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This is usually accompanied by [[High-Pressure Blood|nasty amounts]] of [[Blood From the Mouth]] which is always a bad sign, even when there's no plausible reason for it, and may also involve collapsing. The character will probably try to hide it and will usually succeed until they actually pass out, no matter how ridiculously obvious it is. For some reason the character rarely visits a doctor after fainting/coughing blood/generally feeling like shit, no matter when the story takes place, possibly because of the [[Rule of Drama]]. A character that goes outside in the rain or snow will often die, because he/she didn't "get out of those wet clothes fast enough". This trope is almost always carried out by the [[Ill Girl]] or [[Littlest Cancer Patient]].
 
In Western literature the trope was heavily influenced by the prevalence of tuberculosis, an infectious disease considered by many historians to be the greatest killer in human history - yes, even greater than malaria or plague. The symptoms of tuberculosis (also known as consumption, phthisis, TB, or the White Death) are identical to those of the [['''Incurable Cough of Death]]''', but death would usually come far more slowly for the TB patient, at least in [[Real Life]]. It's hard to say whether pneumonia influenced the trope or not, since pneumonia wasn't always differentiated from tuberculosis in the old days: the rapidity of death sounds more like pneumonia than TB, but then again all lung diseases back then were considered a form of tuberculosis - yes, even lung cancer, which wasn't even recognized as a separate disease until the end of the 19th century.
 
In [[Anime]] this is likely inspired by [[wikipedia:Okita Soji|Okita Souji]], the famed [[The Shinsengumi|Shinsengumi]] captain, who reportedly started coughing up blood due to tuberculosis before passing out during the Ikeda-ya Incident; he was unaware he had the disease until that moment. It's [[Did Not Do the Research|often said that he died 11 days later]], [[Not So Invincible After All|creating the tragic image of a young warrior who defeated all opponents, only to fall to illness at the moment of his greatest triumph.]] It seems that most people fail to notice that two similar dates are four years apart due to the [[Rule of Drama]].
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** Well, we do see her suffering from severe vaginal bleeding as well, so it isn't ''just'' a cough.
* In ''[[Bleach]]'' Juushirou Ukitake subverts the death aspect.. sorta, with a particularly terrible, bloody cough from an unnamed illness he's had from childhood. As a noble-ranked shinigami, he was born in Soul Society (the afterlife) but spirits are still capable of dying and even breathe. Usually, he's either laid up in bed or his activities will be interrupted by a violent coughing fit that will lead to him coughing up blood. Fans popularly conclude he has tuberculosis but the story itself has never confirmed the nature of the disease only that he obtained it in childhood and the shock of being diagnosed with it turned his hair white.
** We don't have any idea what killed Hisana Kuchiki aside from the fact it was some kind of sickness. She didn't survive the end of winter with it and the [[Filler|anime]] gave her an [[Incurable Cough of Death]] to emphasise her weakening condition.
* Uchiha Itachi of ''[[Naruto]]'' dies from one of these. Apparently, he had been keeping himself alive with all sorts of medicine so he could {{spoiler|be killed by Sasuke}}. Then we find out ''why''. On the whole, it comes off as a huge [[Tear Jerker]].
** There's also Kimimaro, who plays this completely straight, and Hayate who has a cough, but averts the death aspect by being sliced in half.
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* Papillion from ''[[Busou Renkin]]'' has such a cough, and escapes his inevitable death by becoming a homunculus. However, his transformation was incomplete, so though he has an immortal, super-human body, his illness wasn't cured like it should have been and his cough carried over.
* In ''[[B't X]]'', Hokuto suffers from radiation poisoning, and is stated to have few months of life left {{spoiler|he isn't planning to last that long.}}
* In ''[[Code Geass]] R2'', Li Xingke has a chronic [[Incurable Cough of Death]] that also causes [[Blood From the Mouth]] every so often when he pushes himself or his [[Humongous Mecha|Knightmare Frame]] too far. {{spoiler|Despite having the disease, he survives to see the end of the series. Then again, he isn't seen in the big wedding portrait in the end}}...
