Cough is one of the most common distressing problems the world over. The affected person feels sick and uncomfortable; they cannot talk or sleep properly because of the persistent cough. It is also one of the commonest symptoms for which people seek medical consultation world wide. It is a common medical problem occurring after rains. Cough is an explosive form of expiration i.e. expelling air from the lungs, the aim of which is to clear the wind pipe and its branches of secretions and foreign bodies. Cough receptors are situated in the respiratory tract, which when stimulated induce cough. Certain stimuli initiate cough by causing inflammation of the respiratory mucous membranes i.e. the inner lining of the respiratory passages and the lungs. This occurs as in bacterial or viral infections of the respiratory mucous membranes as in inflammation of throat or sound box. It may also be caused by common cold, where secretions from the nose irritate the throat. Gastric reflux with aspiration can also induce cough. Infections like T.B. or pneumonia also produce cough by causing inflammation of the respiratory mucosa. Common mechanical stimuli producing cough are dust particles in any form, whether due to occupational or accidental exposure. Compression and closure of the air ways induces cough. This may be either from outside as by foreign bodies or tumours or within as in bronchial asthma or collapse of the lungs. Some systemic diseases like cardiac and renal failure produce cough due to collection of fluid in lungs.Irritation of the throat by fumes, chemicals, droughts of cold or hot air also induces cough. Worm infestations like Ascariasis can cause cough by producing state of allergy within the body and also by direct invasion of the lungs. Cough is produced in bronchial asthma due to allergy to certain substances. Irrespective of the cause, cough is distressful. It may be dry or associated with expectoration, depending on the site affected and severity of affection. If a big or small blood vessel is involved at site of infection or inflammation, expectoration will be blood mixed. Fever, loss of appetite e.t.c. other associated symptoms are present in various amounts depending on the cause of cough. At times severe cough is associated with vomiting, which though harmless, is frightening to the affected person and onlooker both. This occurs because the centre for both is located adjacent to one another in the brain and stimulation of one excites the other. Cough if untreated and very severe can lead to rupture of a part of lungs tissue or air way because of the mechanical stress. Infection causing cough if persistent can lead to complications like infections in the brain, septic arthritis and even infections of the heart. Therefore it should never be ignored. Diagnosis of cause of cough is usually established clinically. Blood tests, X-ray and sputum examination aid in confirmation of diagnosis. Treatment is always of the cause, if possible as in case of infections. If the infection is mild or is viral no treatment is required and cough subsides spontaneously. In case of asthma or allergic bronchitis one has to avoid the offending substance if possible and use medication as advised. Whatever the cause for cough, drinking plenty of water and some hot water at least 2 or 3 times is very useful. Inhalation of steam is also helpful in providing relief. Honey is a good natural mucolytic agent (one liquefying mucous or phlegm). Therefore one or two small spoons of honey taken in hot water or hot milk are very soothing and one gets relief in the cough after taking it. Smokers need to give up smoking if they wish to get rid of, “smoker’s cough”. People engaged in work requiring much exposure to dust should use protective face masks. Protection from cold weather also helps in preventing cough. Cough should not become a distressful symptom and should be stopped at the earliest with appropriate measures rachna212002@yahoo.co.uk
