Fifth-watch cough

Cough occurring or becoming more severe just before daybreak (4–6 a.m.) A few coughs just before daybreak usually indicate phlegm-fire. Cough before daybreak with copious phlegm usually indicates spleen vacuity. A daytime cough that is worse in the early morning indicates food accumulation in the stomach.

Medicinal therapy: Treat phlegm-fire patterns with Two Matured Ingredients Decoction (二陈汤 èr chén tāng) plus scutellaria (Scutellariae Radix, 黄芩 huáng qín), platycodon (Platycodonis Radix, 桔梗 jié gěng), and mulberry root bark (Mori Cortex, 桑白皮 sāng bái pí). Spleen vacuity patterns are treated with Six Gentlemen Decoction (六君子汤 liù jūn zǐ tāng) plus blast-fried ginger (Zingiberis Rhizoma Praeparatum, 炮姜 páo jiāng). For food accumulation patterns see food cough.