What to do with a cough?

Coughs are very close to my heart. I live with a man who suffers with a long term cough after every virus. If he’s overtired, his throat muscles can be irritated by something in his food and coughing can ensue. I could lose a lot of sleep from his coughing fits if I didn’t do something to help!

Two of our three children had whooping cough where the effects lasted for twelve months. We got very good at rushing upstairs with a bowl the minute we heard the first cough! I've worked alongside people with asthma and have dealt with children to defer asthma attacks. My eldest son had a childhood friend with cystic fibrosis. I worked as patient representative in a regional review of lung cancer services for three years and learned many things about the importance of early diagnosis.

Coughs are a normal response to irritation or congestion. The approved medical wisdom is that most coughs are harmless and should heal themselves within three weeks. Three weeks is quite a long time to be without sleep or exhausted because of the cough. Herbs can help.

Before you decide whether or not to do anything there are some questions which need answering first.

• When did the cough start? 
• Have you suffered with a virus recently? Influenza? Whooping cough?
• What does the cough sound like? Is it in the throat? Is it dry and non-productive? Is there a "harrumph" kind of sound like asthma sufferers have? Does it start high up and deepen so that the person ends up either retching or actually vomiting but without the characteristic whoop of whooping cough?
• Is the cough triggered by eating or by lying down?
• Does the cough happen after experiencing heart burn?
• Does the cough bring up any phlegm? (i.e. a productive cough) What colour is it?
• Do you feel breathless after coughing?
• Do you bring up any blood?

Sometimes it’s a good thing to get a medical diagnosis and further tests.

• If the cough produces yellow or green phlegm see your doctor as there is probably an infection which may be deep in your lungs e.g. bronchitis or pneumonia.
• If the cough has been going on for more than three weeks or is getting worse, see your doctor.
• If you are breathless after coughing or have trouble breathing
• If the cough has been going on for three months and you've seen your doctor insist on a chest x-ray.
• If the cough is caused by heartburn, see your doctor.
• If you are coughing up blood, see your doctor.
• If you are asthmatic but are coughing all the time, get your medication checked. You may need your prescription changing or to change the way you take it.

Coughs can actually be a good thing. They expel particulars which reach your windpipe. They get rid of the excess mucous which has been produced by your body in response to a virus.

If a cough is productive and deep you may want to do something to help it. Elecampane root infused in honey can really help to get deep stuff up and out. The roots can be left in the honey and chewed. Nasty thick stuff which is infected also responds well to mullein leaf given as a tea but filter before drinking to remove any hairs.

A standard cough mixture can be made from a combination of equal parts of hyssop, white horehound and marshmallow leaf or root. This is a very old recipe and will both relax and soothe tissue. If you have a really inflamed/sore chest from lots of coughing, add plantain which will soothe inflamed tissue and rehydrate it.

General Cough Syrup Recipe

(from Non Shaw and Christopher Hedley's Herbal Remedies)

1 l (2 pints) water

40 g (1 1/2 oz) dried herb or 100 g  (4oz) fresh chopped herb

450 g (1 lb) sugar

Put herb in water, bring to a boil, let simmer 20-30 minutes, strain.

Clean out pan, pour liquid back into it, let sit on minimum heat until

you only have 2 dl (7 fl.oz) left Add sugar, simmer until sugar has dissolved, pour into jars, label. (This takes time. 1 fluid ounce evaporates about every hour.)

Judith’s cough syrup

1 handful each of dried horehound, marshmallow, sage and thyme

½ handful dried hyssop

Fresh orange peel diced.

1” root ginger grated.

2 pints water

Place everything in a saucepan, cover with water, bring to the boil and simmer with the lid on for 20-30 minutes. Strain and measure the liquid (1.5 UK pints). After cleaning the saucepan, return the liquid and add 1lb 8 ozs sugar. Heat slowly, stirring with a wooden spoon until all the sugar has dissolved. Bring syrup to the boil and pour into sterilised bottles, seal, label and date.

Cough syrups for children can be made from violet flowers or onions or thyme (don't give to under 2s).

Violet flower Syrup

Fill a clean glass jar with violet flowers, cover with boiling water and leave overnight with the lid screwed on. The next day, strain and measure the infused liquid. Don’t worry if it looks and smells strange. For every 7fl ozs of liquid add 5 ozs of sugar. Add the juice of at least half a lemon. The liquid will turn the most delightful shade of pink! Put all the ingredients into a pan and bring to the boil and simmer for a couple of minutes. Pour the resulting syrup into a sterilized bottle or jar, seal, label and date. Store in the fridge and discard if it starts going moldy. The suggested dosage for a child’s cough or slight constipation is 1-2tsps given at bedtime. If you are making this for a child under two years old and usually make your syrups with honey, use sugar this time.

If someone, either a child or an adult is exhausted from coughing and can’t sleep, try using an onion poultice. This method is taken from Kiva Rose Hardin's excellent article on Onions.

