What and Why?

Of all the parts of you that are exposed directly to the outside, the skin of your lungs is far the most delicate and vulnerable. Yet it devotes hardly any effort to self-defence, concentrating entirely on its highly specialized function of exchanging gases between the air and your blood. For its protection it relies on the efficiency of air conditioning in your nose and on other defences in your voice-box and wind-pipe, through which the air must pass to reach your lungs in the first place.

Your nose and throat join in your pharynx so that you can by-pass your nose when breathing hard. Just below that your wind-pipe begins, with two curtains of elastic skin drawn across it to act as vocal cords and sluice-gates. They can shut tight to keep out food and sea-water, but that stops you breathing too — not practical except in extreme emergencies.

Routinely they protect your lungs in a more dynamic way. They close briefly when you swallow food, which does not touch them so that fragments do not drip through afterwards. But you make mistakes sometimes, especially with drinks, and there is often a little mucus or moisture to be cleared out of your lungs. To deal with these you almost close your vocal cords then blow out hard. For a split second air roars through the narrows at gale force, carrying all before it. That is coughing, a natural protective function quite healthy in itself.

‘Clearing your throat’ is normal, but you need to understand why you sometimes cough too much. The usual problem is that uncomfortable air is still getting through, despite the best your nose can do. In cold weather it may simply be too chill and dry, shocking your wind-pipe as well as your face. More often irritant gases, airborne chemicals and smoke penetrate to your vocal cords from overwhelmingly polluted air; coughing is your reasonable but ineffectual protective response.

Colds, asthma, hay fever and catarrh can spread to your vocal cords and wind-pipe, making them touchy. Mucus from an inflamed wind-pipe needs clearing anyway, so some of the coughing is useful; most is not. Hoarseness and loss of voice often accompany the cough.

Least common is what you most expect, the cough that indicates bronchitis or lung cancer. Nevertheless, years of mild irritability eventually make the lining skin in your tubes thicken and inflame, narrowing the tubes themselves and producing catarrh as a matter of daily habit. This is true chronic bronchitis, which is not necessarily an infection at all but makes you much more prone to it. Any chest infection is likely to make you very breathless or produce lots of sputum or pus from your chest — tablespoonsful each day.

Chronic infection or frequent prolonged relapses, is likely to damage the lung tissue eventually. The tiny bubbles that make up its spongy texture are very vulnerable: if they burst, they never repair. Gradual loss of bubbles in this way drastically reduces the area available for work: a few big holes are no use to you. This condition is known as emphysema. This rather than lung cancer is the effect of smoking most to be feared: it affects far more smokers, and it kills them slowly.

Bronchiectasis is a rather similar but less dangerous condition affecting the smallest bronchial tubes: they do not burst but are chronically swollen, usually because of whooping cough in early life. Pus collects there and has to be deliberately drained, since your lung’s usual housekeeping arrangements alone will not shift it.

What can I do?

Advice to maintain and maximise health

1. Steer clear of smokers and smoking, still the largest avoidable cause of cough. Uphold smoking bans if you see them defied. Never let anyone smoke near children. Ventilate any smoking-place well.

2. Practice breathing deeply every day in the freshest air you can find.

3. Eat lots of fresh fruit and vegetables, as much as possible as raw salad. Reduce your reliance on meat of any kind. Supplements of Vitamin C, and garlic in any form, are useful additions.

4. Muffle your face and throat in cold weather to re-breathe some of your exhaled air. This saves you warming every breath from scratch. Ventilate your bedroom at night. Cover your face with warm bedding.

5. Mask your face effectively during any dusty do-it-yourself job. Choose muscle-power over chemicals every time and ventilate any fumes thoroughly to the outside. Avoid aerosol spray-cans for any purpose — there are almost always liquid or solid alternatives that pollute the atmosphere less. Never run the car for long in an enclosed space.

6. Humidify insulated, draught-proofed and centrally heated places with flowers, pot plants, a fish-tank or radiator accessory. An air ionizer may be helpful in high-tech or smoky rooms: addresses of suppliers can be found here.

7. A stubborn cough that only bothers you much at night and resists all these measures is likely to be a version of asthma.

8. Homoeopathic remedies for bronchitis vary widely according to your detailed symptoms, so get further advice from a competent practitioner.

9. The Honey Cider Vinegar recipe makes a wholesome substitute for cough syrup, and the garlic lozenge recipe powerfully builds up your resistance to all respiratory ailments.

10. See detailed advice on dealing with cough.

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