Herbal prescriptions | Home care advice

Coughing up blood or blood-tinged sputum indicates that the respiratory tract is bleeding. The symptom occurs in a variety of conditions. It may be a mild symptom that resulted from violent coughing, inhaling smoke, common cold and even dry weather. Coughing up blood can also be one of the many signs of serious conditions, such as pneumonia, bronchitis, foreign body or lung cancer. The blood that comes up with a cough often looks bubbly and may be bright red, pink, dark red or rusty in color.

Since coughing up blood can be associated with conditions that are quite serious in nature, you should always take it as a health alarm. Seek medical care if you cough up blood, especially when you are accompanied with the followings.

The respiratory tract

	Persistent cough that produces blood or blood-tinged sputum
	Unexplained weight loss
	Night sweats
	Shortness of breath or breathing difficulties
	Fever
	Chest pain
	Blood in the urine

Moreover, it is important for your doctor to determine whether the blood is originating from the respiratory tract, sometimes bleeding from the mouth, nose or stomach may mimic it. Treatment of coughing up blood should be according to the diagnosis. Remember to consult your doctor before taking over-the-counter cough products, as this could end up masking the sign of a serious problem.

In traditional Chinese medicine (TCM) understanding, coughing up blood can be caused by dysfunction of the lungs themselves or other organs involving the lungs. The lungs are vulnerable organs, in which the flow of qi can easily be disturbed. When pathogenic factors weaken the lungs and damage the blood vessels, blood will leak into the airways and cause coughing as well. TCM has extensive experience in treating coughing and bleeding symptoms, not just as "symptom relief" but the healing of the underlying condition. TCM remedies can work with conventional approaches in treating the primary lung problems.

yerbadetajo herb		lotus rhizome node		donkey-hide gelatin

1. Herbal prescriptions for coughing up blood

Generally, coughing up blood is mainly involved the lung system, however dysfunction of the liver or kidneys can affect the lungs and also lead to cough up blood. The common disharmony patterns are as below.

Wind-heat attacking lungs

Coughing up blood-tinged sputum; other symptoms may include fever, slightly chills, wheezing, thirst, sweating and headache. The tongue has a yellow coating and the tongue tip is red, the pulse is floating and rapid. The remedy should aim to dispel wind, clear heat, stop coughing and arrest bleeding.

Sample prescription: Mulberry Leaf and Chrysanthemum Decoction plus gardenia fruit, lotus rhizome node and couch grass rhizome

Dry-heat attacking lungs

Dry coughing that comes up with a small amount of bright red blood; other symptoms may include dryness of the nasal passages, feverish sensation, thirst, itchy throat, constipation, scanty urine and a burning sensation during urination. The tongue is red and covered by thin yellow coating, the pulse is floating and rapid. The remedy should aim to promote moisture in the lungs, stop coughing and arrest bleeding.

Sample prescription: Mulberry and Apricot Decoction plus rehmannia root, lotus rhizome node and couch grass rhizome

Liver fire attacking lungs

Frequent bout of coughing up blood-tinged sputum or fresh blood; other symptoms may include chest pain, discomfort in the rib sides, irritability, bloodshot eyes, a flushed face, mouth dryness, a bitter sensation in the mouth, yellow urine and constipation. The tongue is red and covered by yellow coating, the pulse is taut and rapid. The remedy should aim to soothe liver, clear lung heat, cool blood and stop bleeding.

Sample prescription: Purging Lung Powder combined with Indigo and Clam Shell Powder plus Indian madder root, Chinese gentian root and couch grass rhizome

Yin deficiency creating virtual fire

Coughing up fresh blood frequently, or coughing up thick and blood-tinged sputum that is difficult to expectorate, other symptoms may include chest pain or chest stuffiness, mouth dryness, red cheeks, hot flushes, warm palms and soles, night sweats and irritability. The tongue is red, and the pulse is thready and rapid. The remedy should aim to nourish yin, subdue virtual fire, promote moisture in the lungs and stop bleeding.

Sample prescription: Lily Bulb Decoction to Preserve the Lung plus yerbadetajo herb, thistle herbs and couch grass rhizome

Qi deficiency failing to retain blood

Coughing up blood, other symptoms may include feeble breath, fatigue, chills, sweating, pale complexion, pale lips and nails, a pale tongue and weak pulse. There may be bruise or red patches on the skin or other internal bleeding sites. The remedy should aim to replenish qi and reinforce its ability to astringent blood, invigorate spleen and heart.

