| "The power and corrigible authority of this lies in our wills." |
| Othello |
It might seem as though the will had nothing to do with such very material ailments as coughs and colds, and yet the more one knows about them, the clearer it becomes that their symptoms can be lessened, their duration shortened, their tendencies to complications modified, and to some extent at least, they can be almost literally thrown off by the will to be well. The idea of a little more than a generation ago that coughs and colds would be most benefited by confinement to the house and as far as possible to a room of an absolutely equable temperature has gradually given way before the success of the open-air treatment for tuberculosis and the meaning of fresh air in the management of pneumonia cases. Fresh, cold air is always beneficial to the lungs, no matter what the conditions present in them, though it requires [{197}] no little courage and will power to face the practical application of that conclusion in many cases. When it is bravely faced, however, the results are most satisfactory, and the respiratory condition, if amenable to therapeutics, is relieved or proceeds to get better. Of course it is well understood that any and every patient who has a rise in temperature, that is whose temperature is above 100° F. in the later afternoon hours, should be in bed. Under no circumstances must a person with any degree of fever move around. This does not mean, however, that such patients should not be subjected to fresh, cold air. The windows in their room or the ward in which they are treated should be open, and if the condition is at all prolonged, arrangements should be made for wheeling their beds out on the balcony or placing them close to a window. The cold air gives them distinctly chilly feelings and sometimes they complain of this, but they must be asked to stand it. Of course if the cold disturbs their circulation, if the feet and hands get cold and the lips blue, the patients are not capable of properly reacting against the cold and must not be subjected to it. Their subjective feelings of chilliness, however, must [{198}] not be sufficient to keep them from the ordeal of cold, fresh air; on the contrary, they must be told of the benefit they will receive from it and asked to exert their wills to stand the discomfort with just as little disturbance as possible.
People suffering from coughs, no matter how severe, should get out into the air regularly, if they have no fever, and should go on with their regular occupation unless that occupation is very confining or is necessarily conducted in dusty air. Keeping to the house only prolongs the affection and makes it much more liable to complications than would otherwise be the case. Sufferers from these affections should not go into crowds, should avoid the theaters and crowded cars, partly for the sake of others—because they can readily convey their affection to them—but also for their own sake, because they are more susceptible to other forms of bacteria than those already implanted in their own systems and they are much more liable to pick up foreign bacteria in crowds than anywhere else. They should be out in the open air, particularly in the sunlight, and this will do more to shorten the course of a cough and cold than anything else.
They need more sleep than before and should be in bed at least ten or eleven hours in the day, though if they should not sleep during all of that time, they need not feel disturbed but may read or knit or do something else that will occupy them while they retain a recumbent position. They should not indulge in long, tiresome walks and in special exertion, but should postpone these until the cough has given definite signs of beginning to remit.
With regard to the cough itself, it must not be forgotten that the action of coughing is for the special purpose of removing material that needs to be cleared from the lungs and the throat and larynx. It should not be indulged in except for that purpose. It requires a special effort, and while the lungs and other respiratory passages are the subject of a cold, these extra efforts should not be demanded of them unless they are absolutely necessary. Almost needless to say, people indulge in a great deal of unnecessary coughing. Some of this is a sort of habit and some of it is due to that tendency to imitate, so common in mankind. Every one has surely heard during religious services, in a pause just after heads have been bowed in prayer or for a [{200}] benediction, a single cough from a distant part of the church which seemed to be almost the signal for a whole battery of coughs that followed immediately from every portion of the edifice. If some one begins coughing during a sermon or discourse, others will almost inevitably follow. Coughing, like yawning, is very liable to imitation.
The famous rule of an old-time German physician was that no one was justified in coughing or scratching the head unless these activities were productive. Unless you get something as the result of the coughing, it should not be indulged in. There are a great many people who cough much more than necessary and who delay the progress of their betterment in that way. Whenever material is present to be coughed up, coughing is not only proper but almost indispensable. It is the imitative cough, the coughs which indicate overconsciousness of one's affection, the coughs that so often almost unconsciously are meant to catch the sympathy of those around, which must be repressed by the will, and when the patient finds that he really has to cough less than he thinks, he will be quite sure that he is getting better and will actually improve as a consequence of this feeling.
Coughs need an abundance of fluid much more than medicine, and warm fluids are better than cold; the will must be exercised so as to secure the taking of these regularly. At least a quart of warm liquid, milk if one is not already overweight, should be taken between meals during the existence of a cough. Hot milk taken at night will very often secure much better rest with ever so much less coughing than would otherwise be the case. The tendency to take cough remedies which lessen the cough by their narcotic effect always does harm. Coughing is a necessary evil in connection with coughs, and whatever suppression there is should be accomplished by means of the will. Remedies that lessen the coughing also lock up the secretions and disturb the system generally and therefore prolong the affection and do the patient harm. Most of the remedies that are supposed to choke off a cough have the same effect. Quinine and whiskey have been very popular in this regard but always do harm rather than good. Their use is a relic of the time when whiskey was employed for almost every form of continued fever and when quinine was supposed to be good for every febrile affection. We know now that quinine has no effect [{202}] except upon malarial fevers, and then only by killing the malarial organism, and that whiskey is a narcotic and not a stimulant and does harm rather than good. Those who did not take the familiar Q. and W. have in recent years had the habit of administering to themselves or to their friends various laxative or anodyne or antiphlogistic remedies that are supposed to abort a cough or cold and above all, prevent complications. All of these remedies do harm. Every single one of them, even if it makes the patient a little more comfortable for the time, produces a condition that prevents the system from throwing off the infection which the cold represents as well and as promptly as it otherwise would.
It requires a good deal of will power to keep from taking the many remedies which friends and sometimes relatives insist on offering us whenever a cold is developing, but the thing to do is to summon the will power and bravely refuse them. Medicine knows no remedies that will abort a cold. The use of brisk purgatives, sometimes to an extent which weakens the patient very much the next day, is simply a relic of the time when every patient was treated with antimony [{203}] or calomel and free purgation was supposed to be almost as much of a cure-all as blood-letting. There is no reason in the world to think that the emptying of food out of the bowels will do any particular good, unless there is some definite indication that the food material present there should be removed because it is producing some deleterious effect.