Still Coughing After the Cold Is Over? Doctor Luo Dalun: Zhi Sou San (Stop Coughing Powder) with Honeysuckle and Forsythia, Stewed Pear with Sichuan Pepper, and Master Lin Hehe’s Long-Cough Formula

Patient search terms: cough after a cold / lingering cough / cough won’t go away after flu / residual cough after external contraction / pharyngogenic cough / sore itchy throat and cough / cough after COVID

Corresponding conditions: residual cough after external contraction · pharyngitis / pharyngogenic cough · residual cold pathogen · cough with throat irritation

💬 Note from Doctor Luo: Dear friends, good morning, everyone. These days it feels as if the epidemic is spreading across the whole country, and I have truly been run off my feet — WeChat basically runs from morning to night; I have more than four thousand people in my feed, and countless friends have caught it and are asking me all kinds of questions. The livestreams have stopped, and there is no time to write on Weibo either. So let me talk with you this morning: what shall we discuss? Today: the cough that comes after an external contraction — the residual cough.

Opening: the fever is gone, the throat no longer hurts — so why am I still coughing?

This wave of illness basically follows one script: first high fever, joint pain, headache — that is the northern picture; in the south it may start with dizziness, and word has it that in Guangdong dizziness is the main complaint.

💬 Note from Doctor Luo: Why the difference? The south is heavy with dampness; the north is heavy with cold pathogen. Then the fever slowly comes down, and in those few days after the fever breaks the throat starts to hurt — a pain like being cut with a knife, as if the throat were lined with sandpaper. Then the sore throat gradually improves, and the cough arrives. And this cough is really annoying: no more fever, no symptoms at all, no more joint aches — just coughing, coughing without stopping.

How do you handle this cough? Doctor Luo says you first have to understand where it comes from.

Where does this cough come from? — The external pathogen has not completely left; it is stuck in the throat

Just after an external contraction ends, a little of the external pathogen is still lingering in the body — this remnant can no longer cause great harm, but it is not nothing either.

💬 Note from Doctor Luo: What it causes is not a sore throat but a bit of coughing and irritation — we call this pharyngogenic cough, pharyngitis. Often there is still a little pathogen in the throat area, and the throat may be slightly sore or uncomfortable; that is how this kind of cough arises.

So what do you do at this point? The old doctors’ experience is to walk two roads at once.

The old doctors’ approach: first disperse the cold, then clear a little heat along the way

💬 Note from Doctor Luo: First, disperse the cold — the general experience of the old doctors is that a little cold pathogen is still stuck here, so you disperse the cold. On the other hand, you also need to add a small amount of heat-clearing medicine to dissolve the remaining toxin. So for this kind of cough — right after an external contraction, with a little cold pathogen left — Zhi Sou San (Stop Coughing Powder) works especially well.

The first formula: Zhi Sou San — seven ingredients, six grams each

Zhi Sou San is a classic cold-dispersing, cough-stopping formula in Chinese medicine. The proportions Doctor Luo gives are very neat: jie geng (platycodon root) six grams, jing jie (schizonepeta) six grams, zi wan (aster root) six grams, bai bu (stemona root) six grams, bai qian (cynanchum root) six grams, gan cao (licorice) six grams, chen pi (tangerine peel) six grams — all six grams.

💬 Note from Doctor Luo: The formula is mainly warming: zi wan and bai bu are warm; bai qian and chen pi are warm; jie geng is slightly warm; and jing jie disperses outward a little further — if the person has no chills at all, jing jie can be changed to three grams. The formula scales up or down — if you feel the amounts are too heavy, changing everything to three grams is fine too. But note: I usually do not use this formula alone. It is true that only a little cold remains, but my experience is that there is often a bit of heat as well, so I pair it with jin yin hua (honeysuckle) six grams and lian qiao (forsythia) six grams, to dissolve the remaining toxin — this is what is called regulating cold and heat together (han re bing tiao), and it is a better approach.

The seven ingredients each have their own job, and Doctor Luo went through them one by one:

Jie geng (platycodon root): slightly warm, works upward, opens lung qi, and has some detoxifying action — it can drain fire, disperse cold, and open up the qi of the lungs; it also opens and frees the throat and nasal passages — its nature moves upward.
Jing jie (schizonepeta): disperses cold. Pungent-warm (pungent, bitter, and warm), with a lovely fragrance, and excellent at dispersing cold. In external-contraction illness we often use fang feng (siler root) and jing jie; jing jie disperses cold and induces sweating.
Zi wan (aster root): moistens the lungs, and its qi moves downward. You see, qi can move up or down — when you cough, qi rushes upward, so breathless coughing calls for a little medicine that goes down. Zi wan dissolves phlegm, moistens the lungs, and stops cough; it can bring moisture to the dryness in the lungs, and it regulates the qi.
Bai bu (stemona root): also moistens the lungs, a warm medicine, very good for coughs caused by cold in the lungs.
Bai qian (cynanchum root): slightly cold, but it is a cough-stopping medicine whose nature moves downward; for a little deficiency heat still in the lungs — especially heat brought in by the external pathogen — it can scatter it.
Chen pi (tangerine peel): regulates lung qi; it transforms phlegm, regulates qi, and harmonizes the middle.
Gan cao (licorice): detoxifies and harmonizes all the other ingredients.

