[Case study] ​​one case of cough with blood for more than half a year

One patient, male, over 60 years old, Asian, complained of coughing with blood for more than half a year, and all treatments were ineffective. Cough was due to an unknown cause, with thick yellow sputum, and dark purple blood. The day before, he coughed and spit out a small mouthful of blood, which was dark in colour, and then he rushed to the emergency in the hospital, but no abnormality was found after the medical examination. There is no pain in the lung area. The cough does not affect sleep. The throat is itchy. The mouth is not thirsty. The appetite is normal. The spirit is good, and the stools and urine are normal. Occasionally he feels a bitter taste. The tongue is a bit moist, with tooth marks, and a thin and greasy coating. His right pulse is strong in both Cun and Guan locations,  his left pulse is thin and taut.

The TCM dialectical diagnosis of this disease is the “Fei yong” disease in Zhang Zhongjing’s famous book: Synopsis of the Golden Chamber. 7 days of doses were prescribed. At the second consultation, there was no blood, and no yellow phlegm anymore and the patient said, “I feel so comfortable after taking your medicine. It seems to be better than the medicine prescribed by my doctor in China.”  And this time, the greasy tongue coating had disappeared, and the pulse was slightly big and insufficiency. This shows the symptom of deficiency caused by prolonged coughing have come out after most of the excess illness has gone away. However, the disease evil has not yet been totally eliminated at this stage. After it has all gone, it is necessary to enhance the energy of the body, and then the full health can be recovered.

Cough is often a hard-to-treat disease, so there is a saying that a famous doctor does not like to treat cough. Cough often has complex pathogenesis. The patient had previously taken western medicines of antitussives and antibiotics, which were ineffective. Why is it ineffective? I have repeatedly emphasized that as a patient, we must always remember one thing, we must look at the disease signals from the body positively! Why cough when there is phlegm in the lungs? That is because the human body hopes to expel diseases through coughing, and coughing with phlegm out is a positive direction. Therefore, in the treatment, we should use the method of transforming phlegm, dispelling the lung and lowering lung qi. The “antitussive” treatment is suppressing the normal excretion response of the human body. It looks like the cough stops, but the phlegm will not be excreted in the lungs and make the situation worse. In particular, under the current situation of the Covid-19, we should not relieve cough casually with antitussive, which may turn ordinary cough into a severe case. This is a problem that Western medicine has seen from the experience of a large number of  Covid cases.

The patient was also diagnosed with hay fever before, and the treatment of repeatedly cleaning the nasal cavity is regarded as ignorant of the disease, and the treatment was a waste of time. I will not discuss it here.