Colds, coughs & sore throats; their cause, prevention and cure

Preface

Reader, whoever you may be, this book is intended for you. That person does not exist, unless he be numbered among the very few who have never '' taken cold,'' and is likewise indifferent to suffering and inconvenience among his friends, who is not interested in its subject.

There is not a school boy or girl who cannot understand how to apply the more obvious rules for the avoidance of those conditions which predispose to colds; not a mother who cannot use the simpler methods of prevention and cure; not a business-man, farmer, lawyer, senator or horsewrangler who will not do well to heed the cautions in regard to unnecessary exposure, improper clothing, lack of ventilation, carelessness in eating and neglect of early symptoms.

The primary object of the book is to tell in plain words why we catch cold, how to avoid the causes, how to check or break up the morbid process when acquired, and how to put the body in such a condition of health that it will not readily take cold.

In discussing medical treatment it deals only with remedies that can be safely, promptly and properly used at home, and these it explains fully and clearly so that there need not be the slightest difficulty in

11 PREFACE.

their application. Colds and coughs, with a few well-marked exceptions, come on by rather slow degrees. There is no sudden outbreak, but mild symptoms make their appearance, gradually increasing in severity until the disease is fully developed. This mild commencing period is the golden opportunity for home treatment. As a few drops of water will quench a fire when just starting, so a very small amount of treatment, promptly administered at this critical time, will frequently check the disease so that it never gets beyond the initial stage. When, however, such a disease does begin with much severity, or refuses to yield to simple remedies, or for any other reason seems unsuited for home treatment, a physician should be sent for without delay.

The first part of the book contains a brief description of the respiratory tract; a consideration of the anatomical and physiological changes involved in the process of " catching cold," and a discussion of bacteria, together with the general subject of infectious and contagious diseases. The medicinal remedies and their doses, and the simple apparatus used in the treatment of afifections of the respiratory tract are also considered.

The second part is devoted to the consideration of the diseases to which the respiratory tract is subject. The causes, symptoms and treatment of the simpler forms are discussed at length; the more

COLDS^ COUGHS AND SORE THROATS. Ill

dangerous affections are discussed with such fulness as to secure their early recognition, and, as a result, their prompt treatment at the hands of a competent physician. In all cases the work tries to make plain when professional advice is needed, and, when it is needed, the importance of calling in a doctor before harm, perhaps beyond the possibility of repair, has been done.

And finally, a short section is devoted to the more general principles of hygiene; the methods of securing the necessary sunshine, fresh air, exercise and rest ; the importance of applying common sense to the affairs of daily life so as to make the most of its opportunities for health and exercise, and, generally, the necessity of taking an interest in life, thereby making life interesting, and as a consequence more healthful and better worth living.

William Conyngton, M. D.

Washington, D. C, September i, 1906.

COLDS, COUGHS AND SORE THROATS.

Part I. Preliminary Considerations

Chapter. Page.

I. The Respiratory Tract and Its Diseases... 7

II. Causes of Colds, Coughs and Sore Throats.. 23

III. Bacteria and Their Relation to Disease... 45

IV. Infectious and Contagious Diseases and

Their Causes 6s

V. Apparatus Used in Treatment of Respiratory Diseases 76

VI. Medicinal Remedies and Their Doses 88

Part II. Respiratory Diseases And Their Treatment

VII. Cold in the Head 104

Coryza; Acute Nasal Catarrh; Acute Rhinitis.

VIII. Sore Throat (Common Forms) 129

Naso-Pharjmgitis; Adenoids; Pharyngitis; Laryngitis.

IX. Sore Throat (Severe Forms) _. . 142

Diphtheria; Membranous Croup.

X. Sore Throat (Severe Forms) 159

Tonsillitis.

V

VI

TABLE OF CONTENTS.

Chapter. Page.

XI. Cough (Cold on the Chest) i66

Bronchitis.

