Upper respiratory infection or Common Cold - Preventive care and treatment without medications

COMMON COLD

 Actually, some medical authorities would like to ban the common cold from medical terminology. Their preference: upperrespiratory infection (URI). For most of us, under any name, it will remain the same nuisance ailment it always has been. It's now known to be caused by a vast assortment of agents: rhino viruses (some 30 different types); echo- viruses; adenoviruses; coxsackie viruses; influenza and para-influenza viruses; and even by some organisms, called pleuropneumonia-like (PPLO), which aren't viruses at all. It's this great diversity of causative agents that may explain the frequent recurrence of colds in many individuals.

 Usually a cold has a simple life history or scenario which is depicted with some accuracy by the old adage: "Three days coming, three days staying, three days ageing." The symptoms, of course, are well known: nasal stuffiness, watery discharge, sneezing, and redness of the outer soft part of the nose, slight harshness or sometimes frank soreness of the throat.

There may also be general malaise, possibly some headache and muscle soreness, and a sense of feverishness but usually no real fever. 

For the preventively minded physician, a cold is a real challenge. Can it be prevented? This is an especially important matter for patients with lung or heart disease, particularly If there is serious impairment of pulmonary or cardiac reserves. Colds can be more than mere nuisances for patients with severe diabetes and kidney and liver ailments.

Prevention

Prevention of a cold involves maintenance of optimum health. It also requires avoidance of sources of contamination-which means, if feasible, staying away from close contact with infected people at home, at work, in public conveyances. It means, too, if feasible, avoiding crowds during the high cold-incidence months-in the United States, September-October, January-February, and April-May. A person sneezing nearby can be spewing millions of infective agents at you. 

None of this is easy. But research now has established fairly clearly that such factors as chilling and drafts, once considered important, are not really important at all in causing colds. Until an effective vaccine against colds becomes available, avoidance of carriers remains a prime means of prevention.

And difficult as this may be, it can be of special importance for people with the diseases mentioned earlier. They should, at least, discuss the risks with their doctors. Secondary preventive measures, for cold complications, are available. If you have a severe cold accompanied by fever, suggesting that secondary bacterial infection may be setting in, your physician may prescribe an antibiotic to bring the secondary infection under quick control. If, with your cold, you develop severe headache fever the sinus areas, with high fever and purulent discharge from the nose and down into the throat, pointing toward a frank infection of the sinuses, there may be need to get the sinuses draining freely, and your doctor may advise a visit to a nose and throat specialist. 

Similarly, ringing in the ears accompanied by a feeling that the ears are clogged may suggest the start of a middle ear infection. In that case, it may be advisable for an ear specialist to shrink the Eustachian tubes which have become swollen and inflamed because of the cold. Such complications are not very common. Treatment Usually, if you have a heavy cold but are otherwise in good general health, the doctor can make you feel more comfortable and probably can shorten the course of the cold by a few days. He may prescribe a nasal decongestant, which will allow you to breathe more comfortably and will also permit the nasal tissues to fight the cold agents more effectively.

Nose drops-for example, three drops of 0.25 percent Neo-Synephrine in each nostril every two or three hours-can help, especially if prescribed along with an internal medication such as Propadrine, a vasoconstrictor. Anti-histamine may be prescribed-with some reservation, because people vary greatly in response to antihistamines. One of us once tried 16 different anti- histamines for a personal bout of nasal congestion before finding one that relieved symptoms without causing unpleasant side reactions. Also of value: aspirin, two tablets every four hours, and on a regular schedule rather than just when you feel aches or feverish. Buffered forms are suitable, too. 

No medication in a gargle has been found to be directly useful against cold agents. But when the throat is sore, gentle warm gargling does provide some relief and does bring more blood to the throat tissues to help combat the viruses.

A teaspoonful of table salt added to a pint of warm, not hot, water makes a good gargling fluid. People who have serious diseases- of heart, lungs, and liver, for example- which requires them to be under constant treatment should immediately notify their doctor when a cold starts. A preventively minded physician may deem it wise to actually hospitalize some patients for whom a cold might precipitate a severe attack of heart or lung failure.