Cough is normally referred to a reflex mediated by control centres in the respiratory areas of the brainstem. However, there is much experimental information that indicates that human cough is under voluntary control and that higher centres such as the cerebral cortex have an important role in both initiating and inhibiting cough. Studies on acute cough associated with common cold, and capsaicin induced cough have demonstrated that human cough can be voluntarily inhibited and often abolished. Further evidence for some role of consciousness in the control of cough comes from studies that show that cough is inhibited or abolished during sleep and with light anaesthesia. This paper discusses the historical development of the brainstem 'cough centre' and discusses the experimental evidence on the voluntary control of cough in man. A cough model demonstrating the voluntary and reflex control of cough in man is proposed. A hypothesis is proposed that cough associated with common cold is a mixture of both reflex and voluntary cough.
Copyright 2002 Published by Elsevier Science Ltd.