Cough is a rapid expulsion of air from the lungs typically in
order to clear the lung airways of fluids, mucus, or material. Cough is also
called tussis. Cough can be categorized as acute (less than three weeks) or
chronic (greater than three weeks). There are many different types of cough and
you can hear them all during winter – tickly coughs, chesty coughs, croupy
coughs – but they all have one thing in common; they cause distress and
discomfort to the sufferer (not to mention the listener!) They lead to
irritability, sore muscles, and lack of sleep.
Frequent coughing usually indicates the
presence of a disease. Many viruses and bacteria benefit
evolutionarily by causing the host to
cough, which helps to spread the disease to new hosts. Most of the time,
irregular coughing is caused by a respiratory tract infection but can
also be triggered by choking, smoking, air pollution,
asthma, gastroesophageal reflux disease, post-nasal
drip, chronic bronchitis, lung tumors, heart failure and
medications such as ACE inhibitors.
A cough is a protective reflex in
healthy individuals which is influenced by psychological factors.
The cough reflex is initiated by stimulation of two different classes of afferent
nerves, namely the myelinated rapidly adapting receptors, and
nonmyelinated C-fibers with endings in the lungs. A cough in children
may be either a normal physiological reflex or due to an underlying
cause. In healthy children it may be normal in the absence of any disease
to cough ten times a day.
Types of Cough By Sound
"One of the best ways to diagnose
a cough, and the way we do it, is by listening,"
- A sharp gasp for breath at the end of a long coughing spell characterizes whooping cough, it puts infants at risk and kills one to three babies a year
- Infamous for its "barking" cough, croup is a viral infection that results in swollen vocal chords and throat. It commonly affects children and worsens at night,
- A dry cough is so called because it doesn’t produce phlegm. It can result from a wide variety of problems, from mild environmental irritants,such as smoke, to disorders or infectious diseases, such as asthma, the flu or pneumonia.
- Productive/Wet Cough - Just a regular old cold gives you wetness in the cough because again all that junk in your nasal passages it goes back into your throat into your airways, you’re coughing it up, Besides a cold or influenza, bronchitis and pneumonia can also cause wet coughs.
Conditions that cause coughs
Colds and Flu - Almost all coughs due to the common
cold come and go without trouble; still they can be a big hassle if they keep
you up all night or doubled over during the day.
Post-nasal drip - Most types of coughs are caused by
postnasal drip, triggered by allergies, fumes or an upper respiratory
infection. The sinuses produce fluid that drips down the throat and that
produces a cough, because your body won’t let you drown in your own
secretions,” she says. The cough can be dry or wet, accompanied by a tickling
or sore throat.
Sinusitis/Rhinitis - Sinusitis, an inflammation of the
sinuses, causes that tickling, dripping sensation down the back of the throat
that triggers various types of coughs.
Rhinitis is inflammation of the nasal
passages, which also leads to postnasal drip.
Allergies - Coughs related to rhinitis, sinusitis
and post-nasal drip all can be triggered by allergies.
Asthma - The second most common cause of
coughs is asthma, some people, instead of loud wheezing, get only a cough.
Smoker’s cough - Many smokers think of it as a morning
cough. But a cough can be a sign of a
more serious disease like COPD (chronic obstructive pulmonary disease) or lung
cancer.
Acute bronchitis/Pneumonia, Acute – sudden, but short –
bronchitis is essentially a cold or a viral infection. It can also be bacterial.
Pneumonia, an infection of the lungs, also can be viral or bacterial.
Reflux (GERD) - Surprisingly, if you have acid or
non-acid reflux – the back-up of stomach fluids into your esophagus – your only
symptom may be a cough, not heartburn. More than half of people with reflux
disease have only a cough.
Classification of Cough:
A cough can be classified by its
duration, character, quality, and timing. The duration can be either acute
(of sudden onset) if it is present less than three weeks, subacute
if it is present between three and eight weeks, and chronic when lasting longer than eight weeks. A
cough can be dry or productive, depending on whether sputum is
coughed up. It may occur only at night, during both night and day, or just
during the day.
Acute
Cough: The
cause of the acute cough is usually determined by the person’s history and
physical exam.
·
If cough is present less than three
weeks.
·
Most commonly relates to
o Viral – induced lower respiratory tract infections.
o Post-nasal drip resulting from rhinitis or sinusitis.
o Throat - clearing secondary to laryngitis or pharyngitis.
Post-nasal
drip: Mucous accumulation in the back of the
nose and throat leading to or giving the sensation of mucus dripping downward
from the back of the nose.
Subacute
Cough: if it is present between three and
eight weeks. The most common causes are:
Post infectious Cough, Acute Sinusitis, Asthma.
Chronic
Cough:
·
When cough lasting longer than eight
weeks.
