I thought this would be a quick and easy article to write but as usual things turned out to be more complicated than I first thought.
Simple I thought, there seems to be two main types of cough; dry and irritating or the wet, productive type. Give the dry coughs something to soothe and stop them and the wet coughs something to get rid of all the nasty phlegm and then it’s sorted, isn’t it?
First of all we need to think about why we cough. Ann McIntyre says “a cough is a reflex response designed to remove irritants such as dust, toxins, micro-organisms or mucus blocking the throat or bronchial tubes”. So coughing is natural and if we supress this are we are stopping the body from doing what it needs to?
Something I am coming to realise is that we need to look at why the person has the cough. Michael Tierra says mucus is a by-product of digestion. When digestion is weak an excess of mucus will become apparent in the mucus secreting tissues of the body. This includes the lungs which need moisture to counteract the drying effect of normal respiration. Evenstar says that stimulation of the gastric mucosa affects the bronchial mucosa via the gastro bronchial reflex. I have looked into white horehound before and discovered how this bitter can be good for the respiratory system. Coughs can also be indicators of low immunity.
I have found a thought provoking article by David Hoffman that says a holistic assessment is required to treat a cough, in other words you have to look at the person as a whole not just the symptoms they show. Treating the cause will also get rid of the cough.
There are many more different types of coughs described in herb books than I had imagined; mostly descriptive of symptoms such as “hot dry”. There are also many different theories behind treating coughs, from balancing humours or elements to using herbs purely for their chemical properties. Some treatments are to supress a cough, others are to encourage the cough reflex.
My mentor has asked us to look at coughs that are hot/dry, wet/cold, spasms, nervous and pharmaceutical side effects and to say which herbs I would use for each and why.
Most herbs used for hot/dry coughs are demulcent and include Marshmallow, Mullein, Plantain, Liquorice, Coltsfoot, Comfrey and Slippery elm. These herbs are soothing, moistening, anti-inflammatory and cool mucus membranes. Matthew Wood advocates White Horehound in non-productive coughs where the mucus is dried out and Hyssop syrup to relieve dryness. Michael Tierra recommends cooling expectorants for hot dry phlegm, many being demulcent and moistening including Kelp, Comfrey, Chickweed and Horehound.
For cold/wet coughs Ginger is a warming expectorant that relieves congestion. Thyme, Elecampane, Ground Ivy, White Horehound, Hyssop, Angelica, Coltsfoot and Sweet Marjoram also help liquefy and clear phlegm. Michael Tierra advocates warming, diuretic herbs like Pepper, Cinnamon and Ginger to dry up excess mucus. He also uses Elecampane, Mustard seeds and Eucalyptus to add heat.
A warming cough relieving tea recipe from Sarah consists of 1 inch of ginger, 1 tsp. thyme, 1tsp sage, honey and lemon juice.
Relaxing herbs can be added to preparations for nervous coughs, these include Chamomile and Lemon balm. Thyme and elecampane are also said to have a relaxing effect on the bronchi.
Matthew Wood recommends Primula veris (primrose), a nervine, for sedating spasmodic coughing. Liquorice and thyme also relieve bronchial spasm along with Horehound, Wild cherry, Mullein, Valerian and Plantain.
The group of prescription drugs mostly responsible for coughing as a side effect are ACE- inhibitors. In Cardiac Today it was reported that 15% of users were given antitussive treatment for ACE-inhibitor associated cough, it is thought the number could actually be higher. I know my mother’s GP denies her persistent coughing is related to her medication and she gets codeine linctus on repeat prescription. A cough caused by these drugs is dry, and can range from a scratchy throat to severe hacking. I think this is a case where the symptoms need to be treated and soothing herbs like Marshmallow could be mixed with an herb for dry coughs such as Coltsfoot with Elecampane to relax the bronchi.
Other cough herbs are antimicrobial, helping the body combat infection and supporting the immune system, these include Thyme, Elecampane, Hyssop, Garlic and Cinnamon.
When treating a cough a combination of herbs from the above groups can be used to treat all the symptoms. We must also remember to view the person as a whole and look at what has caused the cough in the first place as treating this will help eliminate the cough.
Evenstar, Copson, Mary Ann (2008) Herbs for Respiratory Ease http://evenstaronline.com/articles/respiratoryease.htm [accessed 06.01.2011]
Hoffman, David (2011) Cough http://www.healthy.net/scr/article.aspx?Id [accessed 06.01.2011]
McIntyre, Ann (2010) The Complete Herbal Tutor London: Gaia
Messerli, Franz, H. (2010) Cough: A nuisance side effect of ACE inhibitors http://www.cardiologytoday.com/view.aspx?rid=78416 [accessed 06/01/2011]
Tierra, Michael (1988) Planetary Herbology http://books.google.co.uk/books?id=3d8UDLDv9LQC&printsec=frontcover&dq=michael+tierra+planetary&source [accessed 06.01.2011]
Wood, Matthew (2008) The Earthwise Herbal Berkeley: North Atlantic Books