89-year-old man complains of lingering cough since February of last year following a flu-like illness. He lies in bed coughing for an hour each morning but rarely coughs the rest of the day. It is a weak cough with no mucus production. Once each afternoon, he will proactively cough to bring up mucus, which is white or clear and sticky. He has a mild to medium yellow coating on the back half of his tongue. He plays a vigorous tennis game 2-3 times/week with no shortness of breath and does not have a fever or any pain. He does not have any thirst but this is not unusual for him. He does not feel cold. Would this be hot/damp?

Andrew said: I think this might be a cough due to dryness or yin deficient empty heat. I don’t see any overt fire signs. The mucous is white because it is most likely normal mucous production attempting to lubricate the mucosa due to the dry/yin deficiency. Also, I think it is unlikely a full heat condition because an 89-year-old would not keep that type of heat for very long; either he would be very ill or it would begin to disrupt other systems and cause a more progressive disease. The yellow moss at the back of the tongue is indicative of kidney yin deficiency with empty heat. Although there a quantity of mucous, it is a small amount and difficult to expectorate. For that reason, I would not call it dampness. Dampness would look like lots of easy to cough up mucous. You might consider a working diagnosis of kidney and lung yin deficiency and see if that fits the man in the case. Otherwise stated, you might want to focus on moistening the lungs to help descend lung qi (as aided by the grasping function of the kidneys).