Acupuncture for Chronic Cough

How Chinese medicine understands chronic cough

In Chinese medicine, the Lung likes to be moist and its Qi is meant to move downward. A cough is Lung Qi “rebelling” upward. A new cough usually comes from outside, with a cold. A cough that has gone on for months is usually seen as an internal problem: something keeps disturbing the Lung, or the Lung has been left too weak or dry to settle.

The common patterns are:

• Lingering wind. A tickly, itchy throat and bouts of coughing set off by talking, cold air or smells, often starting with a cold that never fully cleared.
• Phlegm-damp. A wet cough with plenty of white phlegm, worse in the morning and after rich or sweet foods, with a heavy, tired feeling. In this view, the phlegm comes from weak digestion.
• Phlegm-heat. Thick, yellow or sticky phlegm that is hard to bring up, sometimes with a sore throat or a feeling of heat.
• Lung Yin deficiency. A dry, short cough with little phlegm, a dry throat, and a cough that is worse in the evening or at night.
• Liver fire affecting the Lung. Bouts of coughing that come with stress or anger, a red face, and sometimes a bitter taste or reflux.

The pattern decides the treatment: moistening a dry Lung is very different from drying up phlegm.

What treatment involves

It is best to see your doctor first, so the cause of the cough has been looked for. The first visit includes a lot of questions: when the cough started, what it brings up, what sets it off, the time of day it is worst, reflux, sinus trouble, smoking, and your medicines. I also look at your tongue and take your pulse.

Acupuncture points are commonly chosen on the upper back, the chest, the arms and the legs, with others chosen for your pattern. The aim is to settle the urge to cough and address what keeps it going.

Chinese herbal medicine is often useful with a cough, because it works every day between visits. I write a formula for your pattern and dispense it at the clinic, and it changes as the cough changes. Cupping on the upper back may be used for a phlegmy cough or for muscles tired from coughing.

The clinic is in Keswick. Plan on 5–10 treatments to judge progress.

Between visits

• Stop smoking and avoid second-hand smoke. It is the most common avoidable cause of a long-term cough.
• Sip water or warm drinks through the day to keep your throat moist, and try a humidifier in a dry winter bedroom.
• Treat reflux habits: avoid large late meals and raise the head of your bed if coughing is worse lying down.
• Rinse your nose with saline if you have post-nasal drip.
• Ask your doctor or pharmacist whether any of your medicines can cause a cough. Do not stop a medicine on your own.

When to see your doctor first

Any cough lasting more than eight weeks should be assessed by your doctor. Seek care urgently, or call 911, if you have:

• Coughing up blood.
• Shortness of breath, chest pain, or wheezing that is new or getting worse.
• A high fever, or feeling very unwell.

See your doctor soon if you have:

• Unexplained weight loss, night sweats or loss of appetite.
• A change in a long-standing smoker’s cough.
• Hoarseness lasting more than three weeks, or trouble swallowing.
• Swelling in your legs, or breathlessness when lying flat.
• A cough that started after taking a new medicine.