Pertussis - Bai Ri Ke
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Definition
A seasonal disease caused by seasonal pestilent evils that affecting the lung system in children. Paroxysmal and spasmodic coughs, distinctive inhaling noise after cough attack, stopping temporarily after cough up phlegm. Long course: may last for 2-3 months (hence Bai Ri – a hundred days). Also called Dun Ke (Pause Cough), Qiang Ke (Choke Cough) and Yi Ke (Contagious Cough).
Causes
- Attack by seasonal pestilent evils.
Pathological Mechanisms
- Seasonal pestilent evils attack the Lung, block the air route with Phlegm and impede the functions of the Lung
- Early stage: Wei Qi symptoms due to failure in dispersing of the Lung and Wei Qi
- Middles stage: pestilent evils transform into Fire and gang up with Phlegm, blocking air route and Lung Qi adversely ascending and failing to descend. Paroxysmal and spasmodic coughs not only injures Lung Qi, but also affect other Zang Fu organs (Stomach, Bladder, Large Intestine, Heart, Liver, eyes, etc)
- Late stage: pestilent evils retreat and injuries Genuine Qi
- Weak Constitution and weak Lung Qi: Phlegm and Heat close the Lung – Chuan Zheng; Phlegm and Heat closing the orifice – Jing Feng
Patterns
Early Cough Stage
- Symptoms: Stuffy and runny nose, cough with high pitch noise and getting worse in 2-3 days, worse at night, thin and white phlegm but not much, or stick phlegm hard to cough up. Lasts for 1 week.
- Tongue: Thin white or thin yellow tongue coating
- Pulse: Floating
- Treatment strategy: Dispel wind and the evils, disperse lung qi to stop cough
- Formula: San Ao Tang
- Modification: For Wind Cold add Su Ye, Bai Bu and Chen Pi. For Wind Heat add Huang Qin and Shi Gao. For white phlegm add Ban Xia. For yellow phlegm add Dan Nan Xing and Ting Li Zi
- Acupoints:
Spasmodic Cough Stage
- Symptoms: Persistent paroxysmal and spasmodic coughs with a distinctive inhaling noise after cough attack, stopping temporarily after cough up phlegm and some vomit, worse at night, excitement or irritating smell trigger cough attacks, red eyes, hypochondriac pain, lingual frenulum ulcer. May last for 2-6 weeks.
- Tongue: Red tongue with thin yellow coating
- Pulse: Rapid
- Treatment strategy: Clear away heat and purge the lung, relieve spasm and stop cough
- Formula: Ting Li Da Zao Xie Fei Tang and Sang Bai Pi Tang
- Acupoints:
Recovery Stage - Lung Qi Deficiency and Spleen Qi Deficiency
- Symptoms: Receding paroxysmal and spasmodic coughs, weak coughing noise, thin and white phlegm, lethargy and lassitude, indolence of speech, short of breath, loss of appetite, spontaneous sweating and loose feces.
- Tongue: Pale tongue with thin white coating
- Pulse: Weak
- Treatment strategy: Tonify qi, strengthen spleen, resolve phlegm and stop cough
- Formula: Liu Jun Zi Tang
- Acupoints:
Recovery Stage - Lung Yin Deficiency
- Symptoms: Receding paroxysmal and spasmodic coughs, dry cough with no phlegm, or very little sticky phlegm and hard to cough up, hoarse voice, low fever, afternoon malar flush, vexation, insomnia and night sweats.
- Tongue: Red tongue with little or no coating
- Pulse: Thready and Rapid
- Treatment strategy: Nourish yin and moisturise lung, clear away heat and resolve phlegm
- Formula: Sha Shen Mai Dong Tang
- Acupoints:
References
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