Recurrent Colds and Dry Cough
M, 55 years old. 55-year-old male with a history of frequent colds (5-6 per year), chronic dry cough, weak voice and mild sensation of breathing difficulty.
The patient
- Age and sex
- 55 years · M
- Chief complaint
- 55-year-old male with a history of frequent colds (5-6 per year), chronic dry cough, weak voice and mild sensation of breathing difficulty.
- Tongue
- Pale, slightly dry body, with thin white coating or no coating.
- Pulse
- Weak (Ruo) and empty (Xu) pulse in the right Cun position (Lung).
Symptoms
- Frequent colds with slow recovery
- Chronic dry cough without expectoration
- Weak voice and shortness of breath on exertion
- Tendency to sweat spontaneously (especially during the day)
- Dry and dull skin
- General fatigue
Warning signs to rule out
- Cough lasting more than three weeks in a smoker or ex-smoker, blood-streaked sputum, persistent hoarseness or weight loss. → Referral and chest imaging before continuing. Age and profile require ruling out lung disease before treating the cough as vacuity.
- Progressive breathlessness, ankle swelling, or needing to sleep propped up. → Cardiology assessment: heart failure presents as cough and fatigue more often than expected.
- Fever with purulent sputum, pain on deep breathing, or abrupt deterioration. → Same-day medical assessment. Wei Qi vacuity predisposes to infection, and infection is no longer treated with tonification.
Case resolution
Think through the pattern first, then expand the resolution
- Pattern
- Lung Qi Deficiency with Insufficient Wei Qi
- Meridians involved
- Lung, Large Intestine
- Pathogenic factors
- Lung Qi Deficiency, Insufficient Wei Qi, Lung Dryness
The Lung controls Qi and respiration, and distributes Wei Qi (defensive Qi) over the body's surface to protect it from external pathogens. When Lung Qi is deficient, Wei Qi is insufficient, the surface is unprotected and the person is susceptible to frequent colds. Dry cough without expectoration indicates the Lung is also dry.
Differential diagnosis
Shares: Chronic dry cough and a voice that fades.
Sets it apart: Yin vacuity gives a dry throat, thirst for small sips, hoarseness worse in the afternoon, hot palms and a red tongue without coating. Here the tongue is pale, there is daytime spontaneous sweating and the voice is weak from the morning: this is Qi vacuity.
Shares: Chronic cough and tiredness with a pale tongue.
Sets it apart: When Phlegm is the axis, the cough is productive with copious white sputum, worse in the morning, with heaviness and a greasy coating. Here the cough is dry: the Spleen is treated as the mother of the Lung, not as a source of phlegm.
Shares: Breathlessness and fatigue.
Sets it apart: When the Kidney fails, breathlessness appears on exertion, the in-breath is short, inhaling is harder than exhaling, and there is low back ache with a deep, weak Chi (尺) pulse. If breathlessness dominates over the cough, the treatment moves to another level.
Treatment
Principle: Tonify Lung Qi, consolidate Wei Qi and strengthen the Spleen, the mother of the Lung.
| Point | Role | Technique |
|---|---|---|
| LU9 | Lung Yuan-source and influential point of the vessels: the tonification point par excellence for this organ. | Perpendicular 0.3-0.5 cun avoiding the radial artery, tonifying. |
| BL13 | Lung Back-Shu: with moxa it is what sustains Wei Qi between sessions. | Oblique toward the spine 0.5 cun with moxa. Never deep perpendicular: pneumothorax risk. |
| ST36 | Reinforces the Spleen so it produces the Qi the Lung distributes; without it the tonification does not hold. | Perpendicular 1-1.5 cun with moxa, tonifying. |
| CV17 | Influential point of Qi and Pericardium Mu: it gathers the Qi of the chest, which is where this patient is short of it. | Transverse downward 0.3-0.5 cun. |
| BL43 | Gaohuangshu: the classic point for chronic vacuity that will not lift, always with moxa. | Oblique 0.5 cun with fifteen minutes of moxa. |
| LU7 | Lung Luo point: it releases the exterior at the first sign of a cold, while it can still be cut short. | Transverse toward the elbow 0.3-0.5 cun. |
Formula: Yu Ping Feng San. Jade Windscreen: the reference formula for consolidating the Wei Qi of someone who catches cold again and again. If there is also phlegm and heavy digestion, pair it with Liu Jun Zi Tang.
- Frequency
- One session weekly for eight to twelve weeks, starting in early autumn. This pattern is treated in anticipation: reinforcing Wei Qi in midwinter arrives late for the season.
Home care
- Moxa on BL13 and ST36, ten minutes, twice a week throughout the cold season.
- Cover the upper back outdoors: Wind enters there and this patient has little defence.
- Practise the Lung sound of Liu Zi Jue, or the Baduanjin stretch that opens the chest, for five minutes a day.
- Talk less on long days: the voice consumes Lung Qi and his is already scarce.
Progress
- Session 1 · early autumn Dry cough triggered by long spells of talking, a weak voice from the morning, daytime spontaneous sweating, and five or six colds in the past year. LU9, BL13 with moxa, ST36 and CV17. Yu Ping Feng San is started and home moxa is taught before the cold sets in. Spontaneous sweating stops within two weeks, the first sign that Wei Qi is consolidating.
- Session 4 · week 4 Less coughing, but his voice still gives out by the end of the working day. BL43 with extended moxa is added, the point for chronic vacuity that will not quite lift. The voice holds through a full day from week six onward.
- Session 8 · first cold spell of winter He gets through the first cold spell without catching cold, which had not happened in years, but the cough returns when he goes out into cold air. LU7 is added and he is taught to use it with acupressure at the first chill, along with a scarf covering the nape. The cold-air cough resolves within three weeks.
- Session 12 · end of the season A single mild three-day cold across the whole season, against five or six the previous year. Treatment ends, with home moxa and a course of four sessions at the start of the following autumn. He repeats the pattern of a single mild infection the following year.
- Discharge
- Treatment ends at the end of the cold season, not when the cough settles. This picture is measured in colds per season, and that count does not close in six weeks.
- Watch for relapses
- The following autumn. The first sign to return is daytime spontaneous sweating, weeks before the first cold: that is when to resume treatment.
Health notice. Educational and study content. It describes concepts of Traditional Chinese Medicine and does not replace diagnosis or treatment by a healthcare professional. Needling, medicinal herbs and invasive techniques must be applied by trained professionals. Safety guide.