** {{spoiler|He lives. Check the background during Ougi and Nunnally's handshake. That big ol' mech look familiar?}}
*** {{spoiler|One problem: That's the ONLY thing that appears. Even when the Tianzi goes to the wedding, Xingke doesn't appear, which is strange for her devoted bodyguard. It's entirely possible that someone else is piloting it, whether they're as capable as Kallen and Suzaku, or simply using it on a lower setting.}}
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* In the ''[[Fruits Basket]]'' manga, it is revealed that Tohru's father Kazuya died of a badly treated pneumonia.
* Izumi in ''[[Fullmetal Alchemist]]'' does this, although she isn't the usual character type. And there's a darker reason for the cough than just illness. {{spoiler|A failed attempt to transmute her stillborn infant son back to life caused the destruction of her internal reproductive organs.}} The hemorrhaging gets much worse during periods of extreme stress or guilt, causing her to cough up a truly frightening amount of blood. In spite of this, she still {{spoiler|outlives nearly every major character while enduring heavy combat}}.
** {{spoiler|Hohenheim later cures her [[Incurable Cough of Death]]. Ironic, no?}}
** Alfons Heiderich in the movie also has a Cough of Death, and for a more traditional reason: fumes from the rocket fuels he was creating have destroyed his lungs. {{spoiler|As it turns out, that isn't what eventually kills him. It's Rudolf Hess. }}
** Ed & Al's mom Trisha also succumbs to this, not to mention the deaths of homunculi, and whenever anyone sustains a serious torso wound… Aw heck, ''FMA'' is ''in love'' with this trope.
* Averted in ''[[Gravitation]]'' where Yuki {{spoiler|not only collapses as he also coughs blood in the process but manages to survive. The illness is blamed on stress (it ''might'' be ulcers) and just as mysteriously as it appeared it disappears. Ironically or not Shuichi assumes that his lover is about to die.}}
* In ''[[G Gundam]]'', the "elderly" (actually only 50) Master Asia is the greatest fighter in the world. [[My Kung Fu Is Stronger Than Yours|His Kung Fu is stronger than everybody else's.]] He can effortlessly destroy [[Humongous Mecha]] using just his bare hands, or by swinging [[Nerf Arm|a piece of cloth]] at them. Basically the only one who's even worthy of ''thinking'' about fighting him is the main character... who happens to be his student. Yet when he turns against his boss, a weakling of a normal human, poor Master Asia is conveniently incapacitated by his [[Incurable Cough of Death]].
* Somewhat subverted in ''[[Glass Mask]]'', since Maya's mother, Haru ''does'' suffer from tuberculosis, but {{spoiler|actually dies after being hit by a car}}.
* Also, in the manga ''[[Gundam Seed]] Astray'', a master swordsmith and swordsman named Un'no is also able to fight against [[Humongous Mecha]] on foot...though he uses a katana to do it, and "only" slices the barrels off their guns. His [[Incurable Cough of Death]] actually is TB, which he dies from shortly after passing on his knowledge to Lowe Gear.
* Integra [[Hellsing]]'s father dies of (as one review put it) "a terminal case of coughing up blood".
** Considering the amount ''everyone'' smokes in the series, this ''must'' be lung cancer.
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* In the ''[[Black Butler]]'' manga during the [[Circus of Fear|circus]] arc Ciel is dragged off to the makeshift outdoor baths by his roommate. During this time it's winter and the water the circus performers are washing up with isn't heated (it's [[Victorian London]], after all). After being soaked with the freezing water we later see Ciel coughing, eventually falling into an aggressive coughing fit that causes him to vomit. We find out that he {{spoiler|suffers from asthma, a disease he inherited from his mother. The cold had aggravated it.}} He gets better, though.
