THE COMMON COLD
REMAINS A PROBLEM STATE OF OUR KNOWLEDGE The common cold, probably the most frequent of a Briton's ailments, ie, at the same time, both the doctor's biggest financial asset, and his greatest professional humiliation (writes a medical correspondent in the Manchester Guardian). Nine-tenths of the people of these islands contract ; colds almost every year, and it is charged against us doctors that we have so far been unable to prescribe any measures, prophylactic or curative, that have any more valency than have the old wives' cures which still carry weight among simple and unscientific folk. What do we know about the common cold more than did our fathers or our grandfathers? What that their professional forbears could not do can doctors to-day do to prevent its incidence or to shorten its courses?
A few facte can be regarded as almost established. The basic condition of the common cold is a virus infection —that is, an invasion by particles so small as to be* invisible under the highest powers ot our ordinary microscopes, and able to pass through our finest filters, yet having those properties of self-reproduction and multiplication which we have hitherto assumed to be peculiar to living organisms. Influenza, smallpox, and measles are among the diseases assumed also to be due to specific ultra-microscopic viruses. Whether or not a filter-passing virus is responsible, general experience shows that the common cold is a very infectious disorder; also that it is dependent on seasonal circumstances to which masses of us are coincidentally exposed. It is, in any case, probable that the filtrable virus acts but as a stimulus or fertiliser ot some common, otherwise non-virulent, germ, always abundant. NOT THE ONLY CAUSE.
What has been proved, however, is that whilst the inoculation o.f susceptible individuals with cultures of any of the germs that have from time to time been regarded as specific causative agents fails to give rise to " colds," similar inoculation with germ-free filtered washings from the nasal passages of infected patients does in a large proportion of ca6es lead to an occurrence of the disease. This would seem to prove that the presence of tins ultra-microscopic virus is essential, but it does not prove that the virus is the sole responsible agent. Though no microscopically visible germs may be introduced, such may be already present at the nasal entrances or in the air breathed. This is as far as we can with confidence dogmatise about the pathology of the common cold. What about prevention, and what about treatment? So far, in spite of apparent sporadic successes, it cannot be said that either immunisation or cure can be counted on through the use of vaccines or serums. We are driven to rely on the natural resistance offered by the automatic forces of the body, strengthened in such ways as our limited physiological knowledge suggests. Only a few weeks ago we were reminded of the fact that every hour the inhabitants of an average British city inhales air containing not less than 14,000 germs. Yet, normally, the air which reaches the windpipe is germ free. The nose is evidently an important organ of defence against the parasitic germs ever floating "in those particles of dust with which our air is so heavily charged. The lining of our nostrils and of the airchambers beyond is an elaborately organised structure. It is furnished with complicated and sensitive blood vessels and watchful nerves. On its surface it is equipped with countless miniature hairlike protuberances, or cilia, constantly in motion, ever waving forward a coverlet of mucus, which acts as a sort of fly-paper or bird-lime, trapping gerrfiß and otter particles alike. CAUGHT AT ONCE.
Sir St. Clair Thomson tells u fl that, in the posterior two-thirds of ite extent, the nose has a new coverlet of mucus every 10 minutes, and, in the front twothirds, about ever hour. A lot of germs are trapped almost at the very entrance of the nostrils by the visible hairs or vibviseaß, themselves moistened by sticky mucus.' It is impossible here to describe in further detail this elaborate defensive mechanism. The point is that the occurrence of a " cold" implies that the re-
sponsible agents have succeeded in pass*' inpr or circumventing these defences.-.- rir 1 The,body has, however, a second line of _ defence, the principal elements iii. which aire the liquid blood and its white corpuscles.' A'-good-deal-of- thV discbni--fort of all our; illnesses'is attributable 4 ' not simply to the hostile force itself; buti: in large measure to the defensive activities of our own tissues and to the poisonsliberated from the dead bodies of the" iuv vading and the defending armies alike. We need, therefore, to be careful in our application of forms of treatment which merely aim at relieving unpleasant symptoms. Otherwise, as likely as: not, we may put. our natural defensive forces :out of action. -'..•.-., ;.■ If we would avoid colds, the two most obvious things to do are these: Keep! at the highest possible pitch of functional competence the sensitive lining membrane of the air passages; and, secondly, so far as our present knowledge ■ enables us so to do, to maintain the bactericidal powers of the blood at the highest level of efficiency. In our pursuit of these two.aims; what actual steps should we take?. TEMPERATURE VARIATIONS. Assuming that we have no prohibitive, bodily disease, we should take, abundant; exercise every day of our life: we.should within the limits of reasonable prudence, accustom ourselves to valuations of temperature, so as to maintain physiological resilience of reaction. We should avoid prolonged endurance of climatic im--pleasantness, or. of self-indulgent' • sur?; render to enervating comfort. Most of' us, even to-day, cover ourselves with -too many blankets ft night, and close our, bedroom doors and even our windows'" while we sleep; more and more we are 1 coming to rely on such unhygienic "amenities" as central heating,, the ideal of which is the establishment of tempera-ture-uniformity, calculated to reduce our. bodily liveliness to a level • comparablo • with that to which occupational and social monotony reduces our minds. :;! When we fall victim to the common cold, what is the sensible thing to do? As decent citizens we should keep away, from our neighbours. We should stop at home, and either sit by the fire or lie in, bed, according to the severity of-our at-; tack. It is a good plan to take a smartpurge at the onset —say a couple of casr' cara tablets at night, and an effervescent saline aperient next morning-r-to eat,.plenty of fruit, and to drink plenty of fluid; to sleep all we can, taking art occasional aspirin tablet if necessary-—-in fact, to spend our time reading and dozing and listening to the wireless, as forgetful of. the world and its respon-r sibilities as we can. There is an oldjoke to the effect that, if we have a.cold.'., and do not treat it, it will take 14 days for us to recover; whereas if we call in a doctor he will put us right in a fortnight. With good luck and good 1 management, we can undercut both of these' estimates. Perhaps the.only really*' user'-: ful thing that can be said at present-ia that it is foolish to treat a common cold , as unimportant. ,„ ~'",;
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Otago Daily Times, Issue 22834, 19 March 1936, Page 12
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1,209THE COMMON COLD Otago Daily Times, Issue 22834, 19 March 1936, Page 12
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