Justify cough
Cough is a common symptom of lung lesions and is a disease that makes a gnawing sound in the larynx. Ancients cloud: sound without phlegm is called cough, phlegm is silent called cough, phlegm and sound is called cough. Elder Li believes that from the actual clinical observation, whether it is written into words or oral questions and answers, the word cough is often used as a common name, and there is a phlegm silent symptom, which has never been expressed with the word cough.
Therefore, he argues that the decision should be made from the presence or absence of nibbling sounds to whether it is a cough or not. Whoever has such a sound, whether sputum is present or not, may be called "cough"; without this sound, although the phlegm in the throat is rutted, it must not be called "cough". As for the names of other coughs, it should be affirmed according to the value of diagnosis and treatment, if the quality is the same name, that is, there is no diagnostic value, and it feels that it is a repetitive name, the merger of the merger, the cancellation of the cancellation, so that each name has a clear and fixed standard. Such as "dry cough", "dry cough", "air cough", "autumn dry cough", etc., are related to the invasion of the lungs by dry evil, and the clinical manifestations are characterized by dry cough without sputum and blood, so the above coughs can be combined into a "dry cough".
Another example is the name of "real cough", "false cough", "cold cough", "hot cough" and other names, which are too general and should be replaced by specific internal injuries, external cough certificates, etc. This will not only be easier for doctors to unify in terms of understanding and communication, but also reduce unnecessary concerns for patients. The facts tell us that the doctors' opinions are divergent, and every patient cannot be fully trusted, thus delaying treatment and affecting the work. The ancients said: "If the name is not right, the words are not smooth, and the things are not accomplished." "For the inheritance and improvement of Traditional Chinese medicine, we should first focus on the name, that is, the standardization and unification of noun terms. It is based on this consideration.
The difference between coughs must be carefully discerned
1. Identification of the main symptoms and systemic symptoms of cough
(1) Main symptom: there is a sound in the throat.
(2) Systemic symptoms
1. Cough and rest can not lie down: refers to cough qi upwards, sleep or lean or lean, lean very high, can not lie normally flat. Most of them are caused by external wind chills, or yang deficiency, water reversal, and phlegm drinking to the lungs.
2. Cough and heavy sound: refers to the cough sound is loud and powerful. Most of them are evil and have no false feelings, empirical cough.
3. Cough without sputum: also known as dry cough, mostly caused by dry and yin deficiency of the lungs.
4. Sputum is not easy to cough out: refers to the cough sputum viscous, not easy to cough out. It is mostly caused by dry sputum or weakness in coughing up sputum for a long time.
5. Cough sputum is sparse and abundant: it is the evidence of wet sputum water drinking, the source is in the spleen but not in the lungs, caused by spleen deficiency and water loss of luck.
6. Coughing up blood: refers to coughing and bleeding in sputum, or purely coughing up blood. Most of them are caused by external or internal trauma, heat, and burns to the lungs, or are seen in pulmonary carbuncles, tuberculosis and other diseases.
7. Blood streaks in sputum: also known as hemoptysis, mostly caused by yin deficiency and fire, or dry lungs, heat disturbing the lung network.
8. Partial sleep: refers to lying on one side, can be left but not right, or can be right can not be left, or can be pitched or not. It is a symptom of internal heat of weak bone steaming, or seen in coughing with bruising and blood.
9. Dusk cough: the main symptom of yin deficiency cough.
10. Five more cough: mostly the main symptom of food accumulation cough, to children's food accumulation cough is more common.
11. Cough in winter, healing in spring and summer: mostly the main symptom of yang deficiency cough.
12. Cough: refers to coughing for a long time. Most of them are coughs of internal injuries and fatigue.
13. New cough: refers to the cough that is present. Most of them are external sensations.
14. Exhalation or spitting and smelly: it is one of the evidence of lung fever that hurts the lungs by drinking alcohol.
15. Unfavorable throat: dry throat infarction, one of the evidences of lung fever.
16. Bitter and dry mouth: one of the evidences of lung fever.
17. Puffiness: it can be caused by wind and cold invading the lungs or drinking water to flush the lungs. If you see both breathing and breathing, the pulse is floating and large, most of them are death certificates.
18. Slightly affected by wind chills, that is, wheezing: multifactorial body qi and yin deficiency or qi and blood two deficiencies, compound feeling of wind chill caused.
19. Aphasia: Mostly caused by long-term coughing or flat fire, compound wind and cold, fire for cold beams, cold wrapped in fire.
20. Frequent spitting: the causes of sputum are extremely many, and internal and external wounds can lead to the production of sputum, but spleen deficiency or wet sleepiness are the root causes.
21. Thin body: mostly caused by fatigue and coughing.
22. Clear cough: The so-called golden tone is clear. Most of them are evidence of being partial to fire and not wet.
23. Cough and less breath: that is, cough shortness of breath, less breath laziness. It is a testimony to the deficiency of lung qi.
