External cough is the most common disease in pediatrics. The textbooks are broadly divided into two types: wind-cold and wind-heat. For more than 20 years, the author has been treating pediatric external coughs and believes that they can be divided into four types: wind-cold, wind-heat (wind-warm, spring-warm), wind-dry, and wet-warm, among which wind-cold is mild and severe, and wind-dry is cool and warm. According to the diagnosis and examination of the cause of treatment, the results are quite good. Now summarized as follows.
1.Cause of the disease
(1) External causes: when investigating the six gases
When a cough is felt externally, the six perversions should be investigated, and the six perversions are the excesses of the six gases in the four seasons. The “Su Wen – to the true to the great theory”: “All diseases are born in the wind, cold, summer, humidity, dryness and fire, with the change of the transformation.” The wind is the longest of all diseases, and it is mostly led by the wind, which causes disease, and therefore the clinical evidence is that the two evils are combined to cause disease, and the two evils are combined with the lightness of the evil, or the wind is light and the evil is heavy, or the evil is heavy and the wind is light. The main external causes of external cough in children are wind-cold, wind-heat (wind-warm, spring-warm), wind-dry, and wet-warm.
(2) Internal causes: physiopathological characteristics of children
Children have the physiological characteristics of delicate internal organs and unfulfilled form of qi, because the pure Yang body, unfulfilled form of qi, has poor resistance to disease and is easily injured by the six mirths; the lung is the main respirator of the outer skin, so the lung system is the first to cause disease; there are also the pathological characteristics of easy transmission of rapid onset, as in the “Pediatric Medicine Certificate Direct” “the internal organs are soft and weak, easy to deficiency, easy to cold, easy to heat “Not only are they easily injured by the six external evils, but they also change rapidly, easily transforming into heat and fire, and easily leading external evils to enter and hold stagnation.
2. Types of evidence and treatment
(1) Wind-cold cough
There are light and heavy wind-cold coughs, and the lighter ones are the usual wind-cold coughs, which mostly occur in late autumn and early winter or in summer when you are cold and sleep in the wind. The symptoms are clear runny nose, frequent sneezing, slight heat or no heat; a light cough, no change in the tongue and a floating pulse, with the wind heavy but the cold light. The treatment is to dredge the wind and promote the lung to stop the cough, with the addition of three arguments (sizzling ephedra, almonds, sizzling licorice), nasal congestion plus catkins, coughing manifestation plus Qian Hu, Su Ye, dry stool plus sizzling aster. The clinical use of repeatedly effective. This disease is mostly diagnosed as allergic cough in modern medicine, and the addition of paracetamol is more effective.
Severe wind-cold syndrome is mostly caused by improper treatment of mild wind-cold syndrome or a recurrence of cold, or a light winter wind with heavy cold directly hitting the lung system. The symptoms include frequent coughing or clear snot, no sneezing, heavy coughing both day and night, high acute coughing sound, heavy nasal congestion, spitting of thin white sputum, fever and cold without sweating, and a light tongue with a floating pulse. The treatment involves dispersing cold and dispelling wind, promoting the lung to stop cough and resolve phlegm.
The formula is Ephedra soup with flavor (roasted ephedra, cinnamon branch, almonds, licorice), cough is very plus ejaculate, Qian Hu, sputum plus Su Zi, half summer; note that the decoction should not be long, boiling water for 5-6 minutes; each dose is divided into 2-3 times warm, sweating fever that is to subside, generally 3 doses of cough to most of the cough, transfer 1 to 2 doses of cough flat. Zhai, a 4-year-old male, was diagnosed on December 6, 2002, with frequent coughing for 2 days, especially at night.
He has fever (38℃), no sweating, heavy nasal congestion, coughing and spitting white sputum, and is well tolerated with a light red tongue with thin white coating and tight pulse. The evidence belongs to wind-cold bundling the surface of the lung without declaring and purifying. The treatment involves dispersing cold and dispelling wind, promoting lung circulation and resolving phlegm to relieve coughing, with the addition of ephedra soup with 3g of roasted ephedra, 6g of cinnamon stick, 10g of almond, 3g of roasted licorice, 6g of Chen Pi, 6g of Semen Nux vomica, 6g of Qian Hu, and 2 slices of ginger.
(2) Wind-heat cough (wind-warm, spring-warm)
Wind-heat cough is a combination of wind and heat evils (warm evils), mostly occurring in late spring and early summer. In the case of wind-warm, the wind and the warm evil combine to attack the mouth, nose, and skin; in the case of spring-warm, there is internal heat, and the external wind evil or external wind-cold enters the interior and turns into heat, manifesting a heat image or the image of guest cold encapsulating fire; the symptoms are: fever of 37.5 to 38.5°C, sweating out heat that does not resolve, accompanied by a heavy cough or headache without sweating, sore throat, red face and lips, heat in the mouth and nose, red tongue with yellow fur, and floating pulse.
