"I've had this cough for over a month. The cold cleared up ages ago — the cough just won't stop." A lingering cough is a very common complaint, and one of the easiest to carry indefinitely on cough syrup.

One thing comes before everything else in this article: a cough lasting more than two weeks needs to be investigated first, not managed first. The reason is in section IV. Beyond that, this article is about what a practitioner asks — set out as 5 things.

I. First: a dry cough and a productive cough are different things

The first split in any consultation is between these two:

• Dry — a tickle, a constant need to clear the throat, nothing comes up. Often worse when talking or lying down.
• Productive — something does come up, and its colour, thickness and quantity are all information.

Below that sit several situations people often merge together:

• Constantly clearing the throat — often described as something dripping at the back.
• Coughing on lying down — clearly related to position.
• Coughing when you talk, when you smell smoke or perfume, when air-conditioning blows on you — the trigger is itself a clue.

As for how these are categorised within TCM theory, that belongs to the framework of channels and qi-blood, which is not the same as the modern medical description of the airways.

II. The 5 things a practitioner asks about

• How long — the single most important question. Give a specific number of days or weeks.
• Dry or productive — and if productive, any change in colour and quantity.
• When it is worst — early morning, at night on lying down, when speaking, or all day.
• Triggers — air-conditioning, smoke, perfume, dust, exercise, after a full meal.
• What comes with it — fever, night sweats, weight loss, chest tightness, breathlessness, a sense of reflux.

Night sweats and weight loss in that fifth point need particular attention — see section IV.

If you have doctor-diagnosed asthma or another respiratory condition and use an inhaler or medication, say so during the consultation. Do not stop it or adjust the dose on your own.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

III. How to describe it usefully

This table deliberately does not say what any answer "means". TCM is not a self-matching exercise — the assessment is the practitioner's, after the consultation.

IV. When to see a doctor first — especially past two weeks

A cough lasting more than two weeks should be investigated at a government clinic or hospital first. In Malaysia, a persistent cough is one of the key prompts for tuberculosis screening. Tuberculosis must be diagnosed and treated by a doctor, and the full course completed as they instruct. Delaying that helps neither you nor the people you live with.

Call 999 now, or go to the nearest emergency department:

• Coughing up blood, or blood in the phlegm.
• Severe breathlessness, unable to finish a sentence, or blue-tinged lips.
• Chest pain with difficulty breathing.
• A high fever that will not settle.

Seek medical attention promptly:

• A cough lasting more than two weeks, even if it does not feel serious.
• Night sweats that leave your nightclothes or sheets damp.
• Unexplained weight loss.
• Persistent loss of appetite and fatigue.
• Asthma or another respiratory condition that has become harder to control than usual (if severe breathlessness appears, follow the emergency group above).

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

V. Fitting it into life in Malaysia

• During the haze — whether symptoms change on bad-air days is worth recording specifically.
• Air-conditioning — coughing when the office or car aircon blows on you, or when moving between temperatures, is a very common description.
• Your home — damp, mould, pets, and whether anyone smokes indoors.
• Your workplace — dust, cooking fumes, chemical smells. Long-term exposure is worth describing.
• Cough syrup — how long you have taken it, whether it helps, and whether it was bought or prescribed. Mention all of it.
• Masks — on bad-air days or in crowded places, a simple and practical step.

If your cough and your nose tend to act up together, see recurring nose problems.

In closing

✅ Worth remembering:

1. A cough past two weeks gets investigated first, not managed first.
2. Dry and productive are two different things — sort that out when you describe it.
3. A practitioner asks about duration, dry or productive, when it is worst, triggers, and what comes with it.
4. Coughing blood, severe breathlessness, chest pain with difficulty breathing — call 999 now.
5. Night sweats, weight loss, loss of appetite — see a doctor promptly, do not let these wait.

❌ What not to do:

1. Do not let a cough past two weeks drift on because cough syrup is easing it for now.
2. Do not start with TCM past two weeks without being investigated.
3. Do not stop or adjust medication a doctor prescribed, inhalers included.

