Pertussis+(Whooping+Cough)

Signs and symptoms (SS): Similar to common cold: cough with clear dilute nasal discharge, sneezing, aversion to cold, thin white tongue coating and a floating tense pulse. Eventually wind-cold turns to heat, with increasingly heavy voice, a cough worse at night and worsening daily, inflamed throat, thicker phlegm discharge, red tongue and floating rapid pulse. Treatment principle (TP): Stop the cough by relieving exterior syndrome and opening lung. The literature offers two recommended formulas from which the practitioner may choose. Px: //Jin Fo Cao San//8 For this stage, which resembles a common cold, we resolve exterior wind-heat, descend lung //qi// and clear watery phlegm-heat. In this formula, we find herbs that dispel wind (//xi xin, ma huang, sang ye// and //ju hua//), transform phlegm (//xuan fu hua, qian hu, chuan bei mu// and //ban xia//) and stop cough (//bai bu, xing ren//). In addition, //lian qiao//, an antiviral herb, clears heat and resolves toxin. Of particular use is //bai bu// for that sharp, barking cough peculiar to pertussis. The combination of //xuan fu hua// and //bai jie zi// addresses watery nasal discharge. Px: Combine //San Ao Tang, Sang Ju Yin// and //Dai Ge San// This approach is similar to that of formula one...with some significant adjustments. //Niu bang zi// addresses sore throat, while the last three herbs work together to break up thick sputum due to phlegm-fire. I would recommend formula one for the earlier presentation of watery nasal discharge, and formula two for more pronounced coughing and phlegm production. Experienced herbalists can modify these formulas as they wish. To resolve exterior wind-heat, choose from //sang ju yin, yin qiao san// or //chai ge jie ji wan//. To clear phlegm-heat, choose from //qing qi hua tan wan, ning sou wan// or similar products from American manufacturers. For reinforcing the antiviral effect with herbs that clear heat and resolve toxin, choose from //huang lian jie du wan, gan mao ling, zhong gan ling, chuan xin lian//, etc. SS: Paroxysmal gasping coughs with a strong barking sound, thick sputum that is difficult to expectorate, noisy inhaling of breath, vomiting of mucus, red eye, occasional blood in sputum. The tongue is red with a yellow greasy or sticky coat, and the pulse is rapid, slippery and forceful. TP: Clear heat, resolve toxins, transform phlegm, stop cough. Two formulas are recommended for the practitioner to choose from. With frequent, spasmodic and violent cough, add the following: With dry cough with little sputum, add the following: Px: //Sang Bai Pi Tang// Formula two has stronger heat-clearing and antibacterial effects, combining //huang qin, huang lian// and //zhi zi//. These can be added to formula one. Similarly, the modifications of formula one can be applied to formula two. For lung fire, choose from //huang lian shang qing pian, qing fei yi huo pian//, etc. For deficiency of lung yin, choose from //bai he gu jin wan, sha shen mai men dong wan//, etc. For accumulation of toxic heat or damp-heat, choose from //huang lian jie du wan, gan mao ling, zhong gan ling//, etc., or any product using significant amounts of //ban lan gen// and/or //da qing ye//. Also consider syrups or capsules containing //man shan hong// (radix rhododendri daurici) or //zi hua du juan// (radix rhododendri mariae), such as //hsiao keh chuan//. This stage continues for two to three weeks, but may last several months. The severity of the paroxysmal cough and noisy inhalation gradually decreases. > **A. Deficiency of //Qi//** SS: Weak cough, feeble low voice. Tongue may be pale and the pulse is weak. TP: Tonify lung and spleen //qi//. Px: //Ren Shen Wu Wei Zi Tang// > **B. Deficiency of Yin** SS: Hoarse voice, dry cough, dry throat, red tongue, weak rapid pulse. TP: Moisten lung yin Px: //Qing Zao Jiu Fei Tang//, modified
 * 1. Catarrhal Stage (Invasion of Pathogenic Wind)**
 * Formula One**7 **(for runny-nose stage)**
 * //xuan fu hua// (flos inulae), 9 gm
 * //qian hu// (radix peucedani), 6 gm
 * //bai jie zi// (semen sinapsis albae), 6 gm
 * //xi xin// (herba asari), 3 gm
 * //bai bu// (radix stemonae), 9 gm
 * //chuan bei mu// (bulbus fritillariae cirrhosae), 3 gm
 * //zhi ban xia// (rhizoma pinellia), 6 gm
 * //ma huang// (herba ephedrae), 3 gm
 * //xing ren// (semen armeniacae), 3 gm
 * //sang ye// (folium mori), 9 gm
 * //ju hua// (flos chrysanthemi), 9 gm
 * //lian qiao// (fructus forsythiae), 9 gm