* Yuna Miyama from ''[[Maburaho]]'' starts coughing, but this is later subverted when {{spoiler|Kazuki Shikimori dies healing her.}}
* In ''[[Macross Frontier]]'', the [[Incurable Cough of Death]] is simply one of the V-Type Infection's syndromes (among dizzy spells, fever, keeling over at the drop of a hat...) that {{spoiler|Sheryl Nome}} has to endure, even though {{spoiler|Grace}} has claimed the V-Infection to be incurable and fatal. {{spoiler|Her}} struggling to overcome these in order to reassert {{spoiler|herself and her ideals}} seems to be one of the major plot arcs as the series nears its end.
** {{spoiler|However, Sheryl doesn't die, but is saved when Ranka moves the virus from her brain to her stomach region, turning it into more of a symbiosis than infection.}}
* Zest of ''[[Magical Girl Lyrical Nanoha]]'' has this, due to being one of [[Mad Scientist|Jail's]] botched attempts at an [[Super Soldier|Artificial Mage]]. {{spoiler|While [[Huge Guy, Tiny Girl|Agito]] hates her for doing it, she thanks Signum for killing Zest in battle, letting him die as a knight instead of a sick man.}}
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* We know that since ''[[Rose of Versailles]]'' is a tragic shojo anime, that there's little chance that Lady Oscar will make it to the end of the series alive, but when she starts coughing up blood, that pretty much cinches it. Although, unusually, {{spoiler|she doesn't actually die from the cough (though she is informed that it's terminal) but in a far more suitably dramatic manner while storming the Bastille.}}
* In one episode of ''[[Rune Soldier]]'', Louie helps a little girl to find a rare flower for her grandmother, who has an unspecified sickness, that mostly consists of a bad cough.
* In the "Dream" arc of the ''[[Sailor Moon]]'' manga, Mamoru hides his [[Incurable Cough of Death]] from Usagi at first, but he is soon discovered. He also coughs up some [[Blood From the Mouth|black blood]] and, more significantly, has a black rose in his lungs showing this to be some sort of magic disease (apparently without followup testing for known diseases that can produce anomalous chest x-rays). It turns out {{spoiler|it is a result of his kingdom, Elysion/The Golden Kingdom, that he ruled being attacked which affects him physically... once the enemy is defeated he is cured}}.
* ''[[Uchuu Senkan Yamato]]'' had [[The Captain]] Juzo Okita (a nod to Okita of [[The Shinsengumi]] mentioned above; a.k.a. Captain Avatar for ''[[Star Blazers]]'' fans) suffering from a worsening case of radiation poisoning as the series progressed. The practical effect in the series was demoting him to [[The Mentor]] in favor of [[Hot-Blooded]] [[The Hero|Hero]] Susumu Kodai (Derek Wildstar), the "Acting Captain" to be.
* Raquel Applegate of ''[[Wild Arms 4]]'', {{spoiler|due to suffering from an unknown, incurable disease that's implied to be radiation poisoning}}. This doesn't stop her from being the most powerful character in the game, though it does explain why her HP and speed are so low. {{spoiler|She eventually dies in the [[Distant Finale]] epilogue, having never found a cure for her sickness.}}
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* ''[[Gran Torino]]'' - [[Clint Eastwood]]'s character exhibits the cough complete with bright red blood and the coughing fits being violently enough to bring him to his knees. He passes it off as nothing, but a later scene with the doctor implies that it's a great deal more serious. He doesn't die of it, {{spoiler|instead dying in a hail of bullets to make sure a violent street gang stays put away}}. Given the frequent smoking in the film and his advanced age, it's probably lung cancer.
* ''[[Repo! The Genetic Opera]]'' has Rotti Largo, whose very first scene has him being brought the news that he's dying, and has very little time left. His only symptom is a rather bad cough, and {{spoiler|of course, he's dead by the movie's end.}}
** In fairness, they do hint that it's some kind of cancer--hecancer—he's bald and has lesions on his face, which can both be caused by chemotherapy and similar treatments. {{spoiler|It's the stress of the Genetic Opera that kills him by the end.}}
* ''[[Revenge of the Sith|Star Wars Episode III: Revenge of the Sith]]'' (No [[Star Wars Expanded Universe|Expanded Universe]], although it went in more depth about it) Villainous General Grievous starts coughing as soon as he appears on-screen (Probably so that the audience notices he's not a robot although he looks like one). He'll die... shot.
