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May 16, 1931


JAMA. 1931;96(20):1720. doi:10.1001/jama.1931.02720460066028

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To the Editor:  —Apropos of Dr. Hatcher's instructive article (The Journal, April 25, p. 1383), irritation of Arnold's branch to the ear is by no means a rare cause of obstinate coughing. Aside from disorders of the external ear, such as eczema (which does not often elicit coughing) and impacted cerumen, instrumentation of the canal or region of the drum usually brings on a cough response. The most common cause of obstinate coughing as an aura reflex is a foreign body, and this should always be suspected in case of a stubborn, useless, cough in children who have the common and playful habit of putting beads, small beans or peas into the ear or nose. The danger of postoperative coughing or, in fact, any expulsive effort (sneezing, vomiting, hiccuping) is particularly grave in the case of ophthalmic patients and after cataract or glaucoma operations may burst open the operative wound,

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