Cough

Coughing is an important bodily function. Normally the cilia, or the tiny hairs that line the airways, move in unison (like a ‘Mexican wave’) and transport mucus and particles up from the lungs and bronchi to be cleared from the throat, resulting in a little humphing sound. Coughing is a more forceful removal of unwanted matter, ejecting particles snared in mucus from the lungs at a velocity of up to 160 kilometres an hour.

Coughs are described as being either productive or unproductive, depending on the amount of phlegm or mucus brought up. It is preferable to get rid of the mucus rather than swallowing it, as this can lead to nausea. After a productive cough, examine the colour of your mucus (in private). Clear mucus indicates an irritation, a virus or an allergy, while yellow to green may be sign of a bacterial infection. The presence of blood means that you have been coughing very hard, or possibly something more serious. In either case, mention it to your doctor.

Symptoms

A cough may be a symptom of an underlying condition. But sometimes a cough is just a cough.

What causes it?

• A single cough is usually about expelling dust or something caught in the throat.
• Bronchitis is an infection or irritation of the bronchial tree, the airways leading down to the lungs. Bouts of coughing can occur with or without mucus. You can also wheeze if you have bronchitis.
• Air-conditioning can dry out the membranes of the nose, throat and lungs. In susceptible people, this will cause irritation and may trigger coughing.
• Reflux is where there is a regurgitation of the acid contents of the stomach into the oesophagus, irritating the mucous membranes and causing a cough. Silent reflux is when you are unaware that this is happening, so while the cough seems entirely random, it is in fact in response to the oesophageal irritation. If more obvious reasons for your cough have been addressed, silent reflux is worth investigating with your doctor.
• Coughing can be a side effect of certain medications.
• Some people cough when they are nervous.
• Allergies may cause coughing. Common allergens include preservatives in food or wine, pets, certain plants, mould and cleaning chemicals.
• Coughing can be the sign of a more serious condition such as tuberculosis or lung cancer. If you are concerned about an unexplained cough, ask your doctor to examine your chest, listen to your cough and make whatever tests may be necessary to determine the cause.

What to do

Coughing is a natural way of eliminating matter from the lungs. Unfortunately, many pharmaceutical cough mixtures contain substances that suppress the cough reflex. Therefore, the best cough treatments reduce the viscosity (stickiness) of the mucus and open up constricted airways so that the mucous can be more easily eliminated. Cough suppressants (antitussives) can be used at night to help with a good night’s sleep. Persistent coughing irritates and inflames the membrane lining of throat and lungs so something soothing and healing needs to be included. Infection, which is more likely if mucus is green or yellow, must also be attended to.

Diet

• Fluid makes the mucus less sticky, and elimination therefore easier. It is very important to drink between 2–3 litres of clear liquids daily such as water. Hot fluids are best – hot honey and lemon, herbal teas, broths, miso soup, spicy soups or chicken soup.

Try this fabulous cough-busting brew:

• juice of one lemon
• rind of half the lemon, chopped
• 1 stick of cinnamon (optional)
• 1 handful of fresh thyme, crushed
• 3 cm of fresh ginger root, grated
• 2–3 tablespoons of honey

Place all the ingredients into a teapot. Add boiling water and stand for 5 minutes. Drink 3 cups daily.

• The old-fashioned hot toddy can also work a treat to help you get off to sleep. Pour a shot of whisky, brandy or rum into a cup of hot water, add some lemon juice and honey.
• For some people, dairy products increase mucus. Avoid them if necessary.
• Eat fresh pineapples and drink pineapple juice – they contain bromelain, a substance that helps to break down mucus.
• Foods that are good for the lungs include onion, garlic, pepper, aniseed and cinnamon.

Remedies

• Onion cough syrup. Sounds yuck, but tastes yum. Roughly chop an onion (red, brown or white) and place into a bowl. Pour over some runny honey until covered. Leave in warm place for a few hours or overnight. Adults can take one dessertspoon of onion syrup every hour, or one teaspoon for a child. Onions are part of the Allium family, as is garlic, and they both have bug-killing and mucus-thinning properties.
• Herbs can also help relieve coughing in several ways. Some have expectorant properties that can encourage mucus to move up and out of the airways, while some have antimicrobial properties that can help fight viral, bacterial and fungal infections. Others have mucolytic properties that can reduce the viscosity or stickiness of mucus, allowing it to be more easily removed. Antispasmodic herbs can reduce excessive coughing, promoting a restful night’s sleep. Many herbs combine several of these actions. The following herbs are traditional lung tonics: mullein, grindelia, licorice, thyme, marshmallow, euphorbia, elder, white horehound, garlic and saffron. A mixture of several of these in a tincture or in tea form 3 times a day can relieve the most stubborn cough.
• Quercetin is known for its ability to reduce inflammation often associated with allergies and respiratory complaints.
• Cod-liver oil, which contains vitamin A for mucous membrane support and vitamin D for immunity, can be helpful in preventing coughs. It is good for children, too. Now available in capsule form, rather than the psychologically scarring spoonful of yesteryear.
• Vitamin C and zinc can help prevent and resolve an infection.
• Magnesium (200 mg) taken twice a day can ease the muscular strain of excessive coughing.
• Magnesium phosphate (mag. phos.) tissue salts can help remedy a chronic, hacking, unproductive cough.
• The homoeopathic remedies Ipecac and Antimonium Tartaricum (ant. tart.) are also good for productive coughs, especially if there is gagging.

Other

• Humidifiers, available from chemists, can help moisten the airways and allow for a peaceful night’s sleep. Add a dab of Vicks or a few drops of essential oil to the water in the humidifier (eucalyptus and/or thyme oil for an infection; lavender for a calming effect).
• Coughing can both cause and be caused by a spasm in the smooth muscles that line the airways. If your cough is driving you mad (and those around you), switching on the parasympathetic nervous system by a slight increase in carbon dioxide can relax the smooth muscle and stop the coughing. Sound simple? It is. Try this. Close your mouth. Take a small breath in, then out. With the thumb and forefinger of one hand, gently hold your nose closed for 5 seconds. Release and relax for 10 seconds, breathing gently through your nose. Repeat 10 times or until the coughing stops.
• Try a steam inhalation once or twice a day, and definitely before bed. Steam inhalations relax the airways and help the elimination of mucus. Simply bring a kettle of water to the boil. Pour the water into a large bowl or pot and add a teaspoon of Vicks or eucalyptus oil. Place the bowl on a table and sit close by, draping a towel over your head and the bowl. Keeping a slight distance from the water, breathe the vapours in through your nose. Stay for as long as comfortable. [Author note: changed to bowl to avoid burning] Good thinking, thanks
• Postural drainage uses gravity to help you cough. It is a very useful technique for loosening congestion, and is best done after a steam inhalation. First, lie face down across the bed, bending at the waist so that your hips and legs are on the bed and your trunk is hanging over the side. Place a bowl or towel within striking distance. Make yourself comfortable by resting on your forearms on the floor. In this position, your lungs are upside down. Very gently begin to cough. If you have a helper, ask them to thump rhythmically and lightly on your back, especially on the side and bottom ribs. This can be too rough for some, however. Children, babies and older people can therefore lie on the bed fully and prop several pillows under their middle so that their head is lower than their chest. The helper should apply gentle percussion to the upper back to dislodge phlegm. This is very good for children who vomit up mucus in the night.
• For those with a chronic cough or lung congestion, place bricks or books under the base of your bed so you are lying slanting down towards the bedhead. This will help drain the lungs.
• Don’t smoke.