Preventable Diseases Part 4

COLDS AND HOW TO CATCH THEM

Ancient vibrations are hard to stop, and still harder to control.

Whether they date from our driving back by the polar ice-sheet, together with our t.i.tanic Big Game, the woolly rhinoceros, the mammoth, and the sabre-toothed tiger, from our hunting-grounds in Siberia and Norway, or from recollections of hunting parties pushing north from our tropical birth-lands, and getting trapped and stormbound by the advance of the strange giant, Winter, certain it is that our subconsciousness is full of ancestral memories which send a shiver through our very marrow at the mere mention of "cold" or "sleet" or "wintry blasts."

From the earliest dawn of legend cold has always been ranked, with hunger and pestilence and storm, as one of the demons to be dreaded and fought. And, at a little later date, the ancient songs and sayings of every people have been full of quaint warnings against the danger of a chill, a draft, wet feet, or damp sheets. There is, of course, a bitterly substantial basis for this feeling, as the dozens of stiffened forms whose only winding-sheet was the curling snowdrift, or whose coffin the frozen sleet, bear ghastly witness. It was, however, long ago discovered that when we were properly fed and clothed, the Cold Demon could be absolutely defied, even in a tiny hut made out of pressed snow and warmed by a smoky seal-blubber lamp; that the Storm King could be baffled just by burrowing into his own snowdrifts and curling up under the crust, like an Eskimo dog. Hence, nearly all the legends depict the hero as finally conquering the Storm King, like Shingebis in the Song of Hiawatha.

The ancient terror, however, still clings, with a hold the more tenacious as it becomes narrowed, to one large group of these calamities believed to be produced by cold,--namely, those diseases supposed to be caused by exposure to the weather. Even here, it still has a considerable basis in fact; but the general trend of opinion among thoughtful physicians is that this basis is much narrower than was at one time supposed, and is becoming still more restricted with the progress of scientific knowledge. For instance, fifty years ago, popular opinion, and even the majority of medical belief, was that consumption and all of its attendant miseries were chiefly due to exposure to cold.

Now we know that, on the contrary, abundance of pure, fresh, cold air is the best cure for the disease, and foul air and overcrowding its chief cause. An almost equally complete about-face has been executed in regard to pneumonia. Prolonged and excessive exposure to cold may be the match that fires the mine, but we are absolutely certain that two other things are necessary, namely, the presence of the diplococcus, and a lowered and somewhat vitiated state of bodily resistance, due to age, overwork, underfeeding, or over-indulgence in alcohol.

Not only do these two diseases not occur in the land of perpetual cold, the frozen North, except where they are introduced by civilized visitors,--and scarce a single death from pneumonia has ever yet occurred in the crew of an Arctic expedition,--but it has actually been proposed to fit up a ship for a summer trip through the Arctic regions, as a floating sanatorium for consumptives, on account of the purity of the air and the brilliancy of the sunlight.

There is one realm, however, where the swing of this ancient superst.i.tion vibrates with fullest intensity, and that is in those diseases which, as their name implies, are still believed to be due to exposure to a lowered temperature--"common colds." Here again it has a certain amount of rational basis, but this is growing less and less every day. The present att.i.tude of thoughtful physicians may be graphically indicated by the flippant inquiry of the riddle-maker, "When is a cold not a cold?" and the answer, "Two-thirds of the time." This much we are certain of already: that the majority of so-called "colds"

have little or nothing to do with exposure to a low temperature, that they are entirely misnamed, and that a better term for them would be _fouls_. In fact, this proportion can be clearly and definitely proved and traced as infections spreading from one victim to another. The best place to catch them is not out-of-doors, or even in drafty hallways, but in close, stuffy, infected hotel bedrooms, sleeping-cars, churches, and theatres.

Two arguments in reb.u.t.tal will at once be brought forward, both apparently conclusive. One is that colds are vastly more frequent in winter, and the other that when you sit in a draft until you feel chilly, you inevitably have a cold afterward. Both these arguments alike, however, are based upon a misunderstanding. The frequency of colds in winter is chiefly due to the fact that, at this time of the year, we crowd into houses and rooms, shutting the doors and windows in order to keep warm, and thus provide a ready-made hothouse for the cultivation and transmission from one to another of the influenza and other bacilli. As the brilliant young English pulmonary expert, Dr.

Leonard Williams, puts it, "a constant succession of colds implies a mode of life in which all aerial microbes are afforded abundant opportunities." At the same time, we take less exercise and sit far less in the open air, thus lowering our general vigor and resisting power and making us more susceptible to attack. Those who live out-of-doors winter and summer, and who ventilate their houses properly, even in cold weather, suffer comparatively little more from colds in the winter-time than they do in summer; although, of course, the most vigorous individual, in the best ventilated surroundings, will occasionally succ.u.mb to some particularly virulent infection.

