COUGH

• A cough is a forceful expulsion of air from the lungs and a protective mechanism that serves to expel foreign matter inhaled by accident and to remove secretions from the air passage to keep it clear
• A most common symptom of respiratory disease
• It may be classified as acute (< 3 weeks), subacute (3–8 weeks), or chronic (> 8 weeks), as well as productive (with sputum/mucus expectoration) or dry
• Upper respiratory tract infections (URI) and acute bronchitis are the most common causes of acute cough
• Subacute cough is often a sequela of a URI (post-infectious cough) but can also be due to chronic bronchitis or pneumonia
• Chronic cough is often caused by rhinitis/sinusitis, asthma, GERD, and ACE inhibitors

• Infections of the respiratory tract:
  • Upper respiratory tract: common cold, sinusitis, pharyngitis, laryngitis
  • Lower respiratory tract: Bronchitis, measles, bronchiectasis

• Hyperactive airways: allergic rhinitis with postnatal drip
• Aspiration syndrome: GERD, cleft palate
• Foreign body inhalation
• Congenital anomalies

Type of cough

• Paroxysmal cough in bronchial asthma
• Brassy cough- laryngitis
• Irritative cough- pharyngitis
• Feeble cough- in neuromuscular diseases
• Throat clearing cough- postnasal drip

History of fever

• High fever- acute viral infection

Running nose, earache or sore throat

• Indicate upper respiratory tract infection- either bacterial or viral

Aggravating and relieving factors

• Dry cough- suggests bronchial asthma
• Cough on lying down- GE reflux

Snoring or mouth breathing

• Cough is caused by adenoid hypertrophy

Physical examination

• Growth assessment
• General appearance: adenoid facies
• Anemia/ cyanosis/ clubbing
• Lymphadenopathy

Respiratory system Examination

• Bilateral crepitation: bronchopneumonia
• Silent chest: cough, acute bronchial asthma

Investigations

• CBC- leucocytosis- in bacterial infection, leukopenia- Viral infection
• X-ray- paranasal sinus
• Mantoux test- positive in TB

Ayurvedic Treatment

• Avoidance of allergens

 Internal medications 

 Kashayas

• Dashamoola katutraya Kashaya with honey, Vyaghree shuntyadi Kashaya
  • Up to 1 year: for mother: 2 tsp sookshma choorna is boiled in 2 glass water, strained, and given to mother. If agni bala permits give 1 tsp thrice to the child
  • 1 year to 5 years: ½ tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
  • 5 to 10 years: 1 tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
  • 10-15 years: 1 ½ tsp powder boiled in 1 glass of water and given twice daily mixed with sugar or jaggery

 Swarasa

• Ardraka swarasa+ honey : ½ tsp – 1 tsp

 Arishtas

• Amrutarishta , Vasarishta, kanakaasava ,Punarnavasava
  • Up to 2yrs- ½ tsp arishta diluted with 1 tsp water
  • 2-5 years- 2.5ml-5ml diluted with 5 ml boiled water
  • 5-10 years- 10ml10-15 years- 15ml

 Gutikas

• Gopeechandanadi gutika, Chukkumthippalyadi gutika, Vettumaran gutika, Swasaanandham gutika with appropriate anupanas
  • 2-6 years ¼ tab bd
  • 6-12 years- 1 tab bd
  • 12-15 years- 1 tab tds

 Choorna, Vataka

• Vyoshadi vataka: frequently with honey
• Thaleesapathradi choorna, Jeerakadi choorna, with honey 

 Lehyas 

• Pippali rasayana, Agasthya hareethaki
• 2 to 6 years: ½ tsp
• 6-12 years: 1 tsp

Allergic cause:

Kashayas

• Amrutarajanyadi Kashaya, Guduchyadi Kashaya

Gutikas

• Gopeechandanadi gutika, Nimbarajanyadi gutika 

Choorna

• Rajanyadi choorna ,Haridrakhanda 

Long term use - ½ to 1 tsp based on appetite

• Vidaryadi lehya
• Kushmanda avaleha
• Chyavanaprasha
• Vasishta rasayana
• Amrithaprasha