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.

Bitters and White Horehound

This is another guest posting by Jacqueline Davies, one of my Sanctuary Apprentices. Jackie has chosen to look into white horehound as part of the UK blogparty on bitters, discovering facts about the plant which I wasn't aware of.

Thanks for all your hard work, Jackie!

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Prior to attending Sarah Head’s workshops last year I had never thought there might be any reason why I should need to eat anything bitter, and as lots of other foods tasted better I didn’t bother to very often, grapefruits and rocket were probably it.

During the first workshop I attended at The Sanctuary, Sarah gave us dandelion root to try which I didn’t find a pleasant experience. A month later when we strained our dandelion vinegar we discovered that dandelion roots taste better pickled and had some in a foragers salad, which was quite enjoyable. Since then I’ve learnt bitters are important for our digestive systems and have started to enjoy them more knowing they will do me good.

I have now started an apprenticeship with Sarah and our next task is about bitters. I was looking at my herb list for something bitter to research and remembered what our white horehound cough syrup tasted like. I found Richard Mabey’s bitter definition, which made me realise there might be more to bitters than digestion and I started to understand white hoarhound’s actions.

“Bitters - Herbs containing a range of chemicals that have a bitter taste. Some are useful as appetite stimulants, others as anti-inflammatories, still others as relaxants.”

Mabey identifies horehound is one of the 5 bitter herbs to be eaten by Jews at the Passover supper. He says “The plant’s bitter principle, along with its expectorant properties, is responsible in part for the major medical use of white horehound for respiratory disorders.”

This surprised me as I had only related bitters to digestion but he does go on to say a cold infusion is a bitter tonic for the digestive system. There is evidence to show that as marrubiin, the plant’s bitter principle, breaks down in the body it strongly stimulates bile production. The plant has been traditionally used as a reliable liver and digestive remedy.

Matthew Wood says that as a bitter, horehound promotes expulsion of thick secretions, allowing new mucous and new immune cells to be secreted. This allows the herb to work not by killing germs but by changing the environment so as to enable the body to kill the germs. This theory makes sense to me and has made me think differently about how herbs work.

The CU (Champaign-Urbana) herb society say that the bitter principle, marrubiim, does not exist in the living plant, but is formed during the extraction process. They also say that the bitter action of horehound stimulates the secretion of bile from the gall bladder, aiding digestion. In large quantities it could act as a laxative and cause an irregular heartbeat. Matthew Wood cautions that large doses of horehound are emetic and laxative and can cause arrhythmias.

I came to the conclusion that white horehound stimulates the gall bladder and aids digestion and also relaxes the smooth muscles of the bronchus while stimulating mucous production; this tallies with Richard Mabey’s definition of bitters including relaxants. I then started to worry I had put two and two together and made five but was directed by my mentor, Sarah, to Jim MacDonald’s web site where there is a lot of information explaining how bitters work to aid digestion but he also sees bitters as grounding and says they can release emotional energy from organs particularly anger and frustration linked to stagnant liver energy.

Jim MacDonald refers to a past blog entry of Sarah Head in 2008 where she suggests that bitters promote release. Sarah says different herbs have affinities with different parts of the body so will promote the release of different secretions or emotions from those areas. I now realise there are energetic as well as physical attributes to bitters, the major benefit is to the digestive system but there could be others as well.

References
Campaign-Urbana Herb Society (2004) Herb of the Month: Horehound (marrubium vulgare) www.cuherbsociety.org
Head, Sarah (2008) Bitters: Herbs which promote release? http://kitchenherbwifeblogspot.com accessed 27.1.2010
Mabey, R. (1988) The New Age Herbalist Simon & Schuster: New York
MacDonald, J. (2009) Blessed Bitters http://www.herbcraft.org/bitters.pdf accessed 27.1.2010
Wood, M. (2008) The Earthwise Herbal: A Complete Guide to Old World Medicinal Plants North Atlantic Books: Berkeley