The second fact of experience, catching cold after sitting in a draft or a chilly room until you begin to cough or sneeze, is one to which a majority of us would be willing to testify personally, and yet it is based upon something little better than an illusion. It is a well-known peculiarity of many fevers and infections to begin with a chill. The patient complains of shiverings up and down his spine, his fingernails and his lips become blue, in extreme cases his teeth chatter, and his limbs begin to twitch and shake, and he ends up in a typical ague fit.

The best known, because most striking, ill.u.s.tration is malaria, or fever and ague, "chills and fever," as it is variously termed. But this form of attack, milder and much slighter in degree, may occur in almost every known infection, such as pneumonia, typhoid, tuberculosis, scarlet fever, measles, and influenza. It has nothing whatever to do with either external or internal temperature; for if you slip a fever-thermometer under your chilling patient's tongue, it will usually register anywhere from 102 to 105.

This method of attack is especially common, not only in influenza, but also in all the other so-called "common colds." In fact, when we begin to shiver and sneeze and hunt around for an imaginary draft or lowering of the temperature which has caused it, we are actually in the first stage of the development of an infection which was contracted hours, or even days, before.

When you begin to shiver and sneeze and run at the eyes you are not "catching" cold; you have already caught it long before, and it is beginning to break out on you. Mere exposure to cold will never cause sneezing. It takes a definite irritation of the nasal mucous membrane, by gas or dust from without, or toxins from within, to produce a sneeze.

As to mere exposure to cold weather and wet and storm being able to produce it, it is the almost unanimous testimony of Arctic explorers that, during their sojourn of from two to three years in the frozen North, they never had so much as a sneeze or a sore throat, even though frequently sheltered in extemporized huts, and running short of adequate food-supply before spring. Within a week of their return to civilization they would begin sneezing and coughing, and catch furious colds.

Lumbermen, trappers, hunters, and prospectors in Alaska give similar testimony. I have talked with scores of these pioneers, visiting them, in fact, in their camps under conditions of wet, cold, and exposure that would have made one afraid of either pneumonia or rheumatism before morning, and found that, so long as they remained up in the mountains or out in the snow, and no case of influenza, sore throat, or cold happened to be brought into the camp, they would be entirely free from coughs and colds; but that, upon returning to civilization and sleeping in the stuffy room of a rude frontier hotel, they would frequently catch cold within three days.

One unusually intelligent foreman of a lumber camp in Oregon told me that an experience of this kind had occurred to him three different times that he could distinctly recollect.

It is difficult to catch a cold or pneumonia unless the bacilli are there to be caught. Boswell has embalmed for us, in the amber of his matchless biography, the fact that it had been noted, even in those days, that the inhabitants of one of the Faroe Islands never had colds in the head except on the rare occasions when a ship would touch there--usually not oftener than once a year. Then, within a week, half the population would be blowing and sneezing. The great Samuel commented upon the fact at length, and advanced the ingenious explanation that, as the harbor was so difficult of entry, the ships could beat in only when the wind was in a certain quarter, and that quarter was the nor'east.

_Hinc illae lacrimae!_ (Hence these weeps!) The colds were caused by the northeast wind of unsavory reputation! How often the wind got into the northeast without bringing a ship or colds he apparently did not speculate.

To come nearer yet, did you ever catch cold when camping out? I have waked in the morning with the snow drifting across the back of my neck, been wet to the skin all day, and gone to bed in my wet clothes, and slept myself dry; and have lain out all day in a November gale, in a hollow scooped in the half-frozen ground of the duck-marsh, and felt never a hair the worse. Scores of similar experiences will rise up in the minds of every camper, hunter, or fisherman. You _may_ catch cold during the first day or two out, before you have got the foul city air, with its dust and bacteria, out of your lungs and throat, but even this rarely happens.

How seldom one catches cold from swimming, no matter how cold the water; or from boating, or fishing,--even without the standard prophylactic; or from picnicking, or anything that is done during a day in the open air.

So much for the negative side of the evidence, that colds are not often caught where infectious materials are absent. Now for the positive side.

