Understanding Your Cough

A cough can become intrusive in one's life — it's irritating, tiring and might keep you up at night. Most people struggling with a cough will reach for an over-the-counter suppressant or visit the doctor's office for a prescription. However, if you came to me with a cough, you would experience a different approach; one that tries to understand the pattern of your unique cough. Why do we cough? Your lungs are covered with mucus, a thick layer of gooey substance made of water, electrolytes, sugars and immune cells. Mucus plays a dual role in your lungs: it protects the tissue from friction as air flows in and out, and traps pathogens to clear them from the body through coughing or sneezing. A cough is a functional immune response to the presence of pathogens. From this perspective, suppressing coughs means your body is unable to eliminate the irritant, which can fester and lead to more serious conditions. Instead, you want to support an effective cough. By identifying your type of cough and supporting expectoration, you may trigger more coughing, but it will lead to a quicker recovery. Questions to ask yourself to determine your type of cough: When you cough, does it produce mucus? If your cough produces mucus, what color is your mucus? The color of mucus could be whitish, yellow or green. Contrary to common belief, the color of mucus is not an indication of infection. The greenish color of mucus is indicative of an abundance of neutrophils (a type of white blood cell that is green). The more neutrophils, the greener the color. Energetically, white mucus is associated with a cold pattern or decreased activity, usually more common in chronic or low-grade conditions. Green mucus is associated with an excessive activity pattern, which is generally more common in acute conditions. Is the mucus more dry or damp? Dry mucus adheres to the lung tissue, reducing tissue flexibility and increasing feelings of friction. Usually, drier mucus is not productive because it is dried up, stuck to your tissues and cannot trap pathogens. If you hear fluids in your chest when you cough, then your cough is damp or boggy. Damper tissue is generally more productive, but you may feel like you get rid of a lot of mucus when a lot is staying in your lungs. Is the cough spasmodic? When you start coughing do you get into a coughing fit you cannot stop? This is spasmodic. When we cough, we want our lungs to open fully. If there is tension, the lungs lose the ability to fully open and the cough is uncoordinated and not effective, not to mention painful. A spasmodic cough is a deep cough that rocks your body or a shallow, irritating cough that is not productive. Shallow coughs that do not clear the lungs of pathogens wear down and irritate the lung tissue. How deep can you breathe or inhale? Some people do not cough if they only take shallow inhales, but once they try to take a deep breath, they cough. Others manifest a dry cough in the upper lungs and a damp cough in their lower lungs. This is because the damper the cough, the heavier it is, and it will "sink." Herbs for Cough An herbal term used for coughing is "expectorant;" expectorant herbs increase the volume of airway water to enhance cough effectiveness. This category, however, is too broad to be very useful, as expectations arise from several different actions, and plants helpful in some situations may aggravate others. Dry Cough With dry coughs the mucus feels "dried out," and coughing goes on and on, but isn't productive. The cough may sound hollow or wheezy, and the lung tissues may feel tight from dryness (as opposed to tense from constriction). When the tissue is too dry, it cannot serve as an effective barrier. The mucus is so viscous that pathogens do not stick; hence, they cannot be eliminated. The ability of IgA (an immune antibody) to attach itself to the pathogen is compromised, too. The dry tissue loses its flexibility, the lungs have a hard time expanding and breathing becomes heavy and labored. Energetically, a dry cough is warm and dry. The tissue is too dry (mucus deficiency), leading to irritation (excess heat). The herbs that we use for a dry cough will be moistening and cooling. Two Types of Herbs for a Dry Cough: Demulcents are plants which moisten dry, irritated and/or inflamed tissues, often due to mucilage, a carbohydrate that, when mixed with water, becomes slimy. Demulcents work by direct contact in the digestive tract or by a reflex response. The reflex response is very mysterious, but it has been found effective repeatedly. The mucilage isn't absorbed into the