CRITICAL ANALYSIS OF COUGHS.

Western Star, 2 August 1938, Page 3

CRITICAL ANALYSIS OF COUGHS.

There are many varieties, types and species of coughs—that is, as to cause, writes Dr Irving Cutter in the ‘Chicago Tribune.’ The manifestation is often uttered in lieu of a word or a phrase, or -to; express a mood. Occasionally a gentle “bark” indicates-that the human source can think, of nothing better to do. Every now and then, however, the symptom 'will convey a definite meaning to the physician and help to point the way to the identification of a malady. First we may think of the cough deceptive—the sly, soft “uggr” employed to distract or attract attention. This is 1 resorted to by on© approaching a group of persons as a means of entrance into the circle, or as a preliminary to announcing one’s departure. Then there is the cough butleresque, used frequently to register protest—never, assent. This varies in tone according to the quantity of indignation—the higher and sharper the note the wider the disagreement. Most of us • are familiar with the cough of embarrassment,' which serves to break a painful pause at a dinner party or when one does not know the answer. Once in a while this is paroxysmal in nature, depending upon the amount of confusion that must be covered up. The opera, symphony, or lecture hall species, as a rule, denotes comfort oi satisfaction. It is voiced shortly after

one has found his seat and given 0 - cursory glance- about to identify the neighbours. Should the audieiic© room fill slowly there may be a succession o: these low-pitched “woofs.” They are almost ritualistic and come before the victim relaxes, resigned to his fate. All these forms are of no real medi--5 cal importance. They are not accompanied by a flow of bronchial secretions. But when sputum is “raised,” as the saying goes, a thorough microscopic examination, will tell much about the extent of the disease and its character. In 'pulmonary tuberculosis, for example, the excreted material may contain the typical bacilli, but a single negative examination does not preclude the*pres ence of the infection. Repeated checkt 'should he made if other symptoms poini to a lung disease. * The two questions which the physician will ask: “How long have you had. your cough ?” and “When does it come, on ?” One that has persisted for a long period of time, that is dry and hacking, may arise because there is some slight evidence of heart failure.. If the disorder has existed, however,. for only f few days, we know that it is due to an acute trouble, one that may be identified when the chest is examined carefully. Here X-ray films are advised, as well as a careful inspection of the vocal’ chords and the larynx. A' morning . cough is suggestive of chronic >■ bronchial involvement. The explosions may remind one of machine-gun Vfi re _-the patient’s face becoming deeply ' congested' with the struggle.’for breath; If one wakens at night with a. “spell, ;• we may be fairly certain that an in-, fection has invaded the active lung tissue. V . , ~ Strict attention must be given to the kind that is accompanied by alteration of the voice, as pressure upon a n«x e may be followed by a brassy, metallic, sound from which resonance is absent. We must think also of inflammation f 1 tlie larynx or some difficulty with the I vocal chords themselves. *■' Nervous coughs can be controlled with the use of a little will power. This is necessary because the habit may grow' and become not only a health hazard ’ but a social handicap. The sudden expulsion of air throug it trachea —oft repeated-may - in and o, itself prove hamful. This is why eviy effort is made to ameliorate the sy ptom in bronchitis and pneumonia through the use of appropriate sedaUV No one should 'permit a cough to con tinue unexplained, particularly l “hung on” for more than a ’ few So much can be done to.reheve motion that we should not risk the lishment of chronic disease of the an passages.