** However, the cough had nothing to do with why he died. Obi-Wan shooting out his gutsack with a blaster took care of that.
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* In the [[Errol Flynn]] swashbuckler ''[[Captain Blood]]'', [[Hanging Judge]] [[Historical Domain Character|Lord Jeffreys]] coughs into a cambric handkerchief and is diagnosed by the eponymous hero as dying from "a bleeding death in the lungs." (In the novel and in [[Real Life]], Jeffreys' fatal illness was actually kidney disease. (Admittedly, kidney disease is rather more of a challenge to show tastefully on screen...)
* In ''[[Mildred Pierce]]'' the younger daughter gets the fatal cough after the first 15 minutes.
* The movie Bright Star has John Keats succumb to an [[Incurable Cough of Death]], which is a [[Truth in Television]] because the actual John Keats died of TB.
* ''[[The Road]]'' has the father coughing through most of the movie. His sickness is never identified, but he does die from it.
* In ''[[Gremlins]] 2'', Mr. Wing is coughing from his smoking, and later dies.
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** She did something similar with Gilbert Blythe in her famous "Anne" series. Though it wasn't a cough, other characters begin to notice that Gilbert is looking pale and thin around the middle of "Anne of the Island". By summer, it is revealed he has come down with typhoid fever. This turns out to be a crucial plot point; Gilbert being ill prompts the titular Anne to re-examine her feelings towards him, and she realizes she's in love with him after all. Unlike other characters (dead seems to be a common theme in her novels, both humorous and sad examples), Gilbert does not die.
*** Ruby Gillis, Anne's childhood friend, does die of "galloping consumption" in the same novel, but there is no issue of this being hinted with a cough, as Anne does not learn of Ruby's illness until just before the latter's death.
* Averted and parodied in the Fourth Wall-abusing novel ''The Cat Who Killed Lilian Jackson Braun'''. In one scene near the beginning Philip Roth--yesRoth—yes, that Philip Roth--coughsRoth—coughs, and [[Lampshade Hanging|remarks]] that means he'll be dead by the end of the novel. The protagonist tells him that it's a parody and he shouldn't worry. {{spoiler|As you've probably guessed, it's played straight in the end. Roth knew he was dying all along, and furthermore, had killed Lilian Jackson Braun himself, out of a deep-seated hatred of her books}}.
* Stephen Leacock names this as one of the ways out to end a detective novel without [[Downer Ending|having to hang or imprison the culprit]] in [http://kraalspace.blogspot.com/2007/08/great-detective-by-stephen-leacock.html ''The Great Detective''] , itself a collection of tropes for detective stories, making this [[Older Than Television]].
* In ''[[The House of Night]]'' series, once a fledgling vampyre starts coughing, this means they are rejecting the change and will die. [[Blood From the Mouth]] often occurs as well.
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{{quote|She sighed a great deal, she used to sink down on to the divans, and sometimes even faint. She would interrupt her wearisome embroidery, raising her eyes to the heavens (she was subject to strange mystical states), or let the heavy anglo-saxon novels, which she never finished, drop on to her knees. She often held a delicate batiste handkerchief to her lips, and coughed faintly. In those moments she paraded an ostentatious discretion, and a truly unbearable resignation. I kept a pitiless watch on her, and I can positively state that she never coughed the slightest drop of blood. But she had cultivated the art of languishing gracefully, and no doubt her head had been turned by romantic examples of phthisis, of homecomings from balls where you catch cold in the snow.}}
* Subverted with Mr. Poe in ''[[A Series of Unfortunate Events]]''. He has always had that cough, but doesn't die. Lemony Snicket is just weird like that.
* In the story ''Laura and the Silver Wolf'', the heroine {{spoiler|who has leukemia}} begins to cough... and from then on, she wakes up exactly once and then {{spoiler|dies. But if we believe her, then she is forever in the Ice-Land and [[Died Happily Ever After|quite happy there. ]] }}
* Raistlin Majere in the [[Dragonlance]] novels suffers from this over the course of his entire life to the point of more than once nearly blacking out/suffocating altogether because of particularly nasty incidents of it. Subverted {{spoiler|because it doesn't actually kill him. Much of the description of the ailment points more toward it being asthma rather than anything outright lethal}} despite many occurrences of [[Blood From the Mouth]].
