Symptoms And Signs /Obsolete , Evergreen And New


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?
    1. 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.
    2. 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.

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