Onion Poultice

An onion poultice made from sautéing a chopped onion in oil until transparent, then thickening the mixture with flour. Spread the resulting paste on muslin or a clean piece of old cotton sheet and cover to retain the heat. Lay the poultice on the front or back of the chest with a hot water bottle next to it to keep it warm. Cover with a towel and leave on the skin for 15-20 minutes. Remove and apply a good chest rub.

Coughs in the throat, especially dry coughs respond well to sage and thyme. This can be made into a tea or an elixir

Post viral tea

Infuse 1tsp dry sage with 1 tsp dried thyme with 1inch grated root ginger in a lidded container with just boiled water for ten minutes then strain and pour onto the juice of half a lemon and honey to taste.

Cough Elixir

I make my elixir with fresh sage and thyme (enough to fill a 2lb glass jar) plus 2-3 sprigs of white horehound fresh or dried. Pour over 1lb of honey. Stir to remove any air bubbles then fill the jar to the brim with brandy, stirring well. Leave for 4-6 weeks shaking when you can. Cherry bark and hyssop both relax constricted tissue so are good for dry coughs and could be added to any cough mixture or elixir.

Onion syrup is another simple recipe which is suitable for children. This is KivaRose Hardin’s recipe

Simple Onion Syrup

1 Cup roughly chopped fresh onion

Small handful of fresh or dried Sage or Thyme or Monarda (or equal amount of fresh chopped White Fir, Abies concolor, needles). (Optional)

Juice of half a lemon (Optional)

1 tsp freshly grated Ginger root (Optional)

Enough honey to cover herbs

Place the onion and other herbs in a jar, cover with honey, stir to remove air bubbles and cover. Let it sit overnight. The honey will very effectively suck all the juice out of the onion.  Use by the teaspoonful beginning the next morning. Some people like to eat the onion bits with the honey and some people prefer to strain the solids out. It’s up to you.

Steaming
Coughs caused by post nasal drip can be helped by steaming. Pour boiling water into a bowl with eucalyptus leaves or essential oil (a few drops only) or sage or rosemary or pine needles. Lean over the bowl, trapping the steam in by placing a towel over the head and stay like this until the water is no longer giving off steam. Be very careful not to get burned! For greatest effectiveness, this must be done four times a day for ten minutes for at least 7 days straight.

Sore Throats

Sore throats caused by coughing can be really helped by sipping cider vinegar and honey in hot water (2tps of each in a mugful of water). Infused sage vinegar is really nice and you could add it to rosehip honey or elecampane honey for improved effect.

In our household, coughs happen every year and often last for several months. They can be loud and debilitating for the entire family, not just the sufferer. It's a good idea to make your infused honeys, vinegars and elixirs well before winter sets in and to have a store of dried herbs in the cupboard so they can be reached quickly. Now is the time to discover what you have in the larder and make new remedies.

What to do with sage?

I was standing outside Condicote church after the annual Harvest Festival service when I caught up with someone I hadn’t seen since my cousin’s wedding last year. Her sister was one of my first piano pupils and then my bridesmaid five years later. I told her I was going to raid my aunt’s sage plants before we returned home.

“What are you going to do with it?” she asked. “We have tons of sage and I’d love to be able to make use of it more.”

So this post is for Caroline and anyone else who finds themselves with a glut of herb they don’t know what to do with.

Why do we use sage? Some will only know it as a condiment, mixed with onions as a stuffing for a fatty meat such as pork or goose or as a flavouring to replace salt in a salt-free diet.

While these uses show sage to be an aid to digestion, its myriad of uses stem from very ancient times. Sage is known as a Mediterranean herb which doesn’t like to get its feet wet (as I learned to my cost by over-watering cuttings!).

It’s location has led people to think it must have been brought to the UK by the Romans, but as historical plant expert, Anthony Lyman Dixon, is wont to remark, Romans are blamed for many things, but we really can’t be sure whether they brought all their herbal flavourings with them or whether sage was one of those herbs which was growing here well before they invaded our lands.

Sage, salvia officinalis, is described by Maud Grieve as “about a foot or more high, with wiry stems. The leaves are set in pairs on the stem and are 1 1/2 to 2 inches long, stalked, oblong, rounded at the ends, finely wrinkled by a strongly-marked network of veins on both sides, greyish-green in colour, softly hairy and beneath glandular. The flowers are in whorls, purplish and the corollas lipped. They blossom in August. All parts of the plant have a strong, scented odour and a warm, bitter, somewhat astringent taste, due to the volatile oil contained in the tissues.”

There are many different types of sage, but all those which begin with salvia can be used interchangeably. I prefer purple sage, salvia officinalis purpurascens, because this is the one most used medicinally in the UK and I prefer the flavour to the greener garden sage.

Sage has been a healing plant since ancient times and remained popular through the Middle Ages. Mrs Grieve quotes the latin phrase Cur moriatur homo cui Salvia crescit in horto? ('Why should a man die whilst sage grows in his garden?') and gives a corresponding English proverb, 'He that would live for aye, Must eat Sage in May.'

As with most herbs, I began my journey learning about one particular use. Sage has an affinity with the chest and throat, so is good for sore throats (gargling with a tea) and lingering coughs brought on by the common cold. Then Henriette Kress mentioned sage and thyme together could be taken at the beginning of the year for three months to support the respiratory system in reducing sensitivity to pollens and other particles which induce hayfever in sufferers.