bloodstream and delivered to the lungs; there's no clear mechanism that explains its effect on lung tissue, but mucilaginous, demulcent herbs were found to be beneficial remedies for respiratory dryness, and what they lack in rational clarity, they make up for in their immense benefits. However they do it, demulcents moisten dry lung tissues and loosen phlegm. They also help with easing tightness in the lungs caused from dry mucous membranes that lack pliancy. Some examples of demulcent herbs are: Marshmallows (Althea Officials) Violet leaf (Viols Spp.) Mullein (Verbascum Spp.) Plantain (Plantago Major) Emollient herbs are sweet and moistening but not slimy like demulcent herbs. While we use demulcent herbs to moisten the mucous membranes, emollient herbs work on the entire ecosystem of a person. Licorice (Glycyrrhiza glabra) is a good example of an emollient herb. The mucilaginous saccharides that are found in demulcent herbs and that account for their effect on the mucous membranes are not extracted well in alcohol. For a gut-healing effect, when you are looking to create direct contact between the mucilage and the gut lining, tea is a better preparation. But if you are looking for the demulcent reflex effect, a tincture can work too. Damp Cough Damp coughs are wet in nature. Expectoration is difficult because the phlegm is too loose and fluidic to be coughed out. To treat this, warming, drying herbs are often used to "dry" the phlegm enough so it can be coughed out. Some people complain that their cough is worse at night. If you have excess dampness, it will move down when you are upright. If you take shallow breaths, you will not cough, but once you lie down, the dampness spreads and a cough will ensue. The energetics of a damp cough are damp (excess mucus) and cold (deficient activity). The tissue is like a swamp that cannot flow easily. Aromatic expectorants are most beneficial for a damp cough and are readily recognized by their aroma, associated with their volatile oil content. When crushed, infused or extracted, aromatic herbs release their scent, and with it, their medicinal goodness. The properties of aromatic plants share several common traits, though these may vary in degree and nature across plants. Specific to the respiratory system, aromatics tend to be antimicrobial, anti-inflammatory, stimulating to body processes, relaxing to tissues and "dispersive" in nature — they help dispel congestion or stagnation, either as mucus or that cloudy mind associated with congestion. Aromatic herbs are warming and drying. The oils in aromatic herbs irritate the lungs and provoke them to spasm, attempting to expel. This will make your cough worse, but it will make your cough more effective. Some aromatic herbs are more antimicrobial than others. Always start with herbs that are mildly antibacterial. Thyme (Thymus Vulgaris) Sage (Salvia Officinalis) Hyssop (Hyssopus officinalis) Garlic (Allium Sativum) Elecampane (Inula Helenium) Ginger (Zingiber officinale) Spasmodic Cough Spasmodic coughs can range from violent coughs that rock your entire body to shallow, irritating coughs that do not stop. Sometimes, a spasmodic cough lingers after a cold or flu for weeks, even without irritants. For spasmodic cough, you want to use relaxants; herbs that ease tension, causing a resistance to the flow of energy in the body. Two types of herbs can help get rid of a spasmodic cough that is not effective: Antispasmodic Herbs Antispasmodic herbs lessen spasms, tension and resistance to the flow of circulation and energy. Relaxants are often aromatic, but the stronger ones may possess a skunky or acrid aroma or flavor. To reduce muscle spasm, I mostly use Lobelia Inflata, an acrid-tasting herb used in small doses. Before using antispasmodic herbs, it is important to differentiate between a tense tissue state, which indicates antispasmodic activity, and a dry tissue state, which can manifest as tension. Antitussive Herbs Antitussive herbs shut down the cough response in the brain stem, or specifically in the medulla oblongata. Wild cherry bark (Prunus serotina) is one of the most common antitussive herbs used in both conventional medicine and herbalism. This article is for educational and informational purposes only and solely as a self-help tool for your use. I'm not providing medical, psychological or nutritional therapy advice. You shouldn't use this information to diagnose or treat health problems or illnesses without consulting your medical practitioner. Always seek the advice of your medical practitioner and/or mental health provider about your health situation.