💬 Note from Doctor Luo: Put together, this formula works very well for this kind of residual cold. Add shuang hua (honeysuckle) and lian qiao, and the formula is fairly complete — for residual cough it may work even better.

Do not want to take medicine? Stew a white pear with Sichuan pepper — in old times it was called the “hedgehog pear”

What if you would rather not take medicine? Doctor Luo teaches a small food remedy.

💬 Note from Doctor Luo: Use the Sichuan pepper you cook with, about twenty peppercorns (twenty or thirty is fine; generally about twenty), and one white pear, cut into small pieces with the core removed. Put the peppercorns and pear together in a pot and stew — steaming over water works too — for about twenty minutes. Then drink the liquid and eat the pear — mainly drink the liquid; the liquid is the most important part.

This remedy once had a wonderfully vivid name — the hedgehog pear:

💬 Note from Doctor Luo: In the old days they would poke lots of little holes all over the pear, stuff the peppercorns inside, and steam it over water — after steaming, remove the peppercorns, eat the pear, and drink the liquid. Why this pairing? Because Sichuan pepper is pungent and warm — it disperses cold; if you have a little cold pathogen, it helps push it out; and the pear moistens the dryness, because at the end of an illness the throat becomes dry. Dispersing cold on one side, moistening the throat and dryness on the other — it is also good for the cough. This is a small food-based remedy.

Coughing for two weeks and still not better? Master Lin Hehe’s long-cough formula from Jiangxi

Some friends will say: my cough has lasted even longer, more than two weeks, and it has never stopped. That situation really exists — Doctor Luo has seen residual coughs drag on for two months, even half a year: after one cold, the person just keeps coughing, the throat is always a little itchy, and the urge to cough is always there.

💬 Note from Doctor Luo: If all your other symptoms are gone, and the cough has gone on for more than a week with coughing as the main complaint, in this situation I can introduce the formula of Master Lin Hehe, an old doctor from Jiangxi. Master Lin summed up this very situation — what to do when a little of the external contraction remains? He produced a formula. After I used it, it became the most effective formula I have ever met for residual cough after an external contraction — basically three to four doses and the problem is definitely solved.

Master Lin’s formula: xi xin (asarum) three grams, wu wei zi (schisandra berry) five grams, bo he (mint) nine grams, she gan (blackberry lily rhizome) nine grams, fa ban xia (processed pinellia) nine grams, xing ren (apricot kernel) nine grams, zhi ke (bitter orange) nine grams, jie geng (platycodon root) nine grams, sha shen (glehnia root) nine grams, chen pi (tangerine peel) six grams, gua lou pi (trichosanthes peel) ten grams, gan cao (licorice) three grams.

💬 Note from Doctor Luo: Master Lin prescribes in a very interesting way — he does not stick neatly to three, six, or nine grams; sometimes he uses five, sometimes ten, putting nine grams and ten grams side by side. This is Master Lin’s personal style. Of course, we do not have to keep nine and ten grams together — I do not know why he prescribes it that way, and I am curious myself, but that is how Master Lin writes his formulas. When you take the prescription to the pharmacy, if nine grams is inconvenient, changing everything to ten grams works too.

Where is the subtlety in this formula? Doctor Luo breaks it down:

💬 Note from Doctor Luo: Xi xin paired with wu wei zi — this is a combination Doctor Zhang Zhongjing, the medical sage, used long ago in Xiao Qing Long Tang (Minor Green Dragon Decoction), together with gan jiang (dried ginger). Xi xin disperses, pushing outward; wu wei zi gathers inward. With this one-dispersing-one-gathering action, the momentum of the cough is brought under control. Bo he (mint)? Master Lin says there is still a little heat here, so mint cools and soothes the throat and lets that bit of heat out. She gan (blackberry lily rhizome) clears the throat and benefits the larynx — this kind of cough is pharyngogenic, the pathogen sits in the throat, and she gan targets exactly that. Fa ban xia (processed pinellia) sends rebellious qi down and transforms phlegm; xing ren (apricot kernel) sends qi down and transforms phlegm; zhi ke (bitter orange) regulates qi; jie geng (platycodon root) opens lung qi, disperses upward, and clears and soothes the throat. What is sha shen (glehnia root) for? There is still some dryness here and the body fluids (jin ye) are a little insufficient — sha shen moistens the dryness. Chen pi (tangerine peel) regulates qi; gua lou pi (trichosanthes peel) transforms phlegm — if the pharmacy has no gua lou pi, the whole trichosanthes fruit will do. Gan cao (licorice) harmonizes.

Doctor Luo says that after all these years of using it, he has one more insight — add or remove these two ingredients and the effect is immediate:

💬 Note from Doctor Luo: If cold and heat are mixed — that is, if you feel there is still a little heat behind it — you can add huang qin (baical skullcap root) six grams and sang bai pi (mulberry root bark) nine grams. I normally add them. Why? Because almost all of these cases are cold-heat mixed — I came to realize later that without huang qin and sang bai pi, sometimes the effect really is not good; add them, and the result is immediate.

