoise shell), 30g of Sheng Di (Rehmannia), 12g of Bai Shao (White Peony), 10g of Mu Dan Pi (Moutan), decocted, taken three times a day.
Ke Xue Fang (Hemoptysis Formula) by Zhu Danxi is indicated for phlegm-blood.
Prescription:6g of Qing Dai (Indigo), 10g of Ke Zi (Corydalis), 10g of Gua Lou Ren (Trichosanthes), 10g of Hai Fu Shi (Sea Float Stone), and 10g of Jiao Shan Zhi (Burnt Gardenia).
Modification:If there is constipation, remove Ke Zi, and add 10g of Da Huang (Rhubarb) prepared with wine; if thirsty, add 10g of Hua Fen (Pollen) and 12g of Zhe Bei Mu (Fritillaria); if there is scanty yellow urine, remove Ke Zi, and add 30g of Bai Mao Gen (Imperata) and 30g of Che Qian Cao (Plantago).
Conclusion:Wind-heat cough refers to cough caused by the invasion of wind-heat into the lungs. The external wind-heat pathogen invades the lung system through the mouth and nose. The lungs govern the skin and hair, and the lung qi connects to the nose; both pathways can be affected by external pathogens invading the lungs, leading to cough. For wind-cold invading the lungs, the treatment should focus on spicy-warm methods to disperse the cold; for wind-heat invading the lungs, the treatment should focus on spicy-cool methods to clear and disperse the heat. Any external invasion of wind-cold must be resolved externally. If dampness is present on the surface, it should be resolved from the surface; if it is internal, it should be resolved from within. If dryness and heat invade from the surface to the interior, it must be cleared from within. This is the pathway and resolution of the six excesses; if the pathway is incorrect, the illness cannot be cured.
For wind-heat cough, in the early stage of mild illness, it is advisable to use Yin Qiao San or Sang Ju Yin for spicy-cool exterior release. If the heat is constrained in the upper jiao, it is advisable to use cooling and dispersing methods, using Qing Xin Liang Ge San for mild cases, and Zhi Ling Qing Fei Yin or Qing Fei Jie Du Tang for severe cases. If there is internal fire causing hemoptysis, treatment should cool the blood and clear the fire, using Xi Jiao Di Huang Tang or Dan Xi Ke Xue Fang.
In summary, wind is a pathogen that can be both cold and hot. For wind-cold cough, the wind transforms into cold, and the treatment should focus on dispersing the cold, using spicy-warm methods; for wind-heat cough, the wind transforms into heat, and the treatment should focus on clearing heat, using spicy-cool methods; if there is significant internal heat, treatment should focus on cooling and dispersing; if there is internal fire causing hemoptysis, treatment should cool the blood and clear the fire. Practitioners must determine the treatment methods based on the changes in the condition, differentiating between exterior and interior, cold and heat, deficiency and excess, to achieve effective results.
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