Clinical Case: Female 60 Years Old, Cough

Clinical Case: Female 60 Years Old, Cough

Female, 60 years

Reason for consultation

Cough

Clinical history

The patient suffers from a repetitive cough of 4 years' duration. For one week, the symptoms have reappeared. She was diagnosed with bronchitis 4 years ago. The main symptom is non-asthmatic cough and it begins in winter and when she catches cold. One week ago, she was exposed to cold with a strong cough that worsens during the night. The patient can only sleep for 3 or 4 hours at night.

She has abundant white sputum, permanent feeling of cold but without fever, feeling of chest oppression. poor appetite, diarrhea (3/4 times a day)

Pale tongue with greasy coating, fine and slippery pulse.

Diagnosis

Analysis:

  • First: chronic cough. Lung is affected every winter, Qi does not defend -> Qi deficiency. Confirmed by fine pulse and pale tongue, sensitive to cold.
  • Now: cold attack that generates accumulation of cold Phlegm. If there were heat it would be with less sputum because the fluid would be consumed. The whole Tai Yin is affected -> Spleen Qi affected: poor appetite and diarrhea. Cold has weakened Spleen-Yang.

Recent and urgent Biao pattern: accumulation of cold Phlegm in the Lung. There is also a Spleen-Qi deficiency.


Therapeutic principles

  • Eliminate cold Phlegm, release the lung (will calm the cough)
  • Tonify lung and spleen

Treatment

  • Cold-Phlegm: Interior Pattern:
  • Eliminate Phlegm for Lung:
    • I don't use ST-40 (very generic);
    • BL-13 + LU-1 (shu and mu) (release the chest);
    • GV-14 mobilize yang energy (moxa) + CV-17 (cough point) + CV-22 + CV-12 (center point: will help spleen and stomach)
  • Calm cough and release the surface:LU-7 + LI-4;
  • Tonify the Qi: ST-36 (moxa) + CV-4

Authors:

Page updated on October 14, 2021

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