XII. Cough (Cold on the Chest, Severer Forms) 179 Pneumonia; Broncho-Pneumonia; Pleurisy.

XIII. La Grippe or Influenza 197

XIV. Hay Fever 207

XV. Whooping Cough. (Pertussis.) 211

XVI. General Treatment 218

Constipation; Diarrhoea.

XVII. General Treatment 227

Fever.

Part III. Hygiene

XVIII. Fresh Air and Sunshine 235

XIX. The Food We Eat 248

XX. Exercise 256

XXI. Clothing, Bathing and Sleep 269

XXII. Conclusion and Conclusions 278

COLDS, COUGHS AND SORE THROATS.

CHAPTER I. The Respiratory Tract and Its Diseases

The very common and very annoying disease conditions popularly known as colds, coughs and sore throats, are met with in every family, and in the majority of families they occur many times in the course of a year. The conditions dealt with in this book are all of the acute type; that is, they come on with some degree of suddenness, and they are all affections of the respiratory tract; that is, of those inner portions of the head, neck and chest which take part in respiration or the act of breathing; hence if the book were principally or entirely intended for the reading and study of physicians and medical students it might very properly be termed ''Acute Diseases of the Respiratory Tract.''

Its main object, however, is to furnish a convenient volume for home use, giving wherever possible plain, honest English words in preference to more technical terms, and for this reason the ordinary household words *'Colds, Coughs and Sore Throats" are chosen to form its title. As all of these conditions are more or less directly connected with the respiratory tract, a few words will be here devoted to the consideration of this part of the body.

The respiratory or breathing tract, consists of the air channels of the nose and throat, the windpipe and all of its branches, and the microscopically small air cells of the lungs. All are lined or covered with delicate velvety tissues, the mucous membranes, which serve the purpose of an internal skin, and are kept moist and to some extent protected by their own secretion of mucous.

The air channels of the nose form an admirably effective apparatus for purifying and preparing the inspired air for further progress to, and final usefulness in the air cells of the lungs. A number of short hairs at the entrance form a partial screen through which the air is drawn, after which it is whirled and twisted about, in and through the curiously-shaped nasal passages, in such wise that it is brought into most intimate and thorough contact with the warm, moist membranes, which in this location are peculiar in the great number and large size of blood vessels lying just beneath their surfaces, while the somewhat labyrinthine arrangement of the internal nasal walls increases the amount of surface and prolongs the time of transit. The structure of these membranes favors a rapid transfer of warmth and moisture from the large and constantly changing blood current to the entering air, and so well are these offices performed that the entire quantity of inspired air is saturated with moisture and warmed to the normal bodily temperature before reaching the deeper and still more delicate tissues. It is also claimed that a large proportion of those injurious germs which are so commonly found in the atmosphere are retained and finally destroyed and thrown off by this same useful old nose. When the nose is stopped up, as by a cold in the head, or when from bad habit, mouth breathing is indulged in, the inspired air is only partially warmed, moistened and otherwise prepared for contact with the deeper tissues, and diseases of the throat, windpipe or lungs are very apt to develop as a consequence of such misfortune. The inspired air passes from the cavities of the nose into the throat, which comprises, according to the ordinary usage of the word, the pharynx and larynx. The pharynx is much the larger portion and extends from the nasal openings to the larynx and oesophagus. It is divided into the naso-pharynx, oro-pharynx and laryngo-pharynx, bult lO COLDS, COUGHS AND SORE THROATS.

the divisions are much hke those of latitude and longitude on the earth's surface; that is to say, they are imaginary lines laid down on an unbroken surface.

The naso-pharynx (nose part of the throat) is above and behind the mouth, reaching much higher than is usually realized, so that we have here quite a large concealed cavity. The nasal cavities open directly into it and a little behind these openings and at the sides the Eustachian tubes pass to the middle ear cavities, each tube supplying air to the middle ear of that side and regulating pressure on the tympanum or ear-drum. The Eustachian tubes are of considerable importance in considering diseases of the throat, as inflammation often reaches the ear through these channels and at other times they may be closed by swollen tissues or blocked by increased secretions, giving rise in either case to various disorders of hearing or diseases of the ear. Lymphatic glands are found in considerable numbers in the deeper layers of the walls of the naso-pharynx and their overgrowth causes the very harmful condition of adenoid hypertrophy. (See Part II, Chapter VIII.)

