A dry cough, throat stinging, and a foreign body sensation that persist over a prolonged period cannot be dismissed simply as a cold sequela. Modern medicine also approaches these symptoms by evaluating multiple potential causes. In particular, a cough lasting over eight weeks is classified as a chronic cough and requires a precise diagnosis. What Donguibogam describes as lung heat and stomach fire can be understood through several modern medical mechanisms.
First, stomach fire is closely linked to gastroesophageal reflux disease, or GERD, and especially laryngopharyngeal reflux, or LPR. Gastric acid flows past the esophagus into the larynx and pharynx, producing chronic inflammation in the mucosa. The refluxed gastric acid and pepsin directly irritate the throat mucosa, stimulating cough receptors and triggering an ongoing cough reflex. In these cases, the cough is frequently accompanied by a foreign body sensation in throat, hoarseness, and frequent throat clearing. Unlike classic GERD, LPR often occurs without typical heartburn, making diagnosis challenging. As a result, patients often do not suspect that their cough stems from acid reflux. This mirrors the way stomach fire in Donguibogam silently irritates the throat beneath the surface.
Second, lung heat can be related to chronic airway inflammation or post-nasal drip. When nasal secretions continuously drain down the back of the throat due to allergic rhinitis or sinusitis, this postnasal drip irritates the laryngopharyngeal mucosa and frequently provokes chronic cough and a foreign body sensation in throat. In chronic respiratory diseases such as asthma or chronic bronchitis, ongoing inflammation within the bronchus increases the sensitivity of cough receptors and triggers coughing. Such a chronic inflammatory state stimulates the immune system and releases pro-inflammatory cytokines, creating an elevated internal state akin to excess heat in the body.
Third, nerve hypersensitivity plays an important role. Many individuals with chronic cough experience coughing due to hypersensitivity of cough receptors or the laryngeal nerve, even in the absence of a distinct underlying disease. The body's alarm mechanism becomes overly responsive, reacting to minimal stimuli. Psychological factors like stress, anxiety, and overwork also affect the nervous system, lowering the threshold of cough receptors and worsening the cough. This parallels the Korean medicine view that emotional imbalances, referred to as the seven emotions, disrupt the balance of the five viscera and six bowels and give rise to disease.
Ultimately, Donguibogam's concepts of lung heat and stomach fire encompass complex factors recognized in modern medicine, such as gastroesophageal reflux, chronic inflammation, and nerve hypersensitivity. Rather than simply suppressing the cough, identifying the root cause while combining lifestyle adjustments with appropriate care is essential. Listening attentively to the body's signals and caring for them thoughtfully offers a reliable path away from chronic cough, a perspective shared by both modern medicine and Donguibogam.
