The Common Head Cold:
Principles And Practice Of Hardening
Home Care And Treatment
Nasal Obstruction And Mouth Breathing
Voice And Speech
Summary And Conclusions
Read More Articles About: The Common Head Cold
Home Care And Treatment
( Originally Published Early 1900's )
The main object of home treatment of colds should be their prevention, and we are confident that were it possible to assure intelligent application, appropriate to each individual case, of the principles and practice set forth in the preceding pages their frequency would be materially reduced.
We must reckon, however, with the natural infirmities of the will as well as of the flesh. People may become well informed as to what is best for the health; they may have good intentions to do what is best—even make a good beginning, but resolutions fail and the ills they might so well have avoided, soon follow.
The cure of colds is, fortunately, not quite so hopeless a matter as might be inferred from some of the pessimistic comments emanating from the profession. Medical treatment is of value, not only for mitigating the discomforts of the affection; for, if intelligently administered, it will often succeed in, abbreviating its duration. In the first place it may do much in preventing the attack from becoming converted into a chronic catarrhal condition, and in forestalling the occurrence of complications. Expert advice is imperative in the event of certain complications, for as elsewhere pointed out a serious outcome is always a possibility.
In most cases, however, special medical treatment is unnecessary; besides, there are a great many people who could not afford it and must get over their colds as best they can without it. It is therefore in order to outline such measures of treatment as the patient may himself apply, with special reference to those things which are safe, simple, and conveniently available.
Before discussing what should be done it may be well to say a word as to what should not be done, for the old aphorism of Hippocrates the father of medicine, primum non nocere, has its useful application in this connection. There is never any lack of suggestions on the part of, neighbours, as to how to treat your cold; and the newspapers carry luring advertisements of "colds cured in a day," which one who "runs may read."
The most important thing to know to protect us against some of these follies is that a head cold is not a simple unchanging malady which must yield always to single remedy, but one that re-quires the judicious selection of remedies appropriate to the case, and especially to the particular stage of the disease, combined always with a rational hygiene.
Referring to the description of the course of a common cold under the head of "Symptoms, Complications and Sequelae," it will be recalled that a typical case is characterised by three stages, first the dry stage, second the stage of watery secretion, and third the stage of mucous secretion. During the first stage, which lasts usually only about twenty-four hours, the mucous membranes are swollen, dry and excessively sensitive. The second stage, which lasts usually from one to three days, is marked by the occurrence of abundant watery acrid secretion. The third stage is characterised by the fact that the discharge now assumes a mucous or muco-purulent character. At the onset of this stage the acute constitutional symptoms, which have been present until now, usually subside.
Treatment that is proper to one stage of the affection may be entirely inappropriate to an-other. In the first and second stages constitutional symptoms are prominent and internal treatment is indicated, but on account of the highly sensitive state of the mucous membranes, local treat-ment is generally to be avoided, especially the use of stimulating or astringent remedies, which only increase the congestion and produce irritation.
Quinine is a component of nearly all of the mixtures designated for internal administration for the cure of a cold. It is without doubt one of the most useful drugs in the whole pharmacopeia, in its proper place, but I have yet to see a single case of cold that was ever cured by it. In excessive dosage as sometimes used, it produces congestion of the labyrinth of the ear, and it may be responsible for permanent deafness.
Alcohol, usually in the form of rum, brandy or whiskey, is a popular side partner with quinine in the choice of a cold cure. It is with no intention of increasing the popularity of alcohol that we have ventured to disparage its disagreeable associate. We have pointed out some of the dangers of alcohol in discussing the problem of catching cold. As its physiological effect is to bring about a determination of the vessels to the surface of the body, with increased loss of body heat, it should never be used on going out into the cold, but in coming from the cold outside to indoors, it may be helpful in promoting a necessary reaction.
Because of the physiological effects mentioned too, it is a useful adjunct in hot drinks used in the first stage of a cold for the purpose of bringing on a perspiration. It has no value in the late stages of a cold, and can do great harm in any stage when taken in excess.
When it is certain that one has just contracted a cold, evidenced locally by a stuffy nose and a tendency to sneeze and generally by a sense of chilliness soon followed by a feverishness, head-ache and general malaise, the wise thing is to remain indoors, in a comfortable warm room. Rest in bed for a day or so is strongly advised; also care to keep the body warm and to avoid drafts. One should refrain from cold baths, cold showers and strenuous exercises, for it must be clearly understood that all those hardening methods, so valuable in the intervals of cold, as measures of prevention, are directly contra-indicated when the cold has been contracted.
