COMPLAINT OF EXPECTORATION
WITHOUT COUGH
O P
Kapoor
Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai,
Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400
008.
In my experience about 5% of respiratory
cases come with a complaint of passing sputum without any cough. Even on repeated
questioning they insist that there is no cough. How do they bring out the sputum
without the reflex of cough is difficult to understand and accept.
However, what do these patients suffer from?
- A number of these patients have post
nasal discharge which could be seen if a good torch and tongue depressor
are used. Because these patients suck out the secretion from the back of
the nose and bring out from the mouth without any preceding act of cough,
therefore, they complain of passing sputum without any cough.
- On other occasions, patients having
straight forward smokers bronchitis or bronchiectasis, also complain of
this type of symptom.
But one thing is sure that a large
group of patients of respiratory diseases who suffer from respiratory allergy
and pulmonary tuberculosis will never complain of the above symptom. Both these
type of patients have more cough than the sputum. In fact in the bronchial allergic
cough which forms a very large number of respiratory patients, there are bouts
of cough before the sticky sputum comes out.