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The Common Cold
The Common Head Cold:
 Colds In General

 Anatomical Outlines

 Nose And Throat Functions

 Highways For The Invasion Of Disease

 Predisposing Causes

 Atmospheric Factors

 Colds And Micro-organisms

 Symptoms, Complications And Sequelae

 Principles Of Prevention

 Methods Of Prevention

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Colds And Micro-Organisms

( Originally Published Early 1900's )

It is a matter of more than mere theoretic interest to know something about what germs have to do with colds, for it is a subject intimately bound up with the question of whether or not colds are contagious and as to how valuable are antiseptics or vaccines in its prevention and cure.

It is a rather natural failing of the human disposition to welcome an opportunity to blame other persons for an ill which may have befallen us, and it happens therefore that many of us, in our satisfaction with having found some one whom we can blame for a cold, overlook indiscretions on our own part, which probably were responsible in a greater measure.

It is our contention that germs and certain atmospheric conditions co-operate in the direct causation of a cold, and that one factor is as in-dispensable as the other. We have already dwelt somewhat at length on the part played by the atmospheric conditions, especially because there has been of late a tendency to ignore this factor and to regard colds as solely of microbic origin.

That the micro-organism plays an important part is too well attested to admit of denial. On the ground of analogy the microbial nature of colds seems probable, because, like other diseases of this class, we observe that genuine colds are usually ushered in by a chill or chilly sensation, run a febrile course, and terminate spontaneously after a more or less definite duration. In favour of their bacteriological nature also is the general observation that colds are peculiar to populous communities, rather than to sparsely settled areas, occurring in the crowded cities with much greater frequency than in the open country. The infectious character is evident in the tendency to at-tack at one time so many members of a household, or of a community, assuming even at times an almost epidemic character.

St. Kilda's cold is famous in literature. On this sparsely settled little island of the Western Hebrides colds are almost unknown, except, it is said, upon the. occasion of the visit of a ship, when all the inhabitants are stricken. Dr. Samuel John-son, as quoted by Boswell, considered this such a preposterous story that he was surprised that a reliable historian would take any notice of it. Now, however, we have most authentic accounts of many similar incidents.

It is known that colds seldom attack persons who are roughing it in the open, on fishing, hunting or exploring expeditions, though exposed to every kind of inclemency of the weather, and it has beeen observed with regard to parties engaged in astronomical or other scientific work on the tops of mountains that they are usually entirely free for months at a time, only to be attacked on their return home.

One of the most convincing evidences that micro-organisms are necessary to the causation of a cold is the experience of arctic explorers. Nansen and his men in almost three years sojourn never experienced a cold, in spite of exposure to the extreme low temperature with severe hardships and deprivations. Sometimes after a fatiguing march they would have to sleep in frozen bags, which were thawed out only by the heat generated by their own bodies. Shackleton relates that the only time any colds occured in his expedition was upon the occasion of unpacking some boxes, containing blankets and other materials, that had been packed in London and not previously opened. Peary, who was often treated by the author for acute inflammation of the nose and throat, proving that he was not naturally immune, states that neither he nor his men were ever subject to colds while in the arctic region, but that on their return, as soon as they came to thickly inhabitated places, colds were of common occurrence.

Notwithstanding all the evidence that colds are of bacterial origin, a specific germ always present and certainly responsible for the common cold or rhinitis, has never been discovered. A number of organisms are usually found present in connection with severe cases, such as the influenza bacillus, the streptococcus, the pneumoccoccus, the staphylococcus, and the micrococcus catarrhalis. Certain physicians lay stress upon one, others upon another as the inciting cause. The opinion of the best bacteriologists however, is that these organisms are none of them specific for the disease, and that they are present merely as secondary invaders. This seems evident from the fact that they are not to be found in the beginning of the inflammation but only after it has lasted two or three days.

We might mention that in certain quarters the theory is advanced that the ordinary cold is due to germs of such minute size, that they cannot be seen at all under the microscope, and are, there-fore, designated as ultra-miscroscopic organisms. Some very interesting studies are now being made in bacteriologic laboratories, which would seem to indicate that there are organisms of infinitesimal size, which may be present in a solution after it has been passed through a filter that ordinarily is supposed to remove all germs. The remarkable thing is that these ultra-microscopic organisms have a tendency to destroy the ordinary germ, a fact that is pregnant with hope, if test tube results could be applied without reservation to the human body, that they may sometime prove a valuable instrument for fighting disease, in which case the contagion of good health might become no less a reality than the contagion of disease.

The view that acute rhinitis is due to a filtrable virus, containing a certain ultra-microscopic organism has not been generally accepted, and the consensus of the best opinions to-day is that there is not a specific cause of this troublesome affection, or if there is, it has not yet been found.

Now to return to the practical questions which are closely connected with the bacterial causation of the common cold, we have this to say with regard to its contagiousness. We believe that while this question may be answered in the affirmative, the answer must be made with reservations, and accompanied by explanations. Colds are undoubtedly to be classed as infectious in the sense that they can occur only when certain micro-organisms present in the environment have gained entrance into the system, but exposure to such an environment will not give rise to a cold unless certain other conditions are present at the same time.