If the heat is heavy and the wind is light, the treatment should be to clear the lung heat and dredge the wind to penetrate the surface, so that the wind-heat evil can be resolved from the inside and outside. The formula is chosen from the Yin Qiao San for those with less pronounced internal heat, and the body is strong and solid, the internal heat is strong, slightly with cold bundle, such as no sweat, headache, the guest cold pack fire evidence, should be clearing lung heat as the main, dredge the wind evil as a supplement, the formula is chosen from the Ma Heng Shi Gan Tang combined with Yin Qiao San plus flavor, clinical more scutellaria, mulberry peel, sage, rhizome, orris, bile south star, strengthen the power of clearing and penetrating; foul or dry stool, all indicate the large intestine has accumulated heat plus the whole gua pou, betel nut, zi yuan, clearing heat to open the bowels. Ziziphiopogon, clear heat and laxative, so that heat from the large intestine and go away.
The raw gypsum can be used up to 15-25g with age, the rest of the regular amount can be. These children have a strong constitution, good appetite, easy to eat and accumulate heat.
The fever and cough of a child, Wang, 6 years old, was treated by infusion outside the hospital for more than 5 days. 10g, Radix Salviae Miltiorrhiza 10g, Radix Psidium Guajava 15g, Radix Arctium Lappa 10g, Radix Forsythiae 10g, Radix Glycyrrhiza Uralensis 8g, which helped to remove most of the heat and cough with 2 doses.
(3) Wind-dry cough
Dryness is the main qi of autumn, and the lung is the main organ of autumn. The symptoms of cough caused by wind-cold and dryness are similar to those of wind-cold, except that the cough is dry or less talkative, with dry lips and throat, a lack of fluid on the tongue and a floating pulse. The formula is based on apricot sophora.
Most cases of warm dryness develop in winter because of winter cold and warmth, and even if a heated house has a humidifier, it is still artificial “weather” against the season. Symptoms: cough with sticky sputum and little phlegm, mute voice and itchy throat, red face and dry lips or fever, fondness for cold drinks, dry stool, red tongue and dry coating, treatment should be cool, sweet and moist, promote the lung and moisten dryness; formula selection: mulberry and apricot soup with flavor (mulberry leaf, almond, saxifrage, elephant shell, gardenia peel, pear peel), heat is obvious, add forsythia, gypsum, very dry add saxifrage, smallpox powder, dry stool add whole guadua.
The child Liu, 10 years old, female, visited the clinic in December 2005, with a dry and itchy throat and cough, little sputum and no heat. She likes cold drinks, has a red tongue with little coating, lacks fluid, and has dry stool and poor circulation, which is typical of the disease caused by inappropriate regulation of air temperature and dryness. It is advisable to clear and moisten dryness to stop cough. The formula gives: Almond 10, Mulberry leaf 10, Salvia officinalis 10, Gardenia jasminoides 10, Plumbago spp. 15, Zhi Mu 10, Dabei 10, Smallpox powder 10, Alligator piper 15, Roasted licorice 6, three doses and the cough is stopped.
(4) Dampness and warmth cough
Dampness is the main qi of long summer and its counterpart is the spleen. Damp-temperature cough mostly occurs in late summer and early autumn when dampness is prevalent in long summer, when the heat of the summer and the dampness of the earth are forced on the mouth, nose, and skin, attacking the lung jin and the lung likes to be clear and light, so it loses its ability to clear and purify and becomes a cough; the symptoms of cough are: heavy cough, profuse and sharp sputum, mostly accompanied by fever that is difficult to resolve, with a body temperature between 37.5° and 38.5°. The child’s tongue coating is white and greasy, and the pulse is slippery. Among them, cough with phlegm and white greasy tongue coating are the necessary symptoms.
The treatment is to clear heat and dampness, promote lung dispelling phlegm. Chai Hu Da Yuan Drink (Betel nut, Hou Pu, Cao Guo, Scutellaria baicalensis, Licorice, Chai Hu, Citrus aurantium, Qing Pi, Radix Platycodon grandiflorus, Lotus pediculata) is effective when used repeatedly in clinical practice. Cheng, a 12-year-old female, was at home during summer vacation in August. She came to the clinic after catching a cold and coughing with fever for 1 week, but did not recover: temperature 38℃, coughing with heavy coughing and white sputum, head swelling and discomfort, dullness, light red tongue, white greasy and slightly yellow coating, and smooth pulse.
This is a damp-temperature cough. The prescription was given as follows: Chai Hu 10, Scutellaria baicalensis 10, Almond 12, Radix et Rhizoma hallucinogenes 10, Semen Coix 15, Betel nut 12, Cao Guo 10, Radix Platycodon 10, Radix et Rhizoma Glycyrrhiza glabra 6. The cough subsided with three doses of fever, and the remedy of resolving phlegm and dampness, eliminating food and stomach was given.