👉 If your cough has already been investigated and you would like to set out the wider picture for a practitioner, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you. In-person consultations are coming soon.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

「医师，我这个咳嗽拖了一个多月了，感冒早就好了，就是咳不停。」拖很久的咳嗽是很常见的困扰，也是最容易靠着咳嗽药水一直拖下去的一个。

这篇要先讲一件最重要的事：咳嗽超过两周，第一步是去做检查，不是先调理。 原因见第四节。这篇讲的是医师在问诊时会了解哪些事，整理成 5 件事。

一、先分清楚：干咳与有痰，是两件事

问诊时最先要分开的是这两类：

• 干咳：喉咙痒、想清嗓子、咳不出东西，讲话或躺下时更明显。
• 有痰：咳得出东西，痰的颜色、稠度、量都是资讯。

再往下还有几个常被混在一起的情况：

• 喉咙一直想清：常被描述为「后面有东西滴下来」的感觉。
• 躺下就咳：与姿势明显相关。
• 一讲话就咳、闻到烟或香水就咳、冷气一吹就咳——诱因本身就是线索。

至于这些在中医理论里怎么归类，属于经络与气血的理论框架，与现代医学对呼吸道的描述不是同一回事。

二、医师会了解的 5 件事

• 咳多久了：这是最关键的一题，请给具体的天数或周数。
• 干咳还是有痰：有痰的话，颜色与量的变化值得说明。
• 什么时候最明显：清晨、夜里躺下、讲话时、还是整天。
• 诱因：冷气、烟味、香水、灰尘、运动、吃饱后。
• 伴随的情况：发烧、夜间盗汗、体重下降、胸闷、气促、胃酸逆流感。

第五项里的「夜间盗汗」与「体重下降」需要特别注意，原因见第四节。

若您有医生诊断的哮喘或其他呼吸道疾病，并正在使用吸入剂或药物，请在问诊时说明。切勿自行停药或自行调整剂量。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

三、一张表看懂：怎么描述才有用

这张表刻意不写「哪一个答案代表什么」。中医不做自我对号入座——分辨是医师问诊后的判断。

四、这些情况请先就医——尤其是咳超过两周

咳嗽持续两周以上，标准的做法是先去政府诊所或医院做检查。 在马来西亚，长期咳嗽是结核病筛查的重点项目之一。结核病必须由医生诊断与治疗，请依医生的指示完成完整的疗程。 延误确认对自己和家人都不利。

请立刻拨打 999，或前往最近的急诊部：

• 咳血，或痰中带血。
• 严重气促、讲话都喘不过气、嘴唇发紫。
• 胸痛伴随呼吸困难。
• 高烧不退。

请尽快就医：

• 咳嗽超过两周，即使感觉不严重。
• 夜间盗汗，睡衣或床单会湿。
• 不明原因的体重下降。
• 持续的食欲不振与疲倦。
• 有哮喘或其他呼吸道疾病，而症状变得比平常难控制（若出现上述严重气促，请依上一组处理）。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

五、大马生活里怎么安排

• 烟霾期间：症状在空气差的日子有没有变化，值得具体记录。
• 冷气：办公室或车里的冷气一吹就咳、温差大的时候更明显——这是很常见的描述。
• 家里的环境：潮湿、发霉、有没有养宠物、有没有人在家里抽烟。
• 工作环境：粉尘、油烟、化学气味，长期暴露值得说明。
• 咳嗽药水：吃了多久、有没有效、是自己买的还是医生开的——请一并说明。
• 戴口罩：空气差或人多的场合，这是简单而实际的做法。

若您的咳嗽与鼻子的情况常一起出现，可参考：鼻子问题反覆发作。

结语

✅ 记住这几点：

1. 咳嗽超过两周，第一步是去做检查，不是先调理。
2. 干咳与有痰是两件事，描述时先分清楚。
3. 医师会了解咳多久、干咳或有痰、什么时候最明显、诱因、伴随情况。
4. 咳血、严重气促、胸痛伴呼吸困难——请立刻拨打 999。
5. 夜间盗汗、体重下降、食欲不振——请尽快就医，不要拖。

❌ 不要这样做：

1. 不要因为咳嗽药水暂时缓解了症状，就把超过两周的咳嗽一直拖下去。
2. 不要在咳超过两周时先找中医而不做检查。
3. 不要自行停用或调整医生开立的药物，包括吸入剂。

👉 如果您的咳嗽已经做过检查、想把整体状况说给医师听，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估。亲诊服务即将推出。

无论身在何处，与持证中医师对坐。

汉方现代中医