The diet should be light and free from nitrogenous foods. Nothing could be farther from the right than the injunction, "Feed a cold and starve a fever." A cold is a fever, the inflammation being localised in the respiratory mucous membranes. Overloading the stomach is directly harmful, and meats, gravies, fried stuff and richly spiced food are especially to be avoided.
One should take freely of fluids. A milk diet for a day or so is advisable for those who have no antipathy to milk, and those who have may overcome it in a measure by taking the milk well diluted with Vichy water. Fruit is allowable, and fruit juices in the form of orange, lemon or grape fruit, or cider should be given freely.
In the very beginning of a cold it is helpful to bring about a free perspiration. This is most effectively done by drinking freely of hot lemonade punch, to which has been added a moderate amount of rum or brandy. A hot mustard foot bath or a general warm or hot bath may be taken also with benefit, the patient, going to bed immediately and wrapping warmly with blankets in order to promote good sweat. In the morning following, a saline laxative should be taken; an ounce of sulphate of magnesia, a Seidlitz powder, or a glass of magnesia citrate will answer the purpose.
During the acute febrile stage of a coryza, there is usually a tendency to lessened alkalinity of the blood. To combat this, alkaline treatment is advisable, which can be very satisfactorily given in the form of bicarbonate of soda, in twenty grain doses (about a third of a teaspoonful) every two hours in warm water. If there is fever, headache or joint pains, aspirin in doses of five grains, or phenacetin or salol in doses of three grains may be taken along with the soda. After the first two or three days soda is no longer of value.
Considerable benefit may now be derived from the internal administration of iodine. One may get for the purpose from the drug store an ounce of Lugol's solution and take about five drops in a half glass of water before each meal. No other medicine is to be taken at the same time.
During the first stage of an acute rhinitis, we should have respect for the highly sensitive state of the inflamed membranes and not attempt to use local treatment in any form. In the second stage, local treatment must be cautiously used. Steam inhalations containing menthol, or an oily spray composed of one per cent menthol and one per cent oil of eucalyptus in a liquid petroleum base tends to lessen the congestion, and has a generally healing and soothing effect.
With the onset of the third stage a more energetic scheme of local treatment is in order. Numerous alkaline and antiseptic solutions are on the market, each claimed to be the most valuable of its kind. They have all practically the same formula, the chief differences being in the flavour and colouring matter. If you do not want to pay for name and advertisement, you have only to apply at the drug-store for a few ounces of alkaline antiseptic solution (N.F.). It may be used in a dilution of one to three or four parts warm water, two or three times a day, running it through the nose by means of a medicine dropper or a douche rather than in spray form. When the inflammation is intense and the ears show evidence of being involved the alkaline douch may be fol-lowed each time by a few drops of ten or fifteen per cent solution of argyrol or a ten per cent solution of neo-silvol.
Certain other medicines are indicated for colds when complications have arisen. When there is decided involvement of the pharynx and painful swallowing, chlorate of potash is helpful; if there is tonsil inflammation with general aching of the muscles and joints, the salicylates in some form as salol, should be taken, and if the inflammation has spread downward as evidenced by hoarseness and cough, muriate of ammonia is advisable.
Two or three years ago, a method of treatment for colds by chlorine gas was widely heralded and great success claimed in certain quarters. Colonel Vedder of the U. S. Army, stationed at Edgewood arsenal, impressed with the report of the freedom from cold of employees in the plant producing chlorine, made some careful scientific investigations as to the effect of the agent upon certain bacteria. He came to the conclusion that the gas in a concentration that was harmless to the individual (viz. 0.015 m.g. per litre) had a decided bactericidal effect in acute respiratory diseases, in which the affecting organisms are located on the surface of the mucous membrane. We undertook to make some clinical experiments to test the practical value of this treatment, and came to the conclusion that benefit was frequently derived in simple uncomplicated cases of coryza, when treated in the first stage of the disease, but little effect was to be obtained when the sinuses or tonsils were involved, or when the inflammation had extended to the deeper layers of the membranes, rendering the bacteria inaccessible to the action of the gas.
With regard to the use of vaccines-the treatment of cold by this method is advocated and pro-claimed by many physicians, despite the fact that, as we have attempted to show in another place (See Chapter VIII) it has little or no scientific foundation. That, apparently, very good results are sometimes obtained is probably due to mere coincidence. The profession is generally losing confidence in its efficiency and its popularity as a dependable method of treatment is fast dwindling.