Get it off your chest

摘要

As winter settles over Europe and North America, the sound of coughing starts to fill the air. Every year, most of us catch a cough and our hacking torments us by day and drives us mad at night. But the sound is music to pharmacists' ears. In 2001, Britain alone spent nearly ￡100 million on over-the-counter cough medicines; in the US the figure is close to $600 million. But coughs are more than just an expensive nuisance. For people with lung diseases such as asthma and chronic obstructive pulmonary disease, also known as emphysema, a cough can kill. COPD is the world's sixth-biggest killer, the immediate cause of death being respiratory failure triggered by a bout of coughing. Complications caused by coughing account for about 40 per cent of the cost of caring for COPD patients. Yet despite this litany of nuisance, lost sleep, expense and death, research into coughing is one of the slowest-moving areas of medicine. Treatments have changed little since the 1950s and there is an ongoing debate over whether they actually work. But in the past five years, neurophysiologists have started to take a closer look at coughing, and what they are finding could blow away decades of inertia.