Cough is a reflex phenomenon characterized by a sudden, violent expulsion of air from the mouth, with or without sputum, after deep inspiration and closure of the glottis. This is the most frequent respiratory symptom.

Coughing is an important way to keep the throat and airways clear. However, involuntary excessive coughing means there is an underlying cause that compels the person to cough. The cough may be dry or productive. In dry cough there is only explosive sound with no or little material coming out from the airways.

Whereas a productive cough is one that brings up phlegm or sputum, at times mixed with pus or blood or both. Cough can be either acute or chronic. Acute cough usually appears suddenly, goes away within 2-3 weeks and is often due to common cold, flu, or sinus infection.

Chronic cough lasts longer than 2 to 3 weeks and is a symptom mostly of respiratory tract disease. Besides respiratory infections namely tuberculosis, other common causes of cough include chronic tobacco smoking, naso-bronchial allergy, bronchial asthma, chronic bronchitis with or without airway obstruction, lung abscess, bronchiectasis and bronchogenic tumours, reflux disease of gastrointestinal system, air pollution, heart failure, valvular heart disease and certain medicines used for the treatment of high blood pressure.

The diagnosis of the cause of cough is essential before definitive therapy is initiated. Painful cough in association with fever indicates respiratory tract infection. Intermittent, ineffectual and exhausting cough occurs in chronic bronchitis and bronchial asthma and it is generally worst at night or on waking.

Cough may be loose and readily productive of sputum in bronchiectasis and early stages of bronchial cancer. Sputum Pippali powder for cough  production may be a relatively late development in lung tuberculosis. Loud and harsh cough without explosive character called stridor is found in whooping cough and in the presence of laryngeal or tracheal obstruction.

Cough usually aggravates with change in temperature or weather. The explosive character of normal cough is lost in laryngeal paralysis.        A short troublesome cough of old people due to chronic bronchitis recurs every winter and it is called winter cough. Cough due to smoking is usually dry and irritating. Clinical and radiological evaluation is usually diagnostic in a large majority of cases.

While definitive therapy may wait diagnosis, symptomatic treatment usually provides relief. Ayurveda considers Kasa (cough) as a disease for which a specific line of treatment and various remedies are prescribed. Simple herbal remedies such as Pippali can successfully treat uncomplicated cough, if patients observe the prescribed precautions along with medication.

These are:

1. Exposure to fumes and dust, sudden change of temperature in the surrounding, dry and spicy foods, chilled water and food, leafy vegetables and heavy meals should be avoided.

2. Soft, hot and easily digestible meals, edibles like honey, small cardamom, fresh ginger, radish, meat soup, goat milk and resins help to control cough.

3. It is advisable to resort to sleeping during the day and not to suppress urges of stools, urination and belching. Cough symptom can be controlled easily with frequent drinks of warm water, mental relaxation and with less talking.

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