The oro-pharynx (mouth-pharynx) is that part lying behind the mouth and extending forward to the soft palate. It includes the part of the throat visible from the outside when the mouth is widely opened and afifords passage for food from the

THE RESPIRATORY TRACT AND ITS DISEASES. II

mouth to the oesophagus as well as for air from the upper throat to the larynx. The soft palate and tonsils are anatomically a part of the mouth, but as inflammation of these parts gives a severe sore throat they will be considered in connection with throat troubles. The laryngo-pharynx comprises those portions of the throat adjacent to the larynx and oesophagus.

The larynx lies between the pharynx and trachea or windpipe. It is a box-like structure composed of plates of cartilage, ligaments and muscles, and contains the parts by which the voice is produced. Its largest plates of cartilage form the most prominent part of the external throat in the midline, commonly known as the ''Adam's apple.'' The uppermost part is the epiglottis, a very effective and snug-fitting lid, composed of cartilage and membranes, opening freely and widely in speaking and breathing but closing tightly when food or liquids are swallowed, while at the same time the whole larynx is drawn forward and upward under the root of the tongue.

The larynx opens into the trachea or windpipe, which is a cartilaginous tube about three-quarters of an inch in diameter, extending downward three and a half to four and a half inches as a single tube. At this point it divides into the right and left bronchi, and these bronchi rapidly divide and subdivide until the finest bronchioles (little bronchi)

terminate in the minute alveoli or air-cells of the lungs.

A cold, as ordinarily understood, means a catarrhal inflammation affecting one or more of those internal portions of the body which are concerned in the act of breathing, and is frequently although not always brought on by exposure to cold. All of these internal parts of the body over or through which the inspired air passes, are lined or covered with mucous membranes which in health continually secrete a sufficient quantity of mucous to keep themselves moist and protected from direct contact with the inspired air and whatever it may contain. Catarrhal signifies a condition in which these secretions are so increased in amount as to clog the air passages by their quantity, and so changed or perverted in character that they become injurious and improper substances for retention in the body, hence they are gotten rid of by blowing the nose, coughing and spitting.

A sore throat is any condition in which there is pain and irritation in or about the internal throat, and as these conditions are almost always accompanied by some degree of inflammation and increased and perverted secretions, and are also frequently brought on by exposure to low temperatures, they too are called colds. More commonly such a condition is referred to as "a cold and sore throat," and as this covers all of the disease conditions found, it is perhaps preferable.

A cough signifies the violent and noisy expulsion of air from the lungs, owing to some cause of irritation affecting the membranes of the lower air passages, or some nerve or nerves connected with them. The commonest cause is, of course, the increased and perverted secretions, for getting rid of which coughing is the natural and effective means. Another common factor is some swollen portion of the respiratory tract which partially closes an air channel, interferes with other parts, or presses on some nerve.

At times, however, coughing is caused by disorders in parts of the body entirely distinct from the breathing apparatus, as by stomach disturbance, or by some improper and irritating object lodged in the external ear. The great vagus (vagabond or wandering) or pneumogastric (lung-stomach) nerve supplies a large part of the respiratory tract and is also the chief nerve of the stomach, hence irritation of the stomach terminals may be referred to some part of the throat or windpipe and result in coughing. Or, the trifacial nerve (three-branched nerve of the face) may carry an impulse from an irritated ear over to the nose or throat, of sufficient strength to knock the wind out of the lungs by a good strong cough.