First of all, that typical cold of colds, influenza, or the grip, is now unanimously admitted by authorities to be a pure infection, due to a definite germ (the _bacillus influenzae_ of Pfeiffer) and one of the most contagious diseases known. Each of the great epidemics of it--1830-33, 1836-37, 1847-48, and, of most vivid and unblessed memory, 1889-90--can be traced in its stately march completely across the civilized world, beginning, as do nearly all our world-epidemics,--cholera, plague, influenza, etc.,--in China, and spreading, _via_ India or Turkestan, to Russia, Berlin, London, New York, Chicago. Moreover, its rate of progress is precisely that of the means of travel: camel-train, post-chaise, railway, as the case may be. The earlier epidemics took two years to spread from Eastern Russia to New York; the later ones, forty to sixty days. Soon it will beat Jules Verne or George Francis Train. So intensely "catching" is it, that letters written by sufferers have been known to infect the correspondents who received them in a distant town, and become the starting-point of a local epidemic.

Of course, it may be urged that when we have proved the grip to be a definite infection, we have taken it out of the cla.s.s of "colds"

altogether, and that its bacterial origin proves nothing in regard to the rest. But a rather interesting state of affairs developed during the search for the true bacillus of influenza: this was that a dozen other bacilli and cocci were discovered, each of which seemed capable of causing all the symptoms of the _grip_, though in milder form. So that the view of the majority of pathologists now is that these "influenzoid," or "grip-like" attacks, under which come a majority of all _common colds_, are probably due to a number of different milder micro-organisms.

The next fact in favor of the infectious character of a cold is that it begins with a chill, followed with a fever, runs a definite self-limited course, and, barring complications, gets well of itself in a certain time, just like the measles, scarlet fever, pneumonia, or any other frank infection.

Colds are also followed by inflammations, or toxic attacks in other organs of the body, lungs, stomach, bowels, heart, kidneys, nerves, etc., just like diphtheria, scarlet fever, or typhoid, only, of course, of milder form and less frequently.

Last, but not least practically convincing, colds may be traced from one victim to another, may "run through" households, schools, factories, may occur after attending church or theatre, may be checked by isolating the sufferers; and are now most effectually treated by the inhalation of non-poisonous germicidal or antiseptic vapors and sprays.

One of my first experiences with this last method occurred in a most unexpected field. An old friend, a most interesting and intelligent German, was the proprietor of a wild-animal depot, importing foreign animals and birds and selling them to the zoological gardens and circuses. I used often to drop in there to see if he had anything new, and he would come up to see me, to tell me his troubles and keep my dissecting-table supplied with interestingly diseased dead beasts and birds.

One day he came up in a state of great excitement, with a very dead and dilapidated parrot in his hand.

"Choost look, Dogdor; here's one of dose measley new pollies I G.o.d in from Zingapore. De rest iss coffin' an' sneezin' to plow dere peaks off, an' all de utter caitches iss kitchen him."

As parrots are worth from fifteen to thirty dollars apiece, "green" (not in color, but training), and he had fifty or sixty in the store, the situation was distinctly serious. Now, I was no specialist in the peculiar diseases of parrots, but something had to be done, and, with a boldness born of long practice, I drew my bow at a venture and let fly this suggestion:--

"Try formalin; it's pretty fierce on the eyes and nose, but it won't kill 'em; and, if you put a teaspoonful in the bottom of each cage, by the time it evaporates no germ that gets into that cage will live long enough to do any harm."

Five days later back he came, red-eyed but triumphant. "Dogdor, dot vormaleen iss de pest shtuff I effer saw. It mos' shteenk me out of de shtore, an' de pollies nearly sneeze dere fedders off, but it shtopt de spret, an' _it's cureenall de seek ones_, an' I het a cold in de het, _an' it's curt me_."

Before using it he had fourteen cases and three deaths; after, only three new cases and no more deaths. I would, however, hardly advise any human "coldie" to try such heroic treatment offhand, for the pungency and painfulness of formalin vapor is something ferocious, though the French physicians, with characteristic courage, are making extensive use of it for this purpose, with excellent results under careful supervision.

Another curious straw pointing in the direction of the infectious nature of colds is the "annual cold," or "yearly sore throat," from which many of us suffer. When we have had it we usually feel fairly safe from colds for some months at least, often for a year. The only explanation that seems in the least to explain is that colds, like other infections, confer an immunity against another attack; only, unlike scarlet fever, measles, smallpox, etc., this immunity, instead of for life, is only for six months or a year. This immunity is due to the formation in the blood of protective substances known as _anti-bodies_, which destroy or render harmless the invading germs. Flabby, under-ventilated individuals, who are always "catching cold," have such weak resisting powers that they form hardly enough anti-bodies to terminate the first attack, without having enough left to protect them from another for more than a few weeks or months. Dr. Leonard Williams describes chronic cold-catchers as "people who wear flannel next their skins, ... who know they are in a draft because it makes them sneeze; who, in short, live thoroughly unwholesome, coddling lives." Strong and vigorous individuals may form enough to last them a year, or even two years.

