Cough is a very common clinical symptom, and although the cause is complex, there are many treatment options and, in most cases, good results are achieved. Why did this patient’s cough persist for 8 months and was treated by several hospitals, with unsatisfactory results from multiple Chinese and Western medicines? The key lies in the combination symptom of itchy throat and cough. According to the patient’s description, this cough has an itchy throat as the first symptom, followed by a cough, and many patients say that they would not cough if their throat did not itch. In addition, odors, fumes, dust, cold air, and speech can easily trigger a cough, especially when lying down before bedtime, with a dry cough or a small amount of sputum. This is very similar to “allergic cough” and “cough variant asthma”, but there is no history of allergic disease or exposure to allergic substances, no positive skin test for allergens, no increase in serum total IgE or specific IgE, etc. The basis for the diagnosis of allergic cough is obviously Inadequate. Negative bronchial excitation or diastolic tests also make the diagnosis of cough variant asthma difficult to establish. So, what exactly is a tickly cough? First, the lesion is limited, with the majority of patients describing pharyngeal symptoms as the main cause and some patients with retrosternal discomfort. Most of the patients who have been examined by ENT department suggest acute and chronic pharyngitis, but no significant abnormality is seen on chest X-ray. Secondly, pharyngeal sensitivity is the main characteristic, and the prominent manifestation is pharyngeal itchiness. The cough easily induced by odor, fumes, dust, cold air and speech is also a manifestation of pharyngeal sensitivity. Third, the patient mainly has a dry cough, or a small amount of sputum, indicating that it has little to do with infection and inflammation of the trachea or bronchi. Itch is a sensory abnormality that occurs in the skin (or mucous membranes). The mechanism of pharyngeal itch (or pharyngeal sensitivity) cough generation may be: due to acute or chronic infection of the pharynx, the inflammatory response mechanism is activated, resulting in damage to the pharyngeal mucosa, exposure of sensory nerve endings distributed in the pharynx, larynx, and lung tissue, increased sensitivity of the pharynx, and stimulation of sensory nerve endings by inflammatory mediators and external factors (such as fumes, dust, airborne pollutants, cold air, air currents from speech, etc.) to produce the sensation of itch. This induces a protective reflex – cough. Since the lesion site of itchy cough is limited – the pharynx; the mechanism of triggering symptoms is specific – inflammatory mediators, local hypersensitivity. Therefore, the effects of commonly used central or peripheral cough suppressants and cough suppressants are not satisfactory. Antileukotriene drugs (e.g., cisplatin) and antihistamines (e.g., cetirizine) have some effect. Itchy throat cough has long been recorded in Chinese medical texts and belongs to the category of wind cough. The name “wind cough” was first mentioned in the Treatise on the Origin of Diseases: “A wind cough is a cough that is caused by the desire to speak, but the words cannot be completed.” In the Ming Dynasty, “Introduction to Medicine? The General Theory of Coughing” states that “when the wind rides on the lung cough, the nose is stuffy and the voice is heavy, the mouth is dry and the throat is itchy, and the words are coughing before they are finished”. This shows that wind cough has the clinical characteristics of nasal congestion, dry mouth, itchy throat, coughing because of the desire to speak, and coughing before words can be completed, which is very similar to the itchy throat cough we see today. Studies on the theory of wind diseases in Chinese medicine show that the wind, the first of the six evil spirits, is prone to invade the lung system; the clinical manifestations of wind diseases are characterized by four parts (skin, head, joints, orifices) and eight symptoms (urgency, movement, spasm, paralysis, itching, numbness, pain, and swelling). Itchy pharyngeal cough is characterized by lesions in the head, orifices (pharynx), skin (mucous membranes), and lung system, with itchy pharynx as the main symptom. Of course, itchy pharyngeal cough can also be caused by yin deficiency and lung dryness, as stated in Jing Yue Quan Shu? As stated in “Cough”, “The key to coughing is one of external sensation and one of internal injury. …… The cough of internal injury must start in the yin part, because the lung is gold and is the mother of water, so if the yin is lost in the lower part, the yang is lonely in the upper part and the water dries up and the gold is withered. The lung suffers from dryness, and when the lung is dry, it is itchy, and when it is itchy, the cough can’t be stopped as well …….” It is because itchy pharyngeal cough differs from ordinary cough in its etiology, pathogenesis, location and clinical manifestations that the commonly used clinical remedies for clearing heat, resolving phlegm and relieving cough are not very effective. In terms of clinical practice, TCM often achieves good results in treating itchy cough with evidence-based treatment centered on wind evils. In the small case of the female patient, I identified her as having wind-heat-loving lung. The treatment method was to remove wind and clear the lung. Prescription: Cicada molasses 6g, Sclerotium 10g, Xuan Shen 15g, Burdock 10g, Peppermint 6g, Goldenseal 15g, Zhi Mu 15g, Zhe Bei Mu 10g, Bitter Almond 10g, Radix Platycodon 6g, Raw Licorice 6g. 7 doses, avoid spicy stimulation, protect the throat. One week later: after taking the above, throat itching and dry cough were reduced; daytime occasional cough, 1-2 times before bedtime; dry mouth, food can be eaten, stool is not dry, once a day; night sleep can be. Tongue light red, coating thin yellow, pulse string thin. Treatment abide by the former method, the above plus Mab 6g, 7 doses. 26 October three diagnosis: the patient took the above, still have itchy throat before bed, cough, no sputum; morning also have itchy throat, bad breath; mouth and throat is not dry, can eat, normal stool. Tongue dark light red, thin white coating, pulse string thin. Treatment to keep the former method, adjuvant to strengthen the spleen, the above adjustment as follows: cicada moth 6g, stiff silkworm 10g, burdock 10g, honeysuckle 15g, forsythia 15g, xinyi 10g, zhebei mother 10g, poria 15g, fried white atractylodes 10g, Chen Pi 10g, jiao sanxian each 10g, Su Ye stems each 10g, orris 6g, raw licorice 6g, 7 doses. November 2, the fourth diagnosis: the patient took the above, has no pharyngeal itching and Cough; heavy breath, slightly dry mouth, good food intake, stool is dry, once a day; no distension of the abdomen, sometimes gum swelling and pain; good night sleep. The tongue is dark red, with a thin, yellow, greasy coating and a thin, string-like pulse. Evidence: Dampness and heat are contained within the body and steam upward. Treatment: Clearing heat and dispelling dampness. 9 November 2009 clinic visit: recently, after eating ginger candy, ginger and spicy radish, he had an itchy throat and several coughs at night; his mouth was not dry, he could eat, and his stools were normal. The tongue is light red and dark, with a thin yellow coating and a stringent pulse. On December 5, 2011, the patient visited the clinic for tinnitus and complained that after taking the above formula, the itchy throat and cough were relieved and no further attacks occurred. From the perspective of both modern medicine and traditional Chinese medicine, pharyngeal itch cough is significantly different from ordinary cough in terms of pathogenesis, lesion site, clinical manifestations, and therapeutic use of medicine. Therefore, the treatment is also different from that of ordinary cough. It is worth noting that during the treatment of this condition, patients are instructed to avoid spicy and irritating foods and to avoid excessive use of the throat (e.g., talking loudly, singing, etc.), which also has an important impact on whether the treatment can achieve good results. Even in patients who have achieved short-term results, violation of the above mentioned medical advice may lead to recurrence of the disease.