The one term ''Colds'' is often used to include all of the conditions above referred to, and it is not at all uncommon to hear such a conversation as the following, between distant but friendly neighbors: "Hello, John! How's all the folks?'' to which John replies, "Just tolable to middlin', Henry. Mandy's been havin' a cold in her head most all the winter ; the girls has been havin' theirn in their throats, and Peter, he's had the worst cold on his chest since the war." The phrase "cold on the chest" is commonly used to designate bronchitis, but it is also applied to the graver conditions of pleurisy and the pneumonias.

Besides the colds already referred to, certain other conditions such as la grippe, whooping cough, hay fever and diphtheria, usually classed under other headings, are considered in the present volume, for the reason that in some of their forms, or at some stage of their development, it is itnpossible to distinguish them from diseases which are unhesitatingly classed as colds. A mild case of the respiratory type of la grippe, and a severe cold in the head with extension to throat and upper chest, call for a trained bacteriologist with a good microscope to tell the difference ; whooping cough is a cough both by name and by nature ; hay fever is almost a duplicate of other colds, and diphtheria was formerly, and for very sufficient cause, known as putrid sore throat; and for these reasons they all seem to fall very naturally and properly under the heading of "Colds, Coughs and Sore Throats."

In all of the diseased conditions referred to, with the single exception of hay fever, two ideas are always popularly prominent. One is that some portion of the delicate membranes of the respiratory tract, together with more or less of the underlying structures, is congested or inflamed, the arteries, capillaries and veins engorged with blood, and the tissues swollen with serum and other constituents of the life fluid which have escaped from their proper channels, and that this congestion or swelling, together with the consequent tenderness and pain, causes more or less irritation and inconvenience in the act of breathing. And this first idea is strictly correct.

The other idea is that this condition is caused, either wholly or in part, by low temperature, and from this idea the name "cold" is derived. This belief is only partially true, and so far as absolute cold is concerned, there is nothing to it at all, unless exposure is unduly prolonged. You may freeze a man's ears, his hands or his feet, or all of them, without his catching cold, and the same man may easily catch cold with the thermometer well above the freezing point. What will give him cold is to chill one part of the body more than other parts usually no better protected, hence the danger of cold drafts, getting the feet wet and so on.

Absolute cold, to a robust person, is for a time much of a tonic and stimulates the heat producing centers to greater activity. But when such exposure is extreme and long continued, the bodily organism fails to react fully, the individual becomes "chilled through,'' and the superficial circulation is largely checked. Under these circumstances, cold becomes one of the very depressing forces, lowers vitality, puts the mucous membranes into the finest possible shape for bacterial proliferation and activity, and the end of the process may be a severe cold, that is to say a catarrhal inflammation of nose, throat or chest.

Damp cold is far more depressing and much more likely to result in colds and kindred affections than a temperature low enough to freeze the moisture out of the air, giving what is called "dry cold." Hence we catch cold with the greatest ease and frequency when the temperature is barely above freezing and full of moisture, as in a cold, slow thaw, when melting snow and ice keep the dense, sodden atmosphere saturated with moisture to the fullest limit of its capacity.

Hay fever is the only cold that is not associated with low temperature either by actual relationship or popular belief. It is caused by some form of pollen or other vegetable dust and necessarily comes at that time of the year when the plant (be it rose, rag-weed, golden-rod, or other weed or flower) that furnishes the poisonous substance arrives at the proper stage of development to scatter the causative dust.

Home treatment is proper in many forms of respiratory diseases. Very frequently an ordinary cold in the head, a mild sore throat, or a cough of moderate severity, is not considered of enough importance to justify sending for the doctor, and yet these ailments cause much discomfort and annoyance, and if neglected may lay the foundations for more dangerous diseases in the future. These are the forms that are strictly suitable for home treatment. At home they can be noticed and taken in hand at the very beginning, and at this stage they usually yield readily and completely to comparatively simple and easy treatment. And if from tardiness in recognizing and treating such a condition, or from unusual severity of the attack, it fails to yield completely, the illness is so shortened, the discomfort so mitigated and the general health so much less disturbed, that all of the time and trouble so expended is vastly more than paid for. And again, there is no shadow of doubt but that prompt attention to what was deemed a simple cough or cold has frequently checked some disease process that would have developed into a dangerous or fatal illness if left to run its course.

