Lung-Yin Deficiency

However, I prefer to classify coughs as acute or chronic, since this factor is clinically more
significant. In fact, when presented with a patient with cough the first thing to ascertain is
whether the cough is acute or chronic. Once this has been ascertained, one needs to establish
whether the cough is external or internal. Acute coughs may be external or internal but are
always of the Full type, while chronic coughs may be of the Full or Empty type.

The train of thought and guideline for interrogation of the patient may be represented with a
diagram (Figure 8.1(159)Figure 8.1(160)).

Diagnosis

Cough can be diagnosed according to its sound, the time of occurrence and the character of any
sputum.

Sound

As a general rule, a weak-sounding cough indicates Deficiency while a loud cough indicates
Excess.

A barking cough denotes Heat while a loose, rattling cough indicates the presence of Phlegm.

Time of Day

A cough which occurs only in the late afternoon or evening indicates Yin deficiency.

A cough which is worse in the morning is usually due to Phlegm.

Sputum

A cough without sputum indicates either Deficiency or Heat.

If there is abundant sputum, it is due to Phlegm. A yellow sputum denotes Heat, while white
sputum denotes Cold. White sputum may be sticky or dilute: if it is sticky it indicates the
prevalence of Dampness and Phlegm over Cold, while if it is dilute, it indicates the prevalence of
Cold over Dampness or Phlegm.

Blood-tinged sputum indicates either Full- or Empty-Heat. Greenish sputum indicates Heat,