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.
