Coughing

“ On standing with the feet in thawing snow, many people are liable to incessant coughing. From the torpidity of the absorbent vessels of the lungs, in consequence of their irritative associations with those of the skin, they cease to absorb the saline part of the secreted mucus; and a cough is thus induced by the irritation of this saline secretion; which is similar to that from the nostrils in frosty weather, but differs in respect to its immediate cause; the former being from association with a distant part, and the latter from defect of the stimulus of heat on the nostrils themselves. ”

“ Galen gives some ingenious remarks on the causes of coughing. He states that when any substance becomes fixed in the trachea, as it is a cartilaginous and hard tube, and incapable of contraction, nature brings on coughing, by which a violent expiration of air is induced. A cough, then, is nothing but a violent expiration by which nature endeavours to expel any body that obstructs the air-passages ”

“ So long as a child seems pretty well in the intervals between the fits of coughing, as the hurried breathing subsides after each to a natural frequency, as a long loud hoop follows each cough, as vomiting takes place only after a fit of coughing and never in the intervals, as the child becomes flushed only and not livid during a cough, and recovers itself perfectly afterwards, as it does not complain of constant headache, nor spits blood, nor has nose-bleeding, nor is feverish, nor depressed, nor drowsy, you may feel happy about it. ”

“ Much of the whooping-cough of an epidemic is believed by good authorities, such as Bouchut and Struges [1246] , to be simply mimetic, or a habit of coughing acquired by hearing other children coughing in a particular way, just as chorea is sometimes acquired in schools or hospital-wards through the mere spectacle of it. ”

“ Whooping cough is unlike the other three diseases in that it is a nervous trouble, and probably the germ or the poison formed by the germ attacks the nervous system, and particularly one great nerve connecting the lungs and stomach. This is why the spasm of coughing is frequently followed by vomiting, and the only remedy which is of [Pg 374] value in whooping cough is a nerve depressant which will diminish the activity of the nervous system without at the same time interfering with the strength or vigor of the patient. ”

“ Cough is largely influenced by suggestion. Most of the respiratory reflexes follow this same rule. To see another yawn tempts us to yawn; to hear another cough tempts us to cough. In church or in a theater after an interval of interest one cough will be followed by a battery of coughs. People who have colds think they have a right to cough, and so they often cough much more than is at all necessary. Of course, when material accumulates in the lungs it must be coughed up, but not a little of the coughing might easily be dispensed with—it is unproductive coughing. ”

“ Toward the end of the second week to these symptoms are added irritation of the membrane lining the air-tubes; a frequent and dry cough, commencing with a sense of tickling in the upper part of the windpipe, but little relieved by the cough or only after long coughing; and the expectoration of a small quantity of transparent, glairy mucus. The severity of these bronchial symptoms depends much upon the condition of the atmosphere: if dry and dusty, the cough is much worse; dampness and a rainstorm give relief. ”

“ We have active cold symptoms like sneezing, running at the nose, snorting, snuffling, hawking. The cough is terribly severe, annoying, making the lungs and stomach very sore. The head feels as if it would split. The patient holds his chest and "stomach" while coughing. Symptoms of acute bronchitis develop. Sometimes there is much diarrhea. Pneumonia often develops through carelessness. The fever reaches its height when the eruption is fully developed. ”

“ Then, if they are very young or delicate, it is liable to produce convulsions or some other complication, and a medical man should always be called in. In many children a paroxysm of coughing brings on bleeding at the nose, and in some cases retching, but neither will do any harm. Very often the child who is sick with the cough gets over it quickest. As a rule whooping cough lasts three or four months; I have known it to continue for six. A change to the seaside will nearly always take it away. In fact, any change is beneficial, and will, in nine cases out of ten, cure it completely. ”