How long until it works? “Usually by the fourth dose it should stop”

When it comes to how fast it works, Doctor Luo stresses one point especially: do not expect a single dose to cure it.

💬 Note from Doctor Luo: This kind of long cough — some of you may never have experienced it. There are people for whom you write ten or twenty doses and still cannot fix it; they just keep coughing, and the medicine simply does not work. Spend any real time treating coughs every day and you will know: some people cough after a cold and ordinary medicines simply will not do — no matter how you adjust, it will not come around, and it truly drives you mad — the patient comes back after five doses still coughing, comes back after seven doses still coughing, nothing has changed. Very headache-inducing. If you have not found the right line of thinking, it is genuinely hard to treat.

But with Master Lin Hehe’s formula, once Doctor Luo learned it, the pattern was very interesting:

💬 Note from Doctor Luo: Sometimes it is very strange — this formula acts on the fourth dose. Sometimes even the third dose has no effect, and only after finishing the fourth dose does it work — the cough stops; finally it stops. So I generally dispense five doses: normally by the fourth dose it is basically cured, and the fifth dose is for aftercare. After you recover, you can take a little Tong Xuan Li Fei Wan (Free the Lung and Disperse the Exterior Pills) to finish the job, or take some Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) to tonify kidney qi and warm the yang — either works.

An important warning: if the external contraction is not fully resolved, do not rush to use this formula

Finally, Doctor Luo repeatedly stresses one precondition — this formula cannot be used at any time.

💬 Note from Doctor Luo: This is the experience of an old doctor. Some people are impatient: the external contraction is not even fully resolved and they are coughing, so they use this formula — that I do not advocate. You must be completely free of symptoms: no fever, no chills, no swollen painful throat, no joint pain — the body feels fine in every way, yet the residual cough simply will not stop, coughing day and night — then using this formula is correct.

He also told a real counter-example he has witnessed:

💬 Note from Doctor Luo: I really have seen this: an anxious parent, the child still running a fever, coughing, throat swollen and painful — and they use this formula, saying, “Doctor Luo, it does not work! Why will the cough not stop?” I asked, and sure enough — the child’s external contraction had not ended at all: still feverish, still a swollen painful throat. You need to clear heat and resolve the toxin first; you cannot bring in this formula at that point. That is starting too early. This is experience, and I am telling you all.

💬 Note from Doctor Luo: What I have shared with you today is the problem of long, residual cough after an external contraction. I hope it proves useful in your epidemic prevention. Thank you for chatting with me today — the daytime will certainly bring endless messages again; my phone has already accumulated a lot, and I will answer them slowly in a while. Tomorrow we will continue with new methods. See you tomorrow!

Compiled from Doctor Luo Dalun’s health lecture series (external-contraction prevention series: residual cough).

What to take away

After a cold, the lingering cough means a little pathogen — usually cold — is still stuck in the throat. It is called pharyngogenic cough or pharyngitis: no fever, no sore throat, just an itchy throat and a cough that will not stop.
The old doctors’ rule is two moves at once: disperse the cold and clear a little heat. Almost every such case is cold-heat mixed, so both directions are needed.
Mild case: Zhi Sou San (Stop Coughing Powder) — jie geng, jing jie, zi wan, bai bu, bai qian, gan cao, chen pi, six grams each, with jin yin hua (honeysuckle) and lian qiao (forsythia) six grams each added; if there are no chills, jing jie can be reduced to three grams. The whole amount can also be scaled down to three grams each.
No medicine wanted? The “hedgehog pear”: stew one white pear cut into pieces with about twenty Sichuan peppercorns for about twenty minutes (or steam the old way, with peppercorns stuffed into holes in the pear). Drink the liquid and eat the pear — the peppercorns are pungent-warm to disperse cold, the pear moistens the dry throat.
Two weeks or more: Master Lin Hehe’s long-cough formula (xi xin 3 g, wu wei zi 5 g, bo he 9 g, she gan 9 g, fa ban xia 9 g, xing ren 9 g, zhi ke 9 g, jie geng 9 g, sha shen 9 g, chen pi 6 g, gua lou pi 10 g, gan cao 3 g) — usually works by the fourth dose; the fifth dose is aftercare, followed by Tong Xuan Li Fei Wan or Jin Gui Shen Qi Wan if desired.
The key addition: huang qin (baical skullcap root) 6 g and sang bai pi (mulberry root bark) 9 g — for the cold-heat mixed pattern, adding these two makes the effect immediate.
Do not use this formula early. If the person is still feverish, still has a swollen painful throat, or any acute symptom of the external contraction remains, clear the toxic heat first — using the formula then is starting too early and will not work.
Persistent coughing is treatable once you find the right line of thinking — Master Lin’s formula solved what ordinary cough medicines could not, because it matches the actual pattern: one-dispersing-one-gathering xi xin and wu wei zi, throat-clearing she gan and bo he, qi-lowering ban xia and xing ren, and moistening sha shen.