This remedy then led to a wonderful tea which could be taken for colds, coughs and general symptoms. One of my friends was working in a doctor’s office in Washington State at the time and used to give the recipe to disgruntled patients who had been refused antibiotics for their virus.

Sage and Thyme Tea
1tsp dried sage (or 1 tblsp fresh)
1 tsp dried thyme (or 1tblsp fresh)
Juice of ½ lemon
1 inch chopped or grated root ginger with the peel left on
Honey to taste
Infuse the dried herbs and ginger for approximately 10 minutes in a pint of water in a cafatiere or teapot or mug with a lid. If making the drink without the ginger you can get away with infusing for 3 minutes if you don’t want to have a really strong sage taste. Strain and pour into a mug containing the juice of half a lemon and enough honey to taste.

If you are thinking of making this tea for a child, don’t use either the thyme or honey if the child is under two years of age. They may not like the ginger either.

This drink is really warming and comforting and can be drunk 2-3 times a day.

Sage has been used for increasing blood flow to the brain and therefore to help reduce memory loss. James Wong, in his recent BBC2 series, Grow your own drugs, carried out an interesting experiment with two people in middle age who were having problems remembering things. He asked them to drink cups of sage tea for a week and afterwards both people reported being able to remember things far better.

Obviously two people isn’t a large sample and a week isn’t a long time to take a herb, since herbal actions often take a while to make themselves apparent. Still, it was an interesting experiment and something everyone can try at home. I know I should, since my family constantly sigh at me when I start a sentence and then can’t remember either the rest of it or the key word I wanted at the time I wanted to say it!

Matthew Wood says that sage acts on veins which are depressed and relaxed. Sage also acts on clotted blood. He says he learned of this use from the herbalist Eva Graf. She used it to cleanse blood vessels, remove plaque or hardening, for varicose veins and for diabetic ulcerations of the veins, especially the calves.

This use is something I haven’t tried yet, but I’m tempted to make an oil and see what happens if I add it to horse chestnut oil as a varicose vein salve.

Sage is a potent anti-viral. Like many febrifuges, it encourages sweating when taken as a hot tea, but is cooling when drunk cold. You can make a sage tincture using the simpler method by adding vodka or brandy to a glass jar filled with fresh sage.

Medical herbalist, Jenny Jones, recently demonstrated how to make this tincture at the Herb Society’s Volunteers Day. She recommended not filling the jar completely to the top with vodka as the alcohol would draw water out of the sage leaves. Jenny suggested taking a 30-drop dose three times of day at the first sign of any cold or flu. If you were using a higher percentage alcohol, the drop dose would be much lower.

Sage also acts to dry up secretions, which is why it is so effective for chest and throat issues and can help to alleviate hot flushes of menopause. It can also help to dry up unwanted milk production and has even been known to delay the onset of menstruation by a couple of days if extremely large amounts are taken.

Sage should be safe to take in culinary amounts if you are pregnant or nursing, but it may well be prudent not to use sage medicinally during these times.

I have to be honest and admit sage is not one of my most favourite flavours in tea on its own, but I love the combination of sage and thyme. This year I experimented with a sage and thyme elixir which tastes wonderful.

Sage and Thyme Elixir
Pick enough fresh sage leaves and flowering thyme sprigs to half fill a glass jar. You could use dried sage or thyme, but reduce the volume by three-quarters. Cover with runny honey, stirring well with a chopstick to remove any air bubbles and make sure the herbs are completely covered. Fill to the top with brandy and mix well. Seal with a screw top lid. Label and date. Store in a cool dark place for 4-6 weeks. Strain, bottle and use. Dose is one dropperful every half hour at the first sign of a virus.

Sage also makes an amazing vinegar. I suspect the soil sage is grown in affects the colour which is transferred to the vinegar. My clay-grown garden purple sage only turns vinegar a pale pink, although the taste is good. My aunt’s sage plants, grown on alkaline Cotswold limestone, turn the vinegar a deep crimson within half an hour of being infused. This is why I have been raiding her plants annually for the past three years!

Sage Vinegar
Fill a glass jar with sage leaves. Pour over cider vinegar until the jar is full. Remove air bubbles with a chopstick, then refill with more cider vinegar. Seal the jar with a screwtop lid and label and date. Store in a warm, dark place for three weeks, shaking occasionally. Strain and bottle, label and date. Use with honey for a delightful hot drink or in salad dressings.

Sage Honey
Fill a glass jar with sage leaves. Very slowly, pour runny honey over the leaves, pausing regularly to remove air bubbles by stirring with a chopstick. When the jar is full, seal with a screwtop lid and leave to infuse for several weeks. Strain before use if you don’t fancy eating the sage leaves.

My sage honey and vinegar have now been infusing since the end of August. I’m looking forward to decanting them this weekend and trying out my first sage oxymel. That’s the wonderful thing about herbs. It doesn’t matter how many herbal products you have made with a particular plant, there are always more to experiment with and try.