When viewed through the lens of modern medicine, Donguibogam's principle that the spleen is the source of phlegm aligns closely with what we recognize as acid reflux. The stomach secretes gastric acid, a potent digestive fluid, to break down food. When this gastric acid flows backward into the esophagus or reaches higher toward the throat, it is called gastroesophageal reflux disease. When it travels past the esophagus into the larynx and pharynx, it is classified as laryngopharyngeal reflux, which is precisely what triggers a persistent dry cough.
The throat and larynx are delicate structures that are not designed to withstand gastric acid. When refluxed acid directly irritates the laryngeal mucosa and pharynx, or induces microscopic inflammation, the body reflexively coughs to clear the irritant. Furthermore, the vagus nerve distributed throughout the lungs and airway is intimately linked with the digestive tract, so irritation of the esophagus and laryngopharynx from acid reflux can heighten the cough reflex through this vagus nerve pathway, functioning like an internal alarm.
More than half of patients with laryngopharyngeal reflux do not experience the typical symptoms of gastroesophageal reflux disease, such as heartburn or sour regurgitation. Instead, they primarily report a foreign body sensation in the throat, hoarseness, and above all, a hacking dry cough that persists day and night. Just as Donguibogam observed that the lung stores phlegm, modern medicine explains that inflammation and irritation of the laryngopharynx caused by acid reflux produce respiratory discomfort akin to phlegm, leading to chronic cough.
Taking a prescribed gastric acid secretion inhibitor may offer temporary relief, but symptoms often recur without meaningful adjustments to daily habits. Medication reduces the production of stomach acid, yet it does not resolve the underlying tendency for reflux to occur. Managing acid reflux sustainably requires an integrated approach that addresses dietary habits, lifestyle rhythms, and stress. Because our body operates as an interconnected system, a disruption in one area can disturb the balance of the whole.