·
Patients with chronic cough often
represent more of a diagnostic challenge like individuals with a normal
examination, chest radiograph and lung function tests.
·
Most cough can be explained by
Post-nasal drip secondary to nasal or sinus disease. Asthma , where cough may
be the principal or exclusive clinical manifestation Or Gastro-oesophageal reflux (may require
ambulatory pH monitoring or a prolonged trial of antireflux therapy to
diagnose.
Dry
Cough:
Cough
is dry i.e. there is no phlegm when a person coughs. The throat feels itchy and
scratchy due to the dryness. The throat pains due to excessive coughing. It is
difficult to eat due to excessive coughing. Fever may accompany the cough but
it is not a necessary symptom.
The dry,
hacking cough is caused by: a virus infection, cold or dry air, or Air
pollutants such as cigarette smoke, smog and dust. This sometimes feels like a
tickle at the back of your throat.
Productive
Cough:
Productive
cough are coughs
that produce phlegm,
in contrast to dry coughs. Productive cough may be associated with tuberculosis,
bacterial pneumonia, and bronchitis . The loose productive cough is a sign of chest
congestion or infection due to colds or flu. It clears the lungs and air
passages of excess mucus.
Phlegm
is a sticky material from your mucous membranes in our respiratory system. When
have a cold it might be yellowish brown. If there's an infection, it might be
greenish brown. Normal phlegm is usually clear.
Characteristics of cough originating at
various levels of Respiratory Tract:
|
Origin
|
Causes
|
Characteristics
|
|
Pharynx
|
Post nasal drip
|
Usually Persistent.
|
|
Larynx
|
Laryngitis, tumor, whooping cough,
croup
|
Harsh, barking, painful, persistent,
often associated with strider.
|
|
Trachea
|
Tracheitis
|
Painful
|
|
Bronchi
|
Acute Bronchitis and COPD
|
Dry or Productive, , worse in
mornings
|
|
Asthma.
|
Dry or productive, worse at night.
|
|
|
Bronchial Carcinoma
|
Persistent often with haemoptysis.
|
|
|
Lung Parenchyma
|
Tuberculosis
|
Productive, often with haemoptysis.
|
|
Pneumonia
|
Initially Dry, Productive later.
|
|
|
Bronchiectasis
|
Productive
|
|
|
Pulmonary edema
|
Often at night ( may be productive)
|
|
|
Interstitial Fibrosis
|
Dry, irritant and distressing.
|
General
Management
v Eat healthy
food and avoid sugar or sugary foods which suppress the immune system for up to
5 hours after being eaten.
v Get plenty of
rest so your body can recover
v Maintain
hydration and keep your mucus membranes moist with frequent drinks of water or
soothing teas.
v Soothe inflamed
airways and loosen mucus with steam inhalations and warm showers.
v Avoid
cigarettes and tobacco smoke which paralyse and eventually destroy the
microscopic hairs that line your airways.These fine hairs, called cilia,
normally sweep the mucus upwards in waves, away from your lungs.
Natural Home
remedies
A specific tip for coughs involves black pepper. Pepper has an
antimicrobial effect but in truth, its ability to soothe coughs probably has
more to do with the homeopathic effect of ‘like treats like’; pepper can induce
coughing in a healthy person and so will relieve it in someone suffering from a
cough. Pepper is best added to raw honey and taken by the spoonful several
times a day.
Cinnamon is another
natural antibiotic. It is rich in compounds that inhibit bacterial growth and
strengthen resistance. Add it to your food or drinks to boost your immune
system. Turmeric contains an
anti-inflammatory compound called curcumin, which has strong cold and flu
fighting properties. Stir a teaspoon into a glass of water or use it in your
cooking
Honey and lemon soothe the
mucous membranes of the throat and have an antibacterial effect – raw honey is
best. Research shows that children who take a spoonful of honey before bed
cough less and sleep better than those who take over-the-counter products for
coughs and colds. Adding a little lemon to the honey will increase its
anti-microbial effect. Honey and lemon can also be combined with hot water to
make a soothing tea.
Chocolate and
cough - Chocolate can help a cough! Theobromine, a compound found in the cocoa bean, will suppress coughs just as effectively as many cough medicines but
without their sideeffects. Milk
chocolate contains very little theobromine
compared to dark chocolate. To obtain an effective dose, need to eat 50 –
100g of dark chocolate. Enjoy!
Allopathic treatment uses suppression
or palliation to relieve symptoms for short periods of time. The drawback is
that in the long run, continual suppression leads to worsening
health. Depending on whether the cough
is wet or dry, conventional medicine will offer a suppressant or an
expectorant.