* In ''The Tartar Steppe'' by Dino Buzzati, in the first scene where Lieutenant Pietro Angustina appears, this is how readers are clued in that he's elegant, self-possessed, and ill: "Angustina had a slight fit of coughing. It seemed strange that a sound so disagreeable should proceed from such a refined young man. But he coughed with due restraint, lowering his head each time as if to indicate that he could not help it -- that it was really something he had nothing to do with but which he must endure. So he transformed the cough into a kind of willful habit for others to imitate." Seventy pages later, Angustina dies an elegant and self-possessed death.
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** Jo also contracts some sort of illness (in the book it's smallpox) that causes him to cough blood. Unlike Richard, he does try to seek medical help, however a crooked lawyer tells a constable to force the boy to stay away from people. Ultimately he is found by most of the main cast and brought in for rest. Though he still dies, he at least is safe and relieved of feelings of guilt (worried that he caused Esther to die of the disease as well).
* ''[[Deadwood]]'', Doc Cochrane begins hacking up blood in the third season, and Silas identifies him as "a lunger." Cochrane starts getting depressed, but Swearengen gives him a tough-love pep-talk, telling him that he isn't dead yet and to get back to work. Of course, the fact that Cochrane is the only doctor in town means Swearengen and the rest of the town residents rely on him.
* Don Fernando in the ridiculously [[Narm|Narmy]]y educational Spanish-learning program ''Destinos'' has one of these. He has it throughout the entire 52-episode series and doesn't die. Supposedly, he dies of it after the end.
* Subverted in ''[[Breaking Bad]],'' where the protagonist has been diagnosed with lung cancer at the start of the show and becomes a drug dealer to make money fast for his family. In the episode where he starts coughing badly and even spitting up blood, he assumes he has little time left, kicking off a rather dark take on [[Like You Were Dying]]. It turns out it's just a reaction he's having to the medication, and the blood is from a slight tear due to all the coughing--hecoughing—he's actually in remission.
* ''[[Monty Python's Flying Circus]]'': a couple discusses what's for dinner.
{{quote|'''He:''' Well, what kind of fish you got that isn't jugged?
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** When "Archangel" was active on Omega [[Vigilante Man|"cleaning house"]], there was a serial killer who also was a biologist specialized in virology. His cause of death was found to be "a cough".
* In ''[[Unreal]]'', you'll sometimes hear Nali cough for no plot-relevant reason.
* According to [[Doctor Who Expanded Universe|Doctor Who: The Adventure Games - City of the Daleks ]], getting caught in a paradox will not only cause you to fade into non-existence, [[Back to The Future]] style, but will also give you a really bad cough. Yeah.
* Zhuge Liang in ''[[Dynasty Warriors]] 6''. Oddly, he actually survives, unlike the real person.
** Guo Huai in ''[[Dynasty Warriors]] 7'' has this as his primary character trait. He still manages to kick all kinds of ass with his [[Anachronism Stew|ancient Chinese machine gun]], despite keeling over after performing most of his special attacks.
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== Real Life ==
 
* Legendary gunfighter Doc Holliday eventually died of tuberculosis. It's said that knowing he was terminal was what made him such a [[Death Seeker]] in the first place. (Reportedly his last words were "This is funny.") Accounts of his [[Incurable Cough of Death]] can be found in the historically inaccurate (but still pretty cool) movie ''[[Tombstone]]'' or [http://www.badassoftheweek.com/doc.html here].
* Unfortunately played straight by [[Too Dumb to Live|a few too many TB patients who refuse to take a full course of any antibiotic]] and help in the development of the multi-drug-resistant strains, and anybody who catches those.
* Averted, Post-nasal drip can cause continuous coughing but by itself wouldn't likely cause death. Have fun scaring people though.
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