 * Formula Two**9 **(for beginning cough stage)**
 * //ma huang// (herba ephedrae), 5 gm
 * //xing ren// (semen armeniacae), 10 gm
 * //gan cao// (radix glycyrrhizae), 5 gm
 * //bai bu// (radix stemonae), 10 gm
 * //bai qian// (rhizoma cynanchii stauntoni), 10 gm
 * //sang ye// (folium mori), 10 gm
 * //ju hua// (flos chrysanthemi), 10 gm
 * //niu bang zi// (fructus arctii), 10 gm
 * //jie geng// (radix platycodi), 5 gm
 * //qing dai// (indigo naturalis*), 6 gm
 * //hai ge ke// (concha cyclinae), 6 gm
 * Substitute //ban lan gen// or //da qing ye//.
 * Treatment with Chinese herbal products.** For practitioners without access to custom formulas, I recommend combining several prepared products to achieve the effect of the recommended formulas. In this first stage, we need a formula that resolves exterior wind-heat and another formula to clear phlegm-heat. In addition, I strongly suggest adding an herbal product that has strong antiviral and antibacterial effects.
 * 2. Paroxysmal Stage (Retention of Phlegm-Fire)**
 * Formula One**10
 * //su zi// (fructus perillae), 9 gm.
 * //ting li zi// (semen lepidii seu descurainiae), 9 gm
 * //wu wei zi// (fructus schisandrae), 6 gm
 * //meng shi// (lapis chloriti), 6 gm
 * //jie geng// (radix platycodi), 9 gm
 * //zhi shi// (fructus aurantii immaturus), 6 gm
 * //gua lou// (fructus trichosanthis), 12 gm
 * //da zao// (fructus zizyphi jujubae), 5 pc
 * Modifications**
 * //jiang can// (bombyx batryticatus), 6 gm
 * //di long// (lumbricus), 6 gm
 * //nan sha shen// (radix adenophorae), 12 gm
 * //tian men dong// (radix asparagi), 12 gm
 * //mai men dong// (radix ophiopogonis), 12 gm
 * Formula Two**11
 * //sang bai pi// (cortex mori albae radicis), 10 gm
 * //huang qin// (radix scutellariae baicalensis), 10 gm
 * //huang lian// (rhizoma coptidis), 2 gm
 * //chao zhi zi// (fructus gardeniae, fried), 10 gm
 * //su zi// (fructus perillae), 10 gm
 * //xing ren// (semen armeniacae), 10 gm
 * //chuan bei mu// (bulbus fritillariae cirrhosae), 5 gm
 * //ting li zi// (semen lepidii seu descurainiae), 10 gm
 * //bai bu// (radix stemonae), 10 gm
 * Treatment with Chinese herbal products.** This stage is the most serious in terms of repetitive cough, especially during nighttime. It represents a combined presentation of lung fire, deficiency of lung yin and a stage I call sticky phlegm-heat. Products for each group needed to be combined, with additional herbs to clear toxic heat (antiviral) or dispel damp heat (antibacterial).
 * 3. Recovery Stage (Deficiency of Lung and Spleen)**
 * //dang shen// (radix codonopsis pilosulae), 9 gm
 * //fu ling// (poria), 9 gm
 * //bai zhu// (rhizoma atractylodis macrocephalae), 9 gm
 * //mai men dong// (radix ophiopogonis), 12 gm
 * //wu wei zi// (fructus schisandrae), 6 gm
 * //gan cao// (radix glycyrrhizae), 3 gm
 * //sheng jiang// (rhizoma zingiberis officinalis), 3 pc
 * //da zao// (fructus zizyphi jujubae), 5 pc
 * Treatment with Chinese herbal products.** Choose from the following: cordyceps capsules (//dong chong xia cao//; pulvis cordyceps sinensis), American ginseng capsules (//xi yang shen//; radix panacis quinquefolii), //qing zao jiu fei wan, sheng mai yin, liu jun zi wan//, etc. //Dong chong xia cao// and //xi yang shen// are particularly helpful and should be used in most of these cases.
 * //nan sha shen// (radix adenophorae), 9 gm
 * //sang ye// (folium mori), 9 gm
 * //xing ren// (semen armeniacae), 9 gm
 * //mai men dong// (radix ophiopogonis), 9 gm
 * //tian men dong// (radix asparagi), 9 gm
 * //jie geng// (radix platycodi), 9 gm
 * //hei zhi ma// (semen sesami indici), 12 gm
 * //e jiao// (gelatinum corii asini), 9 gm
 * //da zao// (fructus zizyphi jujubae), 5 pc
 * Treatment with Chinese herbal products.** Choose from the following: cordyceps capsules (//dong chong xia cao//, pulvis cordyceps sinensis), American ginseng capsules (//xi yang shen//; radix panacis quinquefolii), //qing zao jiu fei wan, sheng mai yin, bai he gu jin wan, sha shen mai men dong wan//, etc. Again, the use of //dong chong xia cao// and //xi yang shen// is very helpful.
 * Treatment with Chinese herbal products.** Choose from the following: cordyceps capsules (//dong chong xia cao//, pulvis cordyceps sinensis), American ginseng capsules (//xi yang shen//; radix panacis quinquefolii), //qing zao jiu fei wan, sheng mai yin, bai he gu jin wan, sha shen mai men dong wan//, etc. Again, the use of //dong chong xia cao// and //xi yang shen// is very helpful.

