The longer a physician is in the practice of medicine the less he tries to abort infectious diseases, and coughs and colds are, of course, just infections. They must run their course, and the one thing essential is to put the patient in as good condition as possible so that his resistive vitality will enable him to throw off the infection as quickly as possible. It requires a good deal of exercise of will power on the part of the physician to keep from running after the many will-o'-the-wisps of treatment that are supposed to be so effective in shortening the course of disease, but any physician who looks back at the end of twenty years will know that his patients have reason to be thankful to him just in proportion as he has avoided running after the fads and fancies of current medicine and conservatively tried to treat his patients rather than cure their diseases. The patient is ever so much [{204}] more important than his disease, no matter what the disease may be.
Above all, for the cure and prevention of coughs and colds people must not be afraid of cold, fresh air. A good many seem to fear that any exposure to cold air while one has a cough may bring about pneumonia or some other serious complication. It must not be forgotten, however, that the pneumonia months in the year occur in the fall and the spring, October and November and March and April producing most deaths from the disease, and not December, January and February. The large city in this country which may be said to have the fewest deaths from pneumonia is Montreal, where the temperature during December and January is often almost continuously below zero for weeks at a time and where there is snow on the ground for three or four months in succession. The highest death rate from pneumonia is to be found in some of our southern cities which have rather mild winters and rather equable temperature,—that is, no considerable variation in the daily temperature range. Cold air is bracing and tonic for the lungs and enables them to resist the microbe of pneumonia, and it is now recognized [{205}] by physicians that personal immunity is a much more important factor in the prevention of the disease than anything else.
Coughs and colds and bronchitis and pneumonia, the respiratory diseases generally, are much less frequent in very cold climates than in variable regions. Arctic explorers are but rarely troubled by them, even though they may be exposed to extremely low temperatures for months. Men subjected to blizzards at thirty and forty degrees below zero may have fingers and toes frozen but do not have respiratory affections. Some years ago, it was noted that one of these Arctic expeditions had spent nearly two years within the Arctic Circle without suffering from bronchial or throat disease and within a month after their return in the spring most of them had had colds. Nansen and his men actually returned from the Arctic regions where they had been in excellent health during two severe winters to be confined to their beds with grippy colds within a week of their restoration to civilization, with its warm comfortable homes and that absolute absence of chill which is connected in so many people's minds with the thought of coughs and colds.
The principal reason why colds are so [{206}] frequent in the winter time in our cities and that pneumonia has increased so much is mainly because people are afraid of standing a little cold. Office buildings are now heated up to seventy degrees to make the personnel absolutely comfortable even on the coldest days, and as a consequence the air is so dry that it is more arid—that is more lacking in water vapor, as the United States Public Health Service pointed out—than Death Valley, Arizona, in summer. People dress too warmly, anticipating wintry days and often getting milder weather and thus making themselves susceptible to chilling because the skin is so warm that the blood is attracted to the surface. Will power to stand cold, even though at a little cost of discomfort, is the best preventive of coughs and colds and their complications and the best remedy for them, once the acute febrile stage has passed.
CHAPTER XIV
NEUROTIC ASTHMA AND THE WILL
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"Great minds of partial indulgence To their benumbed wills." |
| Troilus and Cressida |
In closing a clinical lecture on bronchial asthma at the University of Marburg some years ago, Professor Friedrich Müller, who afterwards became professor at Berlin, said, "Each asthmatic patient is a problem by himself and must be studied as such; meantime, it must not be forgotten what an important rôle suggestion plays in the treatment of the disease." This represents very probably the reason why so many remedies have been recommended for asthma and have proved very successful in the hands of their inventors or discoverers as regards the first certain number of patients who use them, and yet on subsequent investigation have turned out to be of no special therapeutic value and sometimes indeed to have no physical effect of any significance.
Of course this is said with regard to neurotic asthma only, and must not be applied too particularly to other forms of the affection, though there is no doubt at all that the symptoms of even the most severe cases of organic asthma can be very much modified and often very favorably, by suggestive methods.