HOMOEOPATHIC MANAGEMENT
Homoeopathic Research
One interesting study with
seriously ill patients on respirators in an intensive care unit showed that
homeopathy not only effectively reduced their respiratory secretions but also
helped them come off their respirators more quickly. The length of time they
spent in the unit was also shorter and without respiratory complications. In
contrast, those in the control group who had not received homeopathic treatment
took considerably longer to recover. Some also had to be returned to the
respirator after extubation because they were struggling to breath from
excessive secretions in their airways – something that was not a problem for
the homeopathic group. As excess respiratory secretions are a major trigger for
coughs, the homeopathic treatment would also have reduced the incidence of
coughs – something that is also substantiated clinically.
Another study of children with
upper respiratory tract infections, including coughs, showed that those who
received homeopathic treatment recovered much more quickly than those who were
treated conventionally in the control group.
A third study showed that those
children whose colds (and accompanying coughs) were treated with homoeopathy
were more likely to feel and do better than those children whose colds had been
treated conventionally. The homeopathically treated children had fewer
complications, and their parents took significantly less sick-leave than the
parents of those children treated with antibiotics.
Homoeopathic
Remedies
Homoeopathy is a safe and effective
system of medicine which uses natural herbal and mineral products to treat
disease. Homoeopathic Remedies are holistic, which means homoeopathy relies on
making a diagnosis from analysis of all of a patient's complaints before
prescribing any treatment. Homoeopathic medicines are often effective in
treating the acute symptoms of coughs, though professional constitutional care
is usually necessary to achieve a deeper level of cure of chronic respiratory
problems.
Aconite - Sudden onset
often after exposure to cold air. Dry croupy cough with runny nose and
sneezing. Irritation of respiratory tract, hoarseness/dryness of throat. Worse:
cold dry winds, talking and deep breathing. Better: lying on back.
Anti Tart - Noisy, rattling, loose cough as if chest
full of mucus. Young children or elderly with cough too weak to expel the
mucus. Worse: night, especially from 10 pm until after midnight, lying flat,
eating. Better sitting up and after expectoration
Bryonia - Dry hacking
cough in the evening and night without sputum. Spasmodic cough shaking the
whole body, pain in the head an abdomen from coughing, better for holding the
painful part. Dryness of all air passages with thirst. Worse: movement, deep breathing,
lying in bed. Better: fresh air and for pressure of painful part.
Causticum - Cough with raw, sore feeling in chest.
Hollow, hard, dry cough from tickling in throat pit. Expectoration not easy to
cough up and slips back down the throat. Worse: lying down, talking and bending
head forward. Better: cold drinks
Coccus Cacti - Paroxysmal, hard, short hacking cough ending
in copious thick, ropes of mucus. Worse: 6-7 am or after 11.00 pm, becoming
heated, warm rooms. Better: cold, open air, cold drinks.
Drosera - Spasmodic, dry irritating coughs like
whooping cough. Barking cough which is dry in the evening and loose in the
morning. Sputum is yellow/green, bitter or offensive, bloody or pus like.
Retching after spasmodic cough. Worse: after midnight, lying down, singing, laughing
and drinking. Better: holding chest.
Hepar Sulph - Productive
cough with thick, yellow mucus. Also dry, croupy cough. Worse: slightest
drafts, uncovering, cold dry air Better: warmth, from expectoration.
Ipecacuanha - Almost always totally dry
cough which comes in paroxysms causing choking, gagging or vomiting. Worse:
night, deep inspiration especially in morning while lying in bed, warm room.
Better: after expectoration and cold drinks. A good children's cough remedy if
the symptoms fit.
Phosphorous - Cough may be dry or loose, (useful in the
early stages of bronchitis/pneumonia) Every cold descends to the chest. Burning
in the chest with raw larynx and feeling of tightness. Scratchy sensation in
the throat, tickling cough. Worse: change from warm air to cold air, talking,
laughing. Better: heat, sleep and lying on right side
Pulsatilla - Catarrhal cough with copious yellow/green
lumpy mucus. Dry cough at night, loose in the morning. Worse: warm stuffy
rooms, lying down, becoming warm in bed. Better: fresh air, gentle walking,
sitting up in bed.
Rumex - Main remedy for tickling irritated coughs.
Incessant, violent, tickling cough with scant expectoration. Intense tickling
in the larynx and trachea , worse cold air. Covers mouth when goes out in the
cold air. Teasing cough preventing sleep. Worse: slightest inspiration of cold
air, going from warm room to cold, talking. Better: warm air
Spongia - Barking, dry croupy cough with wheezing and
rasping. Great dryness of all air passages. Scanty expectoration tasting salty,
looser in the morning but no mucous rattle in the chest. Cough sounds like a
saw being driven through a pine board. Sensation as if had to breath through a
dry sponge. Worse: warm room, talking before midnight. Better: swallowing,
especially warm drin ks, sitting up and bending forward.