Source: //Acupuncture Today//, September, 2006, Vol. 07, Issue 09

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Definition:
(Whooping cough) An acute, highly communicable bacterial disease, characterized by paroxysmal or spasmodic cough that usually ends in a prolonged, high-pitched, crowing inspiration (the whoop).

Etiology:
Bordatella pertussis, a small gram-negative coccobacillus. Transmission is by aspiration of bacteria sprayed into air by patient.

Nutrition:
eating principles: • eat as little as possible • increase foods rich in Vitamin C • increase fluids • short fast

therapeutic foods: • garlic, onions, leeks, turnips, grapes, pineapple, honey, green leafy vegetables (Jensen, p. 61)

fresh juices: • carrot (Walker, p. 133) • carrot and spinach (Walker, p. 133) • carrot, beet, and cucumber (Walker, p. 133)

specific remedies: • take 3-15 g of pumpkin seeds and stir-fry until outer surface is black. Crush to a fine powder, take 1 g mixed with sugar and water. Serve three times daily (Yin-fang and Cheng-jun, p. 105) • take a fresh lemon or orange, slice and add 15 g sugar. Steam in water until soft, mash and serve, including the skin, twice daily (Yin-fang and Cheng-jun, pp. 64, 84) • take 50 g of shelled peanuts, add water and boil, then mash. Drink the broth and eat the peanuts twice daily (Yin-fang and Cheng-jun, p. 97) • take 120 g carrots and 12 Chinese red dates, add 6 cups water and simmer until reduced to 2 cups. Serve this in several small portions throughout the day for 10 days (Chao-liang, Qing-rong, Bao-zhen, p. 13) • take 30 g eggplant, discard the seeds simmer in water with a little brown sugar (Chao-liang, Qing-rong, Bao-zhen, p. 61) • infusion of crushed garlic sweetened with sugar (Chao-liang, Qing-rong, Bao-zhen, p. 87)

avoid: • cow's milk and other dairy products, white bread, refined foods, processed foods, sugar and sweets, catarrh-forming foods: tofu, meat, ice cream, shellfish, heavy protein foods, fats, meats, vinegars