“ See Pyroxylin.
COUGH. Syn. Tus′sis, L. The sudden and violent expulsion of air from the lungs. It is generally symptomatic of other affections, but is sometimes idiopathic, or a primary disease. Many cases of cough depend upon the extension of catarrh to the trachea and bronchiæ, which thus become loaded with mucus or phlegm, which they endeavour to throw off by the convulsive effort called coughing. In some cases it is caused by a vitiation and inspissation of the secretions, arising from the imperfect action of the absorbents; this is the common cause of the dry cough of old people. ”

“ The chronic or paroxysmal cough may often be traced to the presence of tumor, ulcer, local inflammation, or parasite, but in some instances no local trouble is recognizable, the general health remains good, and yet the throat is abnormally sensitive and a cough or fit of coughing may be roused by passing into the cold air from a warm stable, by cold water in drinking, by inhaling irritant gas, by the passage of rough or fibrous food, or by handling the larnyx. ”

“ This Cough is known by the peculiar hoop which is descriptive of the disease. Children are most commonly the subjects of this complaint, and especially those who are teething; but it sometimes attacks those advanced in life. It comes on with a slight difficulty of breathing, thirst, rapid pulse, hoarseness, Cough, and all the symptoms of common Cold. This disorder, if not nipped in the bud, gradually increases; and about the second or third week, assumes its peculiar characteristic symptoms. The expiratory motions, peculiar to coughing, are made with more rapidity and violence than usual ”

“ WHOOPING COUGH.—A contagious disease characterized by fits of coughing, during which a whooping or crowing sound is made following a long-drawn breath. Whooping cough is generally taken through direct contact with the sick, rarely through exposure to the sick room, or to persons or clothing used by the sick. ”

“ Coughing is generally that symptom which soonest attracts the attention of the patient and his surroundings. For that very reason consumption is in its beginning stages easily confounded with such other diseases as are also accompanied by cough. ”

“ Almost needless to say, people indulge in a great deal of unnecessary coughing. Some of this is a sort of habit and some of it is due to that tendency to imitate, so common in mankind. Every one has surely heard during religious services, in a pause just after heads have been bowed in prayer or for a {200} benediction, a single cough from a distant part of the church which seemed to be almost the signal for a whole battery of coughs that followed immediately from every portion of the edifice. ”

“ Pulmonary symptoms which may furnish therapeutic indications are cough and expectoration, hæmoptysis, pain in the chest, and dyspnoea. Cough is of course necessary for the removal of the morbid products within the bronchial tubes and cavities. If the act of coughing be accompanied by expectoration, palliation is not required. But often there is what may be called a superfluous cough—that is, not accompanied by expectoration. This superfluous cough may be frequent, and occur in violent paroxysms which occasion fatigue and exhaustion. Frequently the cough prevents sleep. ”

“ It is not in the least necessary to give way to coughing on every occasion, even though there be really something to expectorate, until the mucus or other irritating matter be within easy reach, and then one good, effective, deliberate cough will do as much, or probably more, for the relief of the individual, than perhaps a dozen repeated, noisy, resultless fits of coughing. ”

“ The symptoms which attend the attack are out of all proportion to the real danger. It is generally the result of exposure to cold or to the cold wind. Irritating, undigested food, often causes it.
Symptoms.—Usually the child goes to bed perfectly well, or has a slight cold and wakes up an hour or two later, coughing and gasping for breath, due to a spasm in the wind pipe. The cough is shrill, more like a bark; the cough is repeated at intervals and soon the patient breathes quickly and laboriously. It must sit up for it can breathe easier sitting. ”

“ Cough.—In the chapter on Coughs and Colds we have outlined how much coughing may depend on suggestion, or habit, or on the tendency to yield to slight bronchial irritation when there is no real necessity for it. Most tuberculous patients cough much more than is necessary. This is always somewhat dangerous for them since it disturbs their lungs, has a tendency to distribute tubercle bacilli in their lungs, or in the air around them, and may by efforts at expulsion lacerate affected blood vessels and produce hemorrhage. ”