Now comes the question, "What are we going to do about it?" Obviously, we cannot "go gunning" for these countless billions of germs, of fifteen or twenty different species. Nor can we quarantine every one who has a cold. Fortunately, no such radical methods are necessary. All we have to do is to take nature's hint of the anti-bodies and improve upon it. Healthy cells can grow fat on a diet of such germs, and, if we keep ourselves vigorous, clean, and well ventilated, we can practically defy the "cold" devil and all his works.

Here is the _leitmotif_ of the whole fascinating drama of infection and immunity. We can study only one phrasing here. We shall, of course, catch cold occasionally, but will throw it off quickly, and probably form anti-bodies enough to last us a year or more. How can this be done?

First and foremost, by living and sleeping as much as possible in the open air. This helps in several different ways. First, by increasing the vigor and resisting power of our bodies; second, by helping to burn up, clean, and rid our tissues of waste products which are poisons if retained; third, by greatly reducing the risks of infection.

You can't catch cold by sitting in a field exposed to the draft from an open gate; though I understand that casuists of the old school of the "chill-and-damp" theory of colds are still discussing the case of the patient who "caught his death o' cold" by having his gruel served in a damp basin.

The first thing to do is to get the outdoor habit. This takes time to acquire, but, once formed, you wouldn't exchange it for anything else on earth. The next thing is to learn to sit or sleep in a gentle current of air all the time you are indoors. You ought to feel uncomfortable unless you can feel air blowing across your face night and day. Then you are reasonably sure it is fresh, and it is the only way to be sure of it.

But drafts are so dangerous! As the old rhyme runs,

But when a draft blows through a hole, Make your will and mend your soul.

Pure superst.i.tion! It just shows what's in a name. Call it a gentle breeze, or a current of fresh air, and no one is afraid of it. Call it a "draft," and up go hands and eyebrows in horror at once. One of our highest authorities on diseases of the lungs, Dr. Norman Bridge, has well dubbed it "The Draft Fetich." It is a fetich, and as murderous as Moloch. The draft is a friend instead of an enemy. What converted most of us to a belief in the beneficence of drafts was the open-air treatment of consumption! Hardly could there have been a more spectacular proof, a more dramatic defiance of the bogey. To make a poor, wasted, shivering consumptive, in a hectic one hour and a drenching sweat the next, lie out exposed to the November weather all day and sleep in a ten-knot gale at night! It looked little short of murder! So much so to some of us, that we decided to test it on ourselves before risking our patients.

I can still vividly recall the astonishment with which I woke one frosty December morning, after sleeping all night in a breeze across my head that literally made

Each particular hair to stand on end, Like quills upon the fretful porcupine,

not only without the sign of a sniffle, but feeling as if I'd been made new while I slept.

Then we tried it in fear and trembling on our patients, and the delight of seeing the magic it worked! That is an old story now, but it has never lost its charm. To see the cough which has defied "dopes" and syrups and cough mixtures, domestic, patent, and professional, for months, subside and disappear in from three to ten days; the night sweats dry up within a week; the appet.i.te come back; the fever fall; the strength and color return, as from the magic kiss of the free air of the woods, the prairies, the seacoast. There's nothing else quite like it on the green earth. Do you wonder that we become "fresh-air fiends"?

The only thing we dread in these camps is the imported "cold." Dr.

Lawrence Flick was the first to show us the way in this respect as in several others. He put up a big sign at the entrance of White Haven Sanatorium, "No persons suffering from colds allowed to enter," and traced the only epidemic of colds in the sanatorium to the visit of a butcher with the grip. I put up a similar sign at the gate of my Oregon camp, and never had a patient catch cold from tenting out in the snow and "Oregon mists" until the small son of the cook came back from the village school, shivering and sneezing, when seven of the thirteen patients "caught it" within a week.

What will cure a consumptive will surely not kill a healthy man. I am delighted to say that it shows signs of becoming a fad now, and sleeping porches are being put on houses all over the country. No house in California is considered complete without them. The ideal bedroom is a small dressing-room, opening on a wide screened porch, or balcony, with a door wide enough to allow the bed to be rolled inside during storms or in severest weather.

Sleep on a porch, or in a room with windows on two sides wide open, and the average living-room or office begins to feel stuffy and "smothery"

at once. Apply the same treatment here. Learn to sit in a gentle draft, and you'll avoid two-thirds of your colds and three-fourths of your headaches. It may be necessary in winter to warm the draft, but don't let any patent method of ventilation delude you into keeping your windows shut any hour of the day or night.