Did you know that pertussis, which was once considered a disease that only young children catch, can also affect adults? Recently, the incidence of adult pertussis has been increasing. The effectiveness of vaccines received in childhood diminishes over time, and because it often appears like a cold accompanied by endless cough and vomiting, differentiation has become even more crucial. Adult pertussis is characterized by coughing to the point of breathlessness, leading all the way to vomiting. This is not a simple cold, but can be a serious respiratory disease caused by a bacterial infection.
The fact that the Donguibogam pointed to spleen-stomach deficiency, food stagnation, and phlegm-fluid as causes provides very interesting implications even in modern medicine. In particular, when cough and vomiting occur together, rather than considering it solely as a respiratory problem, the influence of the gastrointestinal tract must be considered together. Modern medicine can interpret this through several primary causes.
First, gastroesophageal reflux disease and laryngopharyngeal reflux. When gastric acid or stomach contents reflux beyond the esophagus into the larynx and pharynx, they cause chronic irritation that can trigger cough. In particular, cough that worsens at night or after meals raises suspicion of reflux disease. When coughing is too severe, intra-abdominal pressure rises, making it easier for gastric contents to reflux, which can create a vicious cycle that aggravates the cough again. Food stagnation and phlegm-fluid in the Donguibogam could be interpreted as retention of gastrointestinal tract contents and inflammatory states, while spleen-stomach deficiency could be understood as esophageal sphincter hypofunction controlling reflux or gastrointestinal hypomotility.
Second, post-nasal drip syndrome. This is a phenomenon where nasal discharge drips down the back of the throat due to conditions like rhinitis or sinusitis. When this mucus irritates the pharynx, cough occurs, and particularly sticky phlegm caught in the throat can induce nausea or, in severe cases, lead to vomiting. This can be seen as similar to symptoms arising from the accumulation of dampness-phlegm due to spleen and stomach problems.
Third, the neurological link. In our body, there is an important nerve called the vagus nerve, which innervates both the respiratory system, including the lung, and the gastrointestinal tract. A severe cough stimulates the vagus nerve, affecting the gastrointestinal tract, and this can induce nausea or vomiting. The Donguibogam's concept of qi rising adversely might be the very principle explaining such neurological reflexes. Instability or inflammation of the gastrointestinal tract can manifest as respiratory symptoms through the nervous system.
Lastly, decreased immunity and the concept of the gut-lung axis. Spleen-stomach deficiency can be connected to decreased immunity, leaving one vulnerable to external infections. Just as the gut-lung axis theory states that gut health affects lung health, hypofunction of the digestive system can negatively affect respiratory health, causing chronic cough or increasing susceptibility to infection and slowing recovery from diseases like pertussis. We must keep in mind once again that our body is organically connected in this way.
