Cough — spleen yang deficiency

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Textbook Prescriptions Respiratory

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

BL20 Pishu bilateral

Back-Shu of the Spleen; strengthens the spleen to dry damp

Reinforcing method with moxibustion.
CV12 Zhongwan midline

Front-Mu of the Stomach; supports the middle burner to resolve phlegm

Reinforcing method with moxibustion.
- ⚠ Organ
- Pregnancy: caution
ST36 Zusanli bilateral

He-Sea of the Stomach; strengthens spleen and stomach

Reinforcing method with moxibustion.
BL13 Feishu bilateral

Back-Shu of the Lung; warmed to activate lung qi

Reinforcing method with moxibustion.
- ⚠ Pneumothorax
BL43 Gaohuang bilateral

Bladder point beside T4; warmed to support lung qi

Reinforcing method with moxibustion.
- ⚠ Pneumothorax
ST40 Fenglong bilateral

Luo point of the Stomach; resolves phlegm

Reinforcing method with moxibustion.

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

CV12 Zhongwan
- ⚠ Organ injury has been reported after needling this point. Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 4 (Organ injury associated with acupuncture)
BL13 Feishu
- ⚠ Pneumothorax risk: too deep an insertion can puncture the pleura. World Health Organization 1999, Section II §5.2 (Lung and pleura), p. 25; Wu J, Hu Y, Zhu Y, Yin P, Litscher G, Xu S 2015, Table 1 (Pneumothorax associated with acupuncture)
BL43 Gaohuang
- ⚠ Pneumothorax risk: too deep an insertion can puncture the pleura. World Health Organization 1999, Section II §5.2 (Lung and pleura), p. 25

Treatment Principle

Strengthen the spleen and transform phlegm, centred on the spleen's Back-Shu and the stomach's Front-Mu points.

Indications

Cough with copious sputum, worse in winterpoor appetitelistlessnessthick, sticky, slippery white tongue coatingpulse usually deep and slow

Method

Reinforcing method combined with moxibustion.

⚠ Cautions

Chronic productive cough needs medical assessment (e.g. COPD, bronchiectasis). BL13, BL43 and BL20 overlie the lung: needle obliquely and shallowly to avoid pneumothorax; moxibustion on the back carries less risk than deep needling.

About

The textbook's prescription for internally generated cough from deficient spleen yang, where damp accumulates and forms phlegm.

Rationale

BL20, CV12 and ST36 build up the spleen and stomach so that damp is cleared and phlegm no longer forms. Moxibustion at BL13 and BL43 warms and activates lung qi, and ST40 helps resolve the phlegm.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Cough, p. 345–347.

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