24. Heavy cough: heavy turbidity is the sound of earth, if there is more phlegm and no thirst, it is a wet evil spleen, and the water has been drunk.
25. Continuous cough: that is, the cough is continuous and lasts for a long time. It is more common in children with whooping cough, or slow cough.
26. Chest pain: cough and faint pain in the chest. More common in pulmonary carbuncles.
27. Dry nose: mostly dry and hot cough, must also be dry throat and other symptoms.
Second, the six methods of coughing
In the diagnosis of cough disease, it is first necessary to distinguish whether it is an external sensation or an internal injury. Most of the external cough is a new disease, that is, a new cough, but there are also people who have a long-term illness and a new evil; most of the cough of internal injuries is a long-term disease, but there are also new diseases caused by internal injuries. In terms of external sensation, it is necessary to distinguish between fresh wind, cold, summer, wetness, dryness, and fire (heat), especially wind cold, wind heat, summer heat, autumn dryness, cold and dampness, and damp heat; in terms of internal injuries, we must first distinguish the emptiness, reality, cold, and heat of the lungs, and secondly, we must deeply investigate the organs that occur, and find out whether this cough is caused by the lungs themselves or because other organ diseases involve the lungs. If the cure is caused by the lungs themselves, the treatment of the lungs is the mainstay, if it is first started by other organs, it must be mainly used to treat other organs, otherwise the primary and secondary are not distinguished, the end is inverted, and it is difficult to take effect.
When identifying various specific cough symptoms, it is necessary to distinguish from the following 6 aspects:
1. Judging from the time of onset and season: such as cough at dusk, mostly yin deficiency; coughing at five more times, mostly lagging in diet; injured summer cough, mostly occurring in summer and summer; autumn dry cough, which must occur in autumn and so on.
2. Judging from the sound of cough: such as cough sound is heavy, cough and powerful, mostly new diseases, empirical evidence; cough is heavy, that is, although the sound is powerful, but turbid and unclear, mostly for spleen wet water drinking lung evidence; cough hoarseness, or even aphasia, mostly false evidence, long-term illness; cough and yahing sound, that is, wheezing and opening, the sound emitted in the throat, mostly phlegm and wheezing.
3. Judging from the presence or absence of sputum, how much, thickness, color, easy to cough out: such as cough and no sputum, for dry cough, mostly caused by dry heat injury or yin deficiency; phlegm is less thick and sticky, or even yellow sputum, not easy to cough out, mostly dry and hot cough; phlegm is clear and white, easy to cough, mostly cold and wet or yang deficiency.
4. Judging from the causes of the disease and the order of other diseases: such as cough during pregnancy, mostly coughs; coughs do not heal for a long time, chest hunger is painful, and there are white spots on the lips such as millet, which is a worm cough.
5. Judging from the age of the elderly and young: if whooping cough is a common cough in children; the cough of slow branch and pulmonary heart disease is mostly a disease suffered by the middle-aged and elderly, especially the elderly in the north.
6. Judging from the situation of conjunctive disease: such as cough and cold, no sweat, nasal congestion or runny nose, tight pulse floating or slowness, for the wind chill external sensation; cough and fever or cold headache, phlegm yellow viscous and cough sputum is not happy, thirst and sore throat, or sweat or no sweat, pulse floating and counting, for wind and heat cough; cough and phlegm and sputum and thin, tongue white and smooth, not thirsty, pulse strings slippery, do not like cold diet, for wet phlegm or phlegm drink cough; cough and cold cold fever, headache, pulse floating, etc., but also see the hot mouth dry, bitter mouth, bitter mouth, Thirsty people who like cold diet and other symptoms, cough in the cold, dry cough chest pain, cough and spit stinky pus, or a large amount of vomiting blood, the blood seems to have pus and smelly, the pulse number is real, for the pulmonary carbuncle cough;
Coughing up blood during the period when the evidence has been healed or not healed, and those who cannot lie down and lie on their sides are mostly bruised and cough; cough and vomit, vomiting is long worms, for stomach cough; coughing bile, coughing bile, coughing for the bladder cough; coughing and drowning, coughing and full of abdomen, not wanting to eat, for three scorched coughs; coughing and leaving the arrow, for the large intestine cough; coughing and sagittary cough; coughing and breathing, for small intestinal cough; cough and two flank pain, even can not turn, turn to the two flanks full, for the liver cough; cough and the right flank under the faint pain, lead to the shoulder and back, even can not move, move the cough, cough for the spleen cough, cough and wheezing sound, Even salivating blood, lung cough, cough and heartache, laryngeal median such as infarction, and even pharyngeal laryngeal paralysis, for heart cough.