Introduction: Mr. Ni Airan's Experience in Treating Pediatric Cough.

Professor Ni Airan specializes in treating pediatric cough. By considering the sound of the cough, its etiology, and the duration of the illness, combined with visual inspection, he integrates meridian differentiation, organ differentiation, and the four diagnostic methods and eight principles of differentiation, achieving remarkable therapeutic outcomes.

Professor Ni's experience in treating pediatric cough is as follows.

Assess the syndrome to identify the cause, differentiate between external and internal factors

Children have delicate organs and weak defensive qi, making external pathogenic coughs more common. However, disorders of other organs can also affect the normal function of the lungs, leading to cough.

Therefore, it is particularly important to differentiate between external pathogenic cough and internal injury cough during clinical diagnosis.

Based on the season of onset and the clinical manifestations of the child, such as illness in winter or spring accompanied by fever, runny nose, and nasal congestion, treatment is often approached from the perspective of external contraction. If the cough persists for a longer duration without obvious external symptoms, priority is given to regulating the functions of other organs, with flexible treatment tailored to the specific syndrome.

In children, external factors primarily involve exposure to wind, cold, or heat pathogens. Moreover, children are considered to have a "pure yang" constitution, meaning that after contracting pathogens, they often transform into heat, leading to a predominance of heat syndromes. Internally, dietary injuries are common, resulting in impaired spleen function. This prevents the proper transformation of food and water into essential nutrients, instead leading to the production of phlegm turbidity. This phlegm accumulates in the lungs, obstructs the airways, and causes lung qi to fail to disperse, thereby inducing cough.

The main pathological basis of cough in children is phlegm-heat congesting the lungs, leading to impaired diffusion and descent of lung qi.

Treatment should differentiate between deficiency and excess and distinguish the affected disease locations.

Professor Ni believes that pediatric cough should be categorized into two types: excess and deficiency.

Coughs caused by external pathogens entering the interior, transforming into heat, and condensing fluids into phlegm are classified as excess patterns. The key diagnostic points include a relatively robust physique, a heavy and forceful cough sound, coarse breathing with profuse phlegm, thick and sticky sputum, acute onset, short duration, a red tongue with a thick white or yellow coating, and a floating, slippery, and rapid pulse. Treatment primarily focuses on clearing heat and resolving phlegm.

Coughs that persist for a long time without resolution, depleting healthy qi, are classified as deficiency patterns. The key diagnostic points include a thin and weak physique, a low and weak cough sound, thin and white sputum or dry cough with little phlegm, gradual onset, and prolonged duration. Treatment primarily focuses on supporting healthy qi and regulating and tonifying the lung and spleen.

Professor Ni believes that the treatment of cough should combine disease differentiation with pattern differentiation, identify the main contradiction, and distinguish between primary and secondary aspects as well as excess and deficiency.

If the cough is frequent due to external pathogenic factors, with throat itching and a heavy voice, which corresponds to acute pharyngitis in modern medicine, the focus should be on dispelling wind, using cicada slough, mulberry leaf, schizonepeta, great burdock achene, and paniculate swallowwort root, among others;

If the cough sounds hollow and barking, as in acute laryngitis, the focus should be on clearing heat, detoxifying, and soothing the throat, primarily using isatis root, figwort root, blackberry lily rhizome, and Indian trumpetflower seed;

If there is a cough with little phlegm, a feeling of blockage in the throat, accompanied by congested and swollen tonsils, emphasis should be placed on clearing heat and soothing the throat, using puffy ball fungus, blackberry lily rhizome, stiff silkworm, and figwort root, among others;

If there is a cough with copious phlegm that is yellow and sticky, and lung auscultation reveals phlegm sounds, emphasis should be placed on clearing heat and resolving phlegm, using snakegourd fruit, arisaema with bile, and pumice

If the cough is productive with thick, heavy phlegm, and medium to fine crackles are audible in both lungs, heavily use Houttuynia cordata, Mulberry Root Bark, and Siegesbeckia herb to clear heat, resolve phlegm, and promote blood circulation to remove stasis;

If the cough is accompanied by shortness of breath and wheezing sounds, heavily use Earthworm, Perilla Seed, Mulberry Root Bark, Silkworm, and Paniculate Swallowwort to relieve spasms and calm wheezing;

If there is a persistent cough that does not heal, with a weak voice and pale complexion, add Prince Ginseng and Poria to strengthen the spleen and boost qi, as well as Stemona Root and Lily to moisten the lungs and relieve cough;

If there is a dry cough without phlegm, with a red tongue, thin coating, and a thready, rapid pulse, add Southern Adenophora Root, Ophiopogon Root, Chinese Yam, White Hyacinth Bean, and Sichuan Fritillaria to boost qi, nourish yin, moisten the lungs, and relieve cough.

The spleen and stomach are the foundation, emphasizing spleen fortification and stomach regulation

The spleen is the source of phlegm production, and the lungs are the reservoir for phlegm.

Children often have insufficient spleen function, so while using heat-clearing, phlegm-resolving, lung-diffusing, and cough-suppressing medications to treat cough, attention should be paid to protecting the spleen and stomach. Based on changes in the child's physique (such as body weight), tongue coating thickness, duration of illness, and cough sounds, spleen-fortifying and stomach-regulating herbs should be added, such as Pseudostellariae Radix (Tai Zi Shen), Poria (Fu Ling), Dioscoreae Rhizoma (Shan Yao), Lablab Semen Album (Bai Bian Dou), and Galli Gigerii Endothelium Corneum (Ji Nei Jin).

Especially in the later stages of cough, greater emphasis should be placed on tonifying the spleen and stomach to strengthen their functions, ensure normal transportation and transformation of body fluids and food, promote smooth blood circulation, and maintain overall health.