Abstract translated by Ann Fritts, S.I.O.M. 2004

From the book: Ke Chuan Fei Zhang Juan (Shang) The first of two volumes on coughing and wheezing disorders.

In a three page article on treatment principles for cough with the use of Chinese Medicinals, Dr. Ren outlines three main principles.  These treatment principles are diffusing, clearing, and moistening.  Along with descriptions of these three treatment principles, are lists of appropriate herbs and herbal formulas, hints on differentiating with in each category, and cautions with a couple examples on how mistakes can be made.

The first treatment principle elaborated upon is diffusion, which is described as the act of diffusing outward, diffusing and opening, and diffusing and scattering (the Lung).  While diffusing is commonly employed for acute conditions, Dr. Ren reminds us that it is a method that can assist in treating chronic conditions as well.  The two methods of diffusing listed are 1) to use light, bitter, slightly acrid medicinals to open the lung qi, which will the Lungs depurative downbering function can be restored; 2) the use of coursing and releasing medicinals to dispel wind and promote sweat, which will diffuse and open the qi of the fleshy exterior.  Common herbs used for diffusing are listed, such as xing ren, jie geng, and qian hu.  With an additional list of diffusing herbs for specific types of conditions, for example su ye and jing jie for coughs with wind cold. 

Dr. Ren defined Clearing as clearing heat, transforming phlegm, and regulating the lung.  The mechanism for developing a phlegm-heat type cough are described, examples of  appropriate herbs to used are given, and common mistakes in treatment are outlined.  Some herbs listed are: Dong gua zi is described as a sweet and cold medicinal which can clear heat and make phlegm slippery (so that it is expectorated more easily); Lu gen, which is cool, can clear lung heat and regulate lung qi, and it’s sweet nature can help generate more fluids.  A pitfall described is misdiagnosis based on sweating symptoms alone, such as yin vacuity because of night sweating, or exterior vacuity due to spontaneous sweat, can make the patient worse.  Another caution is given for treating patients with excess sweating, where one should be careful to protect the Lung qi and yin from consumption and scattering when diffusing. 

Moistening is emphasized as the Lung is a delicate organ which likes to be clear and moist.  Dr Ren explained that whenever it is attacked by an evil, the lung’s moist nature and clearing function are damaged and chronic coughs can result.  He described the importance of using harmonizing and moistening medicinals to treat chronic cough.   Medicinals such as sweet and cool Ye Shi Yang Wei Tang  for when the Lung fluids are consumed and damaged, there is internal heat, dry cough, a dry mouth and low appetite, constipation, a shiny tongue.  The treatment principle would be different for a chronic cough with scanty white phlegm, with chest oppression and qi counterflow, etc. in this case Dr. Ren suggests the use of warming and moistening herbs to descend qi.  He illustrates how the use of sweet, cool herbs will cause more phlegm, and the use of warm and dry herbs will cause accumulation of heat in this case.  A list of moistening herbs are given and individual attributes are mentioned for some.