A vintage cough syrup doing the rounds on the Internet is the “One Night” cough syrup that contained Alcohol, Cannabis, Chloroform and Morphine ! Maybe the name meant you trade in your cough with a good time for one night ? Old medical posters on cough indeed had fancy imagination…and ingredients ! And of course, there was the tragic Uzbekistan cough-syrup scandal. Vintage trivia aside, cough is usually thought of in terms of being an annoying, otherwise benign symptom of underlying diseases such as asthma, infection or serious ones like cancer, etc. but seldom given attention as a grave trouble-maker by itself.
Besides the good old abominal hernia & flare-up of sciaticas, over the course of my years as a hospitalist physician, I have encountered people with cough-induced syncope, pneumothorax, hernias, vetebral fractures, cough-induced carotid dissection causing a stroke, severe hiatal hernia causing a intra-thoracic stomach from chronic coughing and even cough-induced fall from losing balance and breaking a hip ! This 2020 paper does a good job collecting a list of serious and more benign side-effects of cough. It has a compiled a pretty impressive list including serious ones like arterial dissections, bleeds, syncopes , fatal vehicular accidents, ocular trauma and interesting ones like myxoma embolism, cough-induced takotsubo, cough purpura,etc.
It is therefore important for us clinicians to be aware of this issue and address chronic , persistent cough in people seriously. Not only should we ask about cough history in fractures, falls, syncopes, headaches & bleeds but also inquire about & counsel about it in people started on anticoagulants, those with recent bleeds, surgical sutures, commercial drivers , people operating dangerous equipment etc. We had talked about remembering some common causes of chronic cough before !
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