Other cases in which home treatment is most absolutely proper are those where no doctor can be obtained. Some of our readers will smile at this statement and remark, "Well, this doctor has his imagination with him for sure. Such things might have been a century ago, but not by a jugful in this day and generation." Nevertheless it is a fact that people, and not a few of them either, suffer and die without medical care in this very year of Grace, A. D. 1906, some of them because a medical practitioner cannot be found within a hundred miles or more, others because they prefer to take chances rather than to ride ten, fifteen, or fifty miles and pay anywhere from ten to three hundred dollars for medical attention that is frequently far from firstclass. And in all of the cases falling under either of these classes it is very desirable that some knowledge of the commoner forms of disease should be at hand, with simple directions for treatment that can hardly do harm any way it is applied, while the chances of its doing much good are many and large.

When, then, should a doctor be called? Where a good physician is within easy reach and the disease condition is at all severe, call in your doctor without hesitation, and if in doubt as to whether the case is within your ability or a little too much for home medication, err on the side of safety and send for the physician. A good doctor is a blessing to any community, earns every cent he ever gets and a very great many that he never gets, and if any man deserves patronage and encouragement it is the physician. Hence if he earns a fee where it might have been saved by taking extra risk and unnecessary trouble, do not begrudge it or consider it so much to the bad ; neither for paying him what you justly owe look for a reward from heaven. That rather belongs to the big-hearted old doctor who loses his rest in this wicked world that others may enjoy theirs during health and prosperity, with the well-founded assurance that in time of need they can depend on the medical man's keenest watchfulness and most skillful care, freely given up to such limits that he has to prop his eyes open to keep awake, or drops in his tracks from sheer inability to stand up any longer. May blessings light on every good and honest doctor's head, and down to the deepest depths with all the bad ones, with a millstone tied to every evil neck.

Another object of the present work is to give instructions as to the avoidance and prevention of colds. The story is often told of a recipe in an old time cookbook for preparing hare soup for an invalid, commencing with the proposition, "First catch your hare." If no hare is caught, of course the preparations cease right there, and it is the same way with a cold ; if no cold is caught no treatment is needed, and everybody will agree that this condition is preferable to the finest of treatment after the cold is caught.

Something about the causes of colds and how to avoid them we all know, but we do not know enough, and what we do know we do not properly apply. 'It is a little damp," says the young lady, '*but it will not hurt me to just run around the corner in my slippers," and round the corner she goes and presently her head is going round too, and the next laundry bill is larger by some dozen or two of dainty handkerchiefs. ''Oh, well," says the Congressman, "it used to give me indigestion and a cold to eat lobsters, but lobsters elected me and I reckon they'll treat me better this time," and so the lobsters have their revenge.

And again, while it is generally recognized that getting the feet cold or damp, and indigestion, are very common exciting causes of colds, there are other less commonly understood causes that are just as efficient, such as sitting or kneeling in a cold, damp church through a long prayer or sermon, mouth breathing, wearing too much or too heavy clothing, and going from the hottest part of a hot room to colder outside air, or vice versa. And the fact that many of the commoner colds, as well as diphtheria, consumption and whooping cough, are readily transmitted from person to person, usually through breathing the air contaminated by the coughing or sneezing of the victims of such disorders, is not by any means properly appreciated. Neither is it at all realized what an efficient means of spreading infection our public conveyances are, especially when heavily upholstered, as even the street cars of the present day frequently are. How often does it happen that in a crowded street car the victims of consumption, or sufferers from milder respiratory disease, keep up a constant coughing or sneezing, without even dreaming of screening the moutb with hand or handkerchief, although every cough or sneeze sends the disease germs flying for several yards. What chance then has the weakly individual right across the narrow aisle and in direct range of this volcanic eruption of dangerous germs. Or suppose a victim of tuberculosis has the car to himself ; what a fine ambush the cushioned seats form, and how freely the microbes will be spread throughout the car in its rattling, shaking travels, when they are brushed and rubbed from the cushions by every passenger who does not have to stand.