“ Whooping-cough, is eminently contagious. The child may be noticed to have had during one or more weeks occasional but violent fits of coughing, which are most frequent during the night. If no complication be present, there is practically no cough between these spasmodic attacks. Usually a short feeling of general indisposition precedes the attack, during which the child in vain struggles to suppress the cough about to burst, when all at once the trunk and frame are subjected to a violent series of successive throbs almost threatening suffocation. ”

“ The effort required in coughing is apt to tear the delicate fibres of the lungs. Sometimes people burst blood-vessels, while coughing, and die in consequence. The other objection is, it is unpleasant to those around us, especially in a school-room, church, or other public assembly. ”

“ Constant coughing is precisely like scratching a wound on the outside of the body. So long as it is done the wound will not heal. Let a person when tempted to cough draw a long breath and hold it until it warms and soothes every air-cell, and some benefit will soon be received from this process. ”

“ Nevertheless many consumptives describe their cough as very unimportant on account of their innate sorrowless nature, and they will not even be discouraged by the gravest symptoms. Often however it is fear that induces the patients to make light of their coughing, their spitting blood, their losing flesh and to place but little importance on these circumstances. A hoarse cough is a sure sign of a diseased larynx.
Many consumptives complain of cutting pains between the shoulderblades, under the clavicles or in the side; but these are rarely intense and are often entirely wanting. ”

“ The feverishness and restlessness increase, the cough becomes incessant, the respiration extremely rapid and laboured, the nostrils dilating with each effort, and evidence of impending suffocation appears. The surface of the body is pale or dusky, the lips are livid, while breathing becomes increasingly difficult, and is attended with suffocative paroxysms which render the recumbent posture impossible. Unless speedy relief is obtained by successful efforts to clear the chest by coughing and expectoration, the patient’s strength gives way, somnolence and delirium set in and death ensues. ”

“ Cough.—For a hard, dry cough, Aconitum napellus is required in the early stage, followed by Bryonia if necessary; for a cough with wheezing, difficulty of expectoration and need of keeping the head high in bed, Antimonium tartaricum; for a dry, spasmodic cough, with sore throat and thirst, Belladonna, or for a nervous cough, Hyoscyamus 3x; for cough with expectoration and pain in the side or in the head, or between the shoulders when coughing, Bryonia; for cough accompanied by constipation and fulness at the pit of the stomach, or for cough worse after meals, Nux vomica ”

“ A painful cough occurs in pleurisy, also in laryngitis, bronchitis, and bronchial pneumonia. Pain is shown by the effort the animal exerts to repress the cough. The cough is not painful, as a rule, in the chronic diseases of the respiratory tract. The force of the cough is considerable when it is not especially painful and when the lungs are not seriously involved. When the lungs are so diseased that they can not be filled with a large volume of air, and in heaves, the cough is weak, as it is also in weak, debilitated animals. ”

“ Comes on in consequence of a sudden cold. Children suffering from Hooping Cough are more subject to it. The cough is of a peculiar whistling kind, like the crowing of a young chicken, with rattling in the throat and difficult breathing, fever is present, and often very violent. It is properly an inflammation of the Larynx, but the inflammation may also exist in the Pharynx, the tonsils may be involved, and it may extend to the trachia, [Pg 56] (wind pipe) . A false membrane forms in the larynx if the disease is not arrested, and so obstructs the breathing as to cause death from suffocation. ”

“ When the complaint is protracted, and the defluxion is carried down to the chest and lungs, it [470] gives rise to bad coughs. And a cough often arises from an intemperament; sometimes a hot one, as in fevers, and sometimes a cold, as in northerly states of the weather, which is rather a dry one. Cough is also sometimes symptomatic of some other disease, such as pleurisy, hepatitis, phthisis, or peripneumonia. Wherefore Galen relates that, in certain chronic cases of cough, chalazia (hail-stones) have been brought up from the chest. ”