Botanicals
• Allium sativum: with Baptisia tinctoria and Echinacea spp. for viruses (British Herbal Pharmacopoeia, p. 20) • Atropa belladonna (toxic): anti-spasmodic (Felter and Lloyd, p. 338) • Cephaelis ipecacuanha: controls irritation and inflammation (Felter, p. 433) • Cimicifuga racemosa: antispasmodic, muscular ache • Datura stramonium (toxic): severe paroxysms with hemorrhage from the mouth and nose (Felter and Lloyd, p. 1841) • Ephedra vulgaris (Weiss, p. 219 • Ferula asafoetida: nervous cough following active stage of pertussis (Felter, p. 221) • Grindelia robusta: antispasmodic, expectorant (Ellingwood, p. 247) • Inula helenium: with Trifolium pratense (Priest and Priest, p. 93) • Lobelia inflata (toxic): severe spasmodic coughing (Felter and Lloyd, p. 1203) • Marrubium vulgare: relieves congestion • Pilosella officinarum: pulmonary conditions with excessive sputum, soreness, hemoptysis (British Herbal Pharmacopoeia, p. 159) • Pimpinella anisum: combines with Prunus serotina (British Herbal Pharmacopoeia, p. 160) • Prunus serotina: may be combined with Tussilago farfara, Marrubium vulgare, Urginea maritima (toxic) (British Herbal Pharmacopoeia, p. 172) • Sticta pulmonaria: irritating, persistent, spasmodic cough, with Trifolium pratense (Felter and Lloyd, p. 1835; Priest and Priest, p. 95) • Thymus vulgaris: antispasmodic (Weiss, p. 208) • Tussilago farfara • Urginea maritima (toxic): with Cephaelis ipecacuanha (British Herbal Pharmacopoeia, p. 224) • Viola tricolor: with Tussilago farfara and/or Urginea maritima (toxic) (British Herbal Pharmacopoeia, p. 234)

Chinese Formulae
• Wei Jing Tang; She Dan Chen Pi Mo (patent): Lung Obstructed by Phlegm-Heat: cough with foul-smelling sputum (may be streaked with blood), slight fever, mild chest pain, dry skin, red tongue with greasy yellow coat. (Wei Jing Tang: Yeung, p. 239; Bensky and Barolet, p. 91; She Dan: Zhu, p. 80) • Morus and Platycodon C.; Platycodon and Fritillaria C.: Lung Invaded by Wind-Heat (Morus: Hsu, 1980, p. 563; Platycodon: Hsu, 1980, p. 548; Dharmananda, 1986, p. 205) • Platycodon and Schizonepeta F. (Zhi Sou San): Wind-Cold. (Hsu, 1980, p. 546; Yeung, p. 293; Bensky and Barolet, p. 446) • Minor Blue Dragon C. (Xiao Qing Long Tang): Lung Invaded by Wind-Cold with Spleen Qi Xu (Deficiency): fever and chills (more chills) without sweating, coughing, wheezing, copious white stringy sputum that is difficult to expectorate, generalized sensation of heaviness. (Hsu, 1980, p. 43; Yeung, p. 261; Dharmananda, 1986, p. 127; Bensky and Barolet, p. 38) • Minor Bupleurum C. (Xiao Chai Hu Tang) plus Pinellia and Magnolia C. (Ban Xia Hou Po Tang): Pertussis complicated by Spleen Qi Xu (Deficiency): fatigue, loss of appetite, diarrhea and/or indigestion. (combination: Flaws, p. 126; Minor Bupleurum: Hsu, 1980, p. 91; Yeung, p. 255; Dharmananda, 1986, p. 133; Bensky and Barolet, p. 136; Pinellia and Magnolia: Hsu, 1980, p. 395, Dharmananda, p.226; Yeung, p. 42; Bensky and Barolet, p. 291) • Er Dong Gao: Herbal cough syrup (Flaws, p. 126) • Pinellia 16 (patent): Lung Obstructed by Damp-Phlegm: cough (Dharmananda, 1990, p. 53) • Lily 14 (patent): dry cough (Dharmananda, 1990, p. 20)