Sample prescription: Restore the Spleen Decoction plus hairyvein agrimonia herb, donkey-hide gelatin and garden burnet root (charred)

2. Home care advice for coughing up blood

For those who have chronic lung problems, appropriate daily management can make them feel more comfortable, decrease the risk of bleeding complications and promote the healing process. Individuals are suggested to take measures as below.

	Increase body resistance and keep warm: this is particular important in cold and flu season, so as to prevent further development of the primary lung problems.
	Drink plenty of fluids: to keep the body well hydrated, soothe the throat and help spit out the mucus in the airways. Alcohol, coffee and concentrated tea should be limited.
	Quit smoking: frequent exposure to secondhand smoke can also irritate the airways and cause lung damage.
	Healthy eating habits and good nutrition: a good balanced nutrient supply ensures the body to deal with the effects of lung conditions and the treatment. It is advised to limit the consumption of hot, spicy and greasy foods, as they can irritate the throat and stimulate the production of thick sputum, and thus further aggravate coughing.
	Since bleeding is usually associated with excessive heat that causes reckless movement of hot blood in TCM. Foods that help clearing heat from the lung system are beneficial, including lotus root, tangerine, loquat fruit, water chestnut, persimmon and pears. Other cooling foods like Chinese radish, bean curd, mushrooms, wax gourd and loofah are also recommended.

Below are special food recipes for coughing up blood.

Fresh lotus root and Chinese pears

	Prepare fresh lotus root (250g, chopped) and two pears (peeled and removed the cores). Put the ingredients in a blender and pour a cup of water, smash and filter out the juice. Drink daily, this helps nourish the lungs, clear heat and relieve coughing.
	Prepare fresh lily bulbs (50g), sugar cane juice (20ml) and Chinese radish juice (25ml). Put the lily bulbs in a double steam container and add in 60ml water, steam under high heat for 30 minutes, then add in the sugar cane juice and radish juice. Eat at night before going to bed, this helps nourish the lungs, clear heat, relieve coughing and night sweats, and promote sleep.
	Prepare water chestnut (100g, peeled), lotus root (100g, chopped), one pear (peeled and removed the core), fresh reed rhizome (50g), and dwarf lily-turf tuber (25g).Wash the ingredients, cut in proper sizes, put them in a blender and pour a cup of water, squeeze and filter out the juice. Drink daily, this helps relieve coughing, facilitate expectoration, reduce hot flushes and mouth dryness.
	Prepare dried white fungus (3g), dried black fungus (3g), rock sugar (25g), and 2 pigeon eggs (poached and peeled). Soak the fungi in water for 30 minutes, cut away any hard and discolored portions, rinse and cut the rest into bite-size pieces. Put the fungi and rock sugar in a saucepan with 1000ml water, bring to a boil, then turn to low fire and simmer for about one hour or until the ingredients are fully soft, add in the eggs and further boil for 10 minutes. Eat daily, this can help relieve productive cough, and soothe the throat.
	Prepare dried lily bulb (30g), coastal glehnia root (30g), fragrant Solomonseal rhizome (30g) and a duck (700g). Chop the duck into pieces, marinate with salt, sesame oil, ginger, wine and pepper. Wash the other ingredients. Add a little vegetable oil in a pot and heat up, put in the duck meat and stir slightly, then fill with water to about 1cm from the top, bring to a boil and further cook for 15 minutes; add in the herbs, cook in low heat for about 2 hours. Serve hot and eat the meat. This is suitable for dry coughing accompanying with blood-tinged mucus, chest pain, hot flushes and night sweats.
	Prepare two quails, cordycepes (2 pieces), fresh ginger (5g, sliced), and chicken broth (300ml). Wash the quails thoroughly inside and out, insert one cordycepe into the abdomen of each quail and string them tight, put them in a double steam container, add in ginger slices, pepper and chicken broth. Double steam under low heat for 2 hours. Drink the soup and eat the meat. This is suitable for coughing up blood accompanying with general weakness, hoarseness, hot flushes at nights, sweating and breathing difficulty.
	Prepare green tea (1g), common bletilla tuber (10g), angelica root (10g) and rock sugar (15g). Boil the two herbs with 750ml water for 5 minutes, turn off the heat and add in green tea and rock sugar. The solution is divided in to two portions, serve warm. Drink in the morning and evening. This is suitable for persistent coughing up blood accompanying with hot flushes and fatigue.