And yet one step further: such a condition of physical health and vigor that ordinary causes of disease are harmless as so many drops of water on a duck's back is the ideal state of affairs. Unfortunately this is a better condition than most of us can possibly attain to, notwithstanding which it is worth much effort to approximate it; hence a portion of the present book will be devoted to a consideration of the means by which we may so use whatever advantages are at our command as to increase our bodily health and vigor, which is the first and greatest thing to be desired. The next object is to avoid so far as possible all recognizable causes of ill health. If both of these precautions fail us, as they sometimes will, and a cold, cough or sore throat is caught in spite of all our care, the next thing is to secure the simplest and most effective treatment possible, whether it require the presence of a physician or whether it fall within the scope of home treatment. And if home treatment is decided on, while always striving to do all the good you can, let the old doctor's parting words to his graduating class, ''Young gentlemen, if you do no good be sure you do no harm,'' remain with you and be a cardinal principle in all parts of your home treatment.

CHAPTER II. Causes of Colds^ Coughs and Sore Throats

Everything in this wicked world has a cause and a result, and colds, coughs and sore throats are no exception to this general rule. Every disease has some cause although our ignorance thereof may be profound, and every disease has certain results of which our knowledge is usually pretty full and complete. And as these results are, as a rule, far from agreeable or desirable, our knowledge thereof should lead us to seek out and avoid the causes with an earnestness proportionate to our dislike for the results.

It is customary to divide the causes of disease into predisposing, or those which merely lower vital resistance and put the body into such shape that it may readily fall a prey to sickness, and exciting causes, or those which actually start the disease processes and determine their character. But this division, in our present condition of knowledge or lack of knowledge, can never be mathematically exact and positive, and while some causes must always be regarded as predisposing and others just as certainly exciting, there are a number that hover in a debatable land, sometimes being classed under the one heading, sometimes under the other. And again, circumstances may easily be such that an exactly similar cause is at one time, or to one person, merely predisposing, while at another time, or to another person, it is actively exciting. For instance, a forced march through sleety rain and freezing mud, to some of the seasoned veterans, will apparently be no more than a temporary source of discomfort and grumbling, but in a large proportion of the soldiers it will markedly lower vitality and predispose to disease, while to many it will be the exciting cause of pneumonia, pleurisy, rheumatism, or other form of disease.

The most reasonable and useful division, and that which will be adhered to in this book, is to consider those factors which have to do with methods and habits of life, are prolonged in action and slow to produce results, as predisposing causes, while those which are of brief duration and quickly followed by ill effects are accounted as the exciting ones.

Lowered vitality is often given as the greatest of the predisposing causes of ill health or disease. It is really a condition of the body brought about by the action of one or many predisposing causes, as lack of exercise, neglect of fresh air and sunshine, worry, overwork, indigestion, — in short anything that decreases the bodily vigor and health, and it may be regarded as a sort of common center, or a halfway station on the road from health to disease, to which all other predisposing causes tend and from which the exciting causes find their most favorable starting point.

Those early stages of life known as infancy and childhood are rightly placed in the front rank of predisposing causes. The tender little bodies have in themselves small power of resisting adverse influences, experience is lacking and reasoning powers undeveloped. Nature's provision for this period of helplessness is the care and wisdom of the parents, but while the care is ungrudgingly bestowed, wisdom and education along these lines are frequently most woefully deficient, and the young human being has a poorer outlook as to health (although better as to mere existence) than the offspring of any other free animal.

Old age and a fairly high degree of vitality are not inconsistent, but this combination is the rare exception and few who live the civilized life can hope to attain it. Lowered vitality and feebleness of the physical frame are the usual characteristics, and they are only partially compensated by the wisdom of experience and the less active and more protected life ; hence old age is a potent predisposing cause of various forms of disease.