Acupuncture
after assessing the person and palpating, consider these patterns: Wind-Cold, esp. Lung Cold; Lung Heat; Wind and Heat; Lung Xu (Deficiency); Lung Invaded by Wind-Heat; Lung Obstructed by Damp-Phlegm and/or Phlegm-Heat

» illustrative combinations: • UB-13, UB-12, CV-12, St-40, LI-2, Lu-5 and hua tuo jia ji of T1 to T4 for pertussis (Shanghai, p. 576) • Lu-7 and UB-13 (daily) for pertussis (Shanghai, p. 576) • Lu-5 and St-40: clear Phlegm (and Heat) of bronchitis or pertussis • GV-12, GV-14 and UB-12 for pertussis (Shanghai, p. 197) • si feng, PC-6 and LI-4 for pertussis (Shanghai, p. 256); also consider GV-14, GV-12, Lu-9, St-40 (Lee and Cheung, p. 229) • UB-13 (bilateral) and Lu-7 (bilateral) for pertussis (Lee and Cheung, p. 230) • GB-20, GV-14, UB-12, CV-22, CV-13, Lu-9, St-36, UB-10, Kd-27, CV-12, Lu-8 and St-40 for pertussis (Lee and Cheung, p. 230) • Lung Cold pertussis: if vein at san guan (radial side of index finger) red, needle GB-20, UB-13 and CV-6; tui na: reduce fei jing (rubbing vigorously up and down along the Lung channel on the forearm), spread CV-17, grasp GB-20, grasp GB-21, knead UB-13, push san guan (Ambrose) • Lung Heat pertussis: needle GB-20, UB-13, Lu-5; tui na: reduce fei jing, push CV-17 to CV-12 area, grasp GB-21, knead UB-12, knead UB-13, push lin fu - Lung channel forearm (Ambrose) • Lu-9 (+ and ind. D) and LI-4 (-): spread Lung Qi; dispel Wind-Cold; alleviate cough • Lu-5 and Lu-11 (-): clear Wind-Heat; can bleed Lu-11 to clear Phlegm-Heat (Eisen) • CV-22 and CV-17 (+): ease difficult breathing; spread Lung Qi; resolve Phlegm (Ambrose) • Lu-7 and Kd-6: open and regulate the Ren Mai (Conception Vessel) for which Phlegm congestion as well as respiratory conditions such as cough and bronchitis are signs of dysfunction

Homeopathy
• Aconitum napellus: clear ringing or whistling cough, excited by burning sticking in larynx, generally without expectoration; rarely, during day, expectoration of mucus with coagulated blood • Antimonium tartaricum: cough provoked when the child gets angry, or after eating, which culminates in vomiting of mucus and food • Carbo vegetabilis: short hard, but infrequent coughing spells, excited by a creeping irritation in larynx and throat; in the evening without, in the morning with yellow, greenish, purulent, or tenacious mucoid sputum, < by eating or drinking cold things, in damp cold air, by passing into a cold atmosphere; irritability and despondency; bleeding from eyes; coldness with thirst, especially in cold damp or cold frosty weather; stitching headache • Dirca palustris: cough day and night, gagging and vomiting, dyspnea, suffocative cough, hoarse after eating, rawness of larynx, takes cold easily; follows well after carbo-v. • Drosera rotundifolia: cough periodically returning in spasms, quickly succeeding barking coughs which do not allow the patient time to recover breath; excited by sensation of dryness, or of feather in throat; in the morning with yellow mucus, in the evening without; bitter expectoration which patient has to swallow; < after lying down, after midnight, by laughing, singing, weeping; bloody mucus diarrhea, gasping of breath, cough with vomiting of food, first and at end of the fit; child holds each hypochondrium during cough, and if sputum is not raised, retching and vomiting ensue • Kali bichromicum: dry, barking cough, < morning, generally relieved by expectoration of tough, stringy, yellow mucus, < after eating and deep inspiration • Sulphur: frequent relapses, without any known cause, or from exposure to cold in psoric patients; suppressed cough • Thuja occidentalis: cough only in daytime; oily-looking skin, constant eructations when eating, spasm and stitches in chest from drinking anything cold • Zincum metallicum: children, as soon as they begin to cough, grasp their genital organs with their hands; in adults, varicose veins may burst and bleed from the exhausting spasmodic cough; sweetish metallic taste of yellow purulent mucus or of bright blood

