Case Study: Post-External Pathogen Yin Deficiency Cough

Patient Profile:

• Female, Asian, 58 years old
• Chief Complaint: Persistent cough lasting over one month.

History:
The patient initially sought treatment from a Chinese medicine practitioner and was diagnosed with wind-cold cough. After taking one dose of herbal medicine, the cough worsened, prompting her to discontinue the treatment. She then turned to Western medicine and was prescribed steroids (prednisolone) and antibiotics. The patient reported that her cough improved by 80% after taking the Western medication. However, after consuming a small amount of chicken recently, her cough significantly worsened again. The symptoms now include phlegm, dryness, throat itchiness, and frequent nocturia (5–6 times per night).

Examination Findings:

• Tongue: Red with minimal coating
• Pulse: Floating, wiry, rapid, tight, thin, and slippery

Pathogenesis Analysis:

• Wind-heat damaging fluids
• Kidney Yin deficiency
• Phlegm-damp retention

Treatment Outcome:
After two weeks of treatment, the patient (possibly due to a misunderstanding of instructions) only followed the regimen for seven days. Further follow-up and adjustments were required.

Further Discussion：

• Why is it not a wind-cold cough?
  Although the pulse exhibits floating and tight qualities, it also includes a rapid component. While the patient did not present with obvious cold symptoms (due to physical weakness), the pulse indicates a combination of wind-heat and cold. This represents an error in diagnosis by the previous practitioner, whose use of purely warming herbs led to a worsening of the cough.
• Why were steroids and antibiotics initially effective but led to recurrence?
  Fundamentally, the treatment was not addressing the root cause. The medications could not eliminate the internal wind-heat or resolve the phlegm-fluid stagnation. The initial improvement was achieved through the strong suppressive effects of steroids. Once the medication’s effects wore off, the unchanged pathogenesis allowed the original symptoms to re-emerge. The patient followed my advice and discontinued further steroid use. Continuous suppression until symptoms no longer manifest could risk latent lung-related diseases developing in the future.
• Why it is crucial to tonify Yin? This patient is very thin and maintains an overly bland diet, which already predisposes her to a yin-deficient constitution. The external wind-heat invasion further damaged her yin, leading to symptoms such as throat dryness and thirst. At this stage, the treatment must focus on nourishing yin to stop the cough and prevent further depletion of kidney yin, which could undermine the body’s fundamental vitality.

Case NO.105  @ Anfa clinic, Melbourne

Note: TCM doesn’t ‘treat’ any certain WM disease name. TCM has its own system and method to rebalance the human body, release the symptoms and help the body truly recover on its own. TCM treatment methods and effects are different according to individual differences, and the sharing of the case study does NOT constitute treatment recommendations.