Winter Coughs
Published Mar 12, 1955 ·
British Medical Journal
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Abstract
As any theatre-goer knows all too well, this is the season of persistent coughs. Usually they are the result of the common cold which has " gone to the chest" and produced a chronic tracheitis or tracheobronchitis. Although many people recover quickly, in some the cough may persist. This is especially true of those who have an inherited asthmatic tendency or are liable to bronchospasm. In children the common cold is often accompanied by a sinusitis which persists after the nasal discharge has ceased, and this is the commonest cause of chronic cough in the child of school age. Influenza epidemics usually reach their peak in the first few months of the year, and the early, dry, irritating cough of this disease is nearly always followed by a more productive tracheobronchitis. In some patients the cough persists for several weeks after recovery from the febrile stage of the illness. If radiographs were taken of the chest of every sufferer from a persistent upper respiratory-tract infection with cough, some would be found to have mottled opacities indicating absorption collapse, a condition which is called benign or localized aspiration pneumonia. It is clearly desirable to examine carefully all patients who seek advice about a cough which has persisted for more than a short time after an acute respiratory illness. The great majority will be found to have no eradicable cause, and treatment must perforce be symptomatic. For the child with sinusitis, ephedrine nasal drops (i% in saline) may diminish the severity of the cough. But in general the problem is to decide what sort of cough medicine to administer. Drugs given for the relief of cough fall into three main groups: those intended to liquefy the sputum and help its removal by stimulating the cough centre; those intended to depress the cough reflex; and the antispasmodic drugs which are used when bronchospasm is present as well. In view of the large quantities of cough mixtures which are dispensed-Dunlop et al.1 in a pilot survey found that they constituted