Knock Out Colds & Coughs

OBSERVATION:
An eight year old boy walked into my office with a severe and persistent, harsh cough. His mom said that his coughing lasts for ½ an hour without stopping. He is fearful and anxious when he can’t inhale and is totally exhausted after the attack. His tongue is purple and pale. His pulse is slow and tight. His face is pale as well.
His mom said he has suffered from chronic cough since he was about 18 months old. He catches colds easily; it usually goes to his Lungs and becomes a low, barky, croupy cough. The cough is also aggravated by hay fever or when he is tired or distressed. He is a sensitive kid and frail in his body.
His mother was offered bronchodilators, steroid sprays and antihistamines as treatment options for him but chose to use Chinese herbs.

DIAGNOSIS:
The acute (immediate) condition is the result of external attack of pathogenic wind-cold. This diagnosis corresponds broadly to attack by viral or bacterial agents in western medicine. He also has a chronic condition: Lung and Kidney Qi deficiency.
While it is tempting to assume “pathogenic wind-heat” when diagnosing children (they tend toward heat because they are more active than adults), if we look at his specific symptoms, we see his pulse is slow and tight (indicates restriction by cold) and the type or quality of his cough also indicates cold. Wind-heat would have been indicated by a sore, painful throat and a rapid and floating pulse which the patient did NOT have.

TREATMENT (ACUTE CONDITION):
The patient was fearful because of the severity of his cough creating additional tension in the pectoral muscles. With his mother in the treatment room, I coached him through his cough so he could relax his chest and use his diaphragm to control his breathing instead. I massaged the points (RN17, UB11, UB13, LI4, LU7) instead of stimulating with needles and prescribed Chinese herbs.
In Chinese medicine the Lungs influence the Defensive Qi (immune system).

If Lung Qi is strong, Defensive Qi will be strong and the person will have good resistance to attack by exterior pathogenic factors. If Lung Qi is weak, the …person will be prone to attack by exterior pathogenic factor.” [1]

The focus of the treatment is to “open the chest” – dispersing wind-cold and remove the blockage caused by the wind-cold attack.

OUTCOME (ACUTE CONDITION):
That night, he felt better. He still had some coughing fits, but they were shorter in duration and less severe. A benefit of his mother observing the treatment was it reduced anxiety for both of them: she could coach him through the cough and remind him how to relax his chest and breath with his diaphragm.
When I saw him the following week, he was over the cold. His mom said he almost doesn’t cough and when he does, it doesn’t last. He is still weak but went back to school after a few days.

TREATMENT (CHRONIC CONDITION):
To treat the chronic condition, the aim is to tonifying (strengthen) the Lungs and the Kidneys as opposed to Dispersing wind-cold like we did in the acute stage. I massaged the points RN17, UB11, UB13, LI4 as in the acute stage, LU9 instead of LU7, added ST36, and prescribed Chinese herbs.
The weakness of his Lungs can be hereditary or due to catching a cold that weakened the Lungs. If a cold has been treated with antibiotics, it can “lock” the cold in the chest and interfere with the Lung Dispersing and Descending functions, so that some pathogenic factor remains in the body and, in the long run, cause Lung Qi deficiency.

OUTCOME (CHRONIC CONDITION):
This boy stayed on the tonifying formula and it was recommended he come once a week to stimulate his Lung function. His mom reports that he almost doesn’t cough, only when he is catching a cold. She is very pleased with the formulas we used because herbs she tried in the past were hard for her boy to take because of the taste. He takes this Chinese formula by himself with no problem

GOING FORWARD:
I recommended he continue treatments to work on his chronic cough. When there is an underlying deficiency (such as with the elderly, children, and adults with compromised immune systems), any mild cold can turn a chronic cough into more severe complications like asthma or pneumonia requiring more medical intervention. It is important to treat the underlying lung deficiency.

References:
[1] Maciocia, Giovanni. The Foundations of Chinese Medicine.
Edinburgh: Churchill Livingston, 1989
ISBN 0-443-03980-1