Lou is a 35-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately three weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is a cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Lou has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.

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