Subtle Support
• notes: A, A#, B, C, C#, D, D#, E, F, G, G#

• chords: dominant 7th, diminished 7th, diminished 8th, A Major, A# Major, C Major, G Major, G# Major (Gimbel, p. 116)

Mind/Body
Chinese psychophysiology: • Lung ~ Fei is the home of the Po (Corporeal Soul); governs the Qi; facilitates the immune function by assisting the dispersal of the Wei (Protective) Qi; regulates the rhythm of respiration, the pulse, and all bodily processes; relates to strength and sustainability; includes the throat; and opens at the nose. » Healthy expressions are righteousness and courage. » Weakness, dysfunction, and illness associated with excessive grief, sadness, worry, and depression. » Lung Xu (Deficiency) signs include cold shoulder and back; changing complexion; and inability to sleep (Seem, p. 28); shortness of breath; changes in urine color; rumbling in the bowels with loose bowel movements; pallor; malar flush; chills; sniffles; sneezing; light cough; and sensitivity to cold. Chronic Lung Yin Xu (Deficiency) increases susceptibility to Heat rising and acute Shi (Excess) conditions such as Phlegm, Wind, Heat and Cold. » Lung Shi (Excess) signs include panting; yawning; sneezing (Seem, p. 28); pain in the upper back, shoulder, and chest; colds with stuffed nose; hoarseness; wheezing respiration; frequent urination with small amounts; heavy chest; reduced lung capacity; coughing; and nasal discharge.

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============================================================================================== //Pediatrics:// Pertussis Rates are on the rise with 70% of these cases in children under age 5. Death Rate is 1/100. The FDA admits there does not seem to be vaccination protection for infants (Lancet). In older kids it is between 63-93% effective. There are strong side-effects of pertussis vaccine. 1/25 will get a fever over 102 deg. 1/333 will develop a fever over 105. 1/1000 develop a high pitched cry. 1/1667 develops convulsions. 1/10,000 develops severe brain problems. This brain damage is permanent in 1/ 310,000. Occasionally there is anaphalaxis, residual seizures and sometimes death.

infants and young children usually only severe < 1 9 cases of severe pertussis reported in infants < 7 weeks of age, 6 were fatal (Eur J Pediatr 2000 Dec;159(12):898 in adults - causes persistent cough, often prolonged paroxysmal coughing attacks worse at night, dyspnea during coughing, tingling in throat; diagnosis highly suggested in cough > 14 days (J Resp Dis 1995;16(10):876, JAMA 1995 Apr 5;273(13):1044) increasing incidence among infants; cases per 100,000 infant population in US were 34.2 in 1980s and 51.1 in 1990s (JAMA 2003 Dec 10;290(22):2968)
 * Who is most affected:**

mortality in first few months of life review of 23 children deaths reported from pertussis 20 (87%) aged < 1 year, 18 (78%) had not received pertussis vaccine, 12 (60%) born at < 37 weeks gestation complications included pneumonia in 22 (96%), seizures in 4 (17%), and acute encephalopathy in 3 (13%) suggestions made to start pertussis vaccination at earlier age (6, 10 and 14 weeks) and consider booster vaccinations for adults (carriers) consider pertussis in underimmunized infant with persistent cough, only 9 of these cases had whooping cough This illness is treated with TCM – I could find no stats on improvement of death rates.
 * Prognosis:**