First and foremost of those conditions are favourable atmospheric causes, such as the sudden chilling of the body by a draft or otherwise, which, as we have indicated, can upset the neuro-vascular mechanisms in such a way as to directly affect the function of the upper respiratory system, especially the nose. But both of these direct causes may be present and still no cold occur if the patient's general health be good and his resistance not reduced as a result of certain general or local predisposing conditions. We think there-fore, the danger of contracting a cold by merely coming into the presence of one who is already affected is much exaggerated, although one had best avoid this when fatigued, run-down, or other-wise below par.

For several years past, many sufferers from colds have been induced to submit to the use of the so-called vaccine treatment for the purpose of cure or prevention. Its results have been disappointing and it is rapidly losing favour as a therapeutic measure by physicians, but it is probable, as often happens in similar cases, that it will continue to be used by the public after the medical profession has entirely given it up.

Vaccines, notwithstanding the name, have nothing to do with vaccination and are not based upon the same principle. In vaccination, a living virus is employed to produce a modified form of the disease, which protects against the occurrence of the genuine attack in its more severe form, a method of treatment which could apply only to that class of disease in which one attack confers immunity from subsequent attacks. In the case of colds, no such immunity is ever observed; in fact it is generally believed that a person from having had a cold, is rendered more susceptible rather than less so.

Vaccines must not be compared with antitoxin, which is based upon a scientific rationale, and has proved one of the greatest triumphs of modern medical science. Antitoxin is a serum derived from animals already immune, or made so by injecting into their bodies the toxin of the disease in question. This antitoxin therefore contains the elements which the system elaborates to overcome a particular infection, and which when introduced into the human organism has an immediate effect in destroying the toxins of this infection.

Vaccines are nothing less than an emulsion of dead germs which must be of just the kind as that causing the disease for which they are administered. Their use is evidently based on the principle that the way to get rid of a disease is to give more of it, the explanation being that the additional dose stimulates the protective forces of the body to increased activity. But how do we know that we are not just nagging the cells of the body to a desperate effort that will end in their own destruction?

In the early days, when this line of treatment was first instituted, such possibilities were already recognised, and emphasis laid upon the necessity of determining whether the phagocytes which were to be stimulated were in what was called the positive or negative phase. This could only be done by painstaking biological tests which in latter days have been altogether discarded as too difficult and time consuming, and now vaccines seem to be given blindly and without any check than that of the patient's own uncertain clinical reactions to the treatment.

All cases of rhinitis are not the same, and there occur very often slight abortive attacks, the so-called cases of pseudo-rhinitis, which are destined to last a few hours and pass away. Furthermore, it must be remembered that acute rhinitis is by nature a self-limited disease, which, treated or not, has a definite duration usually ending in recovery. Disregard of these facts is responsible for many unwarranted claims of the efficiency of vaccines as a cure.

As to their value as a preventive agent, the conclusions often drawn are equally baseless; a patient who has taken a preventive dose, and for a few months finds himself free of a cold, is very optimistic during that interval of the benefit of the treatment, entirely ignoring the fact that such intervals are just as common when no vaccine has been used. And often enough it has happened to us, that some patient reports for relief of a cold, within a very short time, it may be only a week or so, after an intensive preventive course of vaccine injection. Of course, this latter patient will be pessimistic, but such cases do not seem to off-set the optimism of apparent success of others.

To justify the employment of vaccines, containing millions of dead germs, it must be assumed that the live germs causing the disease which we aim to cure, have failed either to ex-cite sufficient reaction, or else the wrong kind of reaction in the natural protective forces of the body. As regards the first, it is very difficult, as we have intimated, to judge Nature's efforts precisely enough to say that it needs or does not need reinforcement. It is really in the very severe types of infection that assistance is needed, be-cause then the natural production of antigens is unequal to the excessive virulence of the infection.

It is in just such cases, that the use of vaccines seems the worst. The natural forces of the body are already exhausted and the addition of fresh stimuli could only have the effect of overwhelming them.

There is to my mind no better illustration of the philosophy of the situation, than that of a drowning man, struggling and calling for help. Your vaccine enthusiast would scorn to throw him a rope or give him a helping hand, but would push him further under the water, in order, he would no doubt explain, to make him increase his efforts to save himself.

In regard to the contention that vaccines might be indicated, not because the natural body reactions were inadequate, but because they are of the wrong kind, it is difficult to see the rationale of such an hypothesis. Is it not more logical to assume that the natural body reactions to the living organisms causing a disease would be specific for those organisms, that is, just of the right kind to overthrow them, than such as might be produced by dead germs, even though of the same kind, which have been sterilised and changed by chemical treatment or heat ?

As we see the matter, if the vaccines used have an effect which is in some way different from that of the living organisms, it is a wrong kind of effect, and if it is the same, it is evidently only an undesirable augumentation of the hostile forces with which nature has already to contend.

To sum up then, the use of vaccines to prevent colds cannot be justified on theoretical grounds, because in the first place, the bacterial cause of cold is unknown, and in the second place, even if known it could not be expected to be effective, because a cold is not a self-immunising disease. Their use for the cure of the trouble is equally indefensible, as they cannot be expected to be more than an additional burden on the already overtaxed protective forces of Nature.

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