"Colds" have truly been called a product of modern civilization. The trouble was rare among the aborigines and is more common among the cultured than among the laboring classes. If we make a plant an exotic, we must keep it in the conservatory, and even here it is not free from danger. On the other hand, if we wish to harden it and make it proof against atmospheric and climatic changes, we must prepare it by judicious exposure for these conditions. The warm clothing which is thought to be a protection against cold is frequently the most fertile cause. It relaxes the body, moistens the skin, and the perspiration which is induced especially prepares the unresisting body for its attacks. This applies especially to warm covering around the neck, to which the air has periodic access. Except in unusually severe weather, the throat requires no more covering or protection than the face.
The method of having only two systems of underclothing, the heavy to be worn until it is quite warm, and vice versa, is also a source of danger. There should be three changes: one of the lightest texture for the warm weather of summer, a medium for spring and fall, and the pure wool for winter, which in this climate need not be very heavy. Waterproof shoes, rubbers, furs, etc., are not recommended for customary use, and should be worn only when absolutely indicated.
The best preventive of recurrent colds is the judicious use of the sponge or cold shower bath. The ordinary bath should usually be of a temperature not disagreeable to the body, but after the question of cleanliness has been attended to, an application, either by means of a sponge or shower, of ordinary cold water should be made. This should be of short duration, and friction with a coarse towel follow at once. When properly conducted, a reaction sets in so that there is no danger from this, and the toning effect of the method is of the utmost value in the prevention of colds. This applies, of course, only to persons in ordinarily good health. Even in these cases there are rare occasions in which this method is not advisable, and it may on general principles be stated that it should not be used by persons who do not react promptly. As stated, however, the application of cold water should be only momentary. The daily application of cold water to the throat and chest is also a useful practice for strengthening these parts.
In addition to these means there are certain injurious conditions that it would be well to avoid. One almost universally present in large cities is that of dust. The constant inhalation of the small particles of sand and of organic impurities of which dust is composed has an irritating effect on the delicate lining of the nose and throat, which may develop a chronic inflammation, resulting in injury to both the throat and ear. This evil, however, can be prevented by the artificial watering of our streets.
Excessive tobacco smoking produces injurious effects in the nose and throat. Of all forms of smoking, the cigarette is the most injurious, and allowing the smoke to pass through the nostrils the most dangerous. Occasionally ladies inhale the smoke of a closed room where the male members of the household are smoking, and this is injurious to a delicate throat.
Loud and excessive talking is sometimes a factor in throat diseases. The former is more apt to be exercised in transit in our steam or electric cars, and members of the theatrical profession realize this so well that they rarely use their voice while traveling. In excessive talking, in addition to the mechanical wear and tear of the throat, the respiration is usually spasmodic, a combination that is likely to lead to evil results. At puberty, when the voices of boys and girls are changing, the former sometimes almost an octave and the latter usually a note or two, special care should be taken of the voice, and singing or vocal exercises should be discontinued until the change has been finally established.
The effect of singing on the throat is of much interest, but it is one of such an extensive character that it can be only casually referred to here. The exercise required in singing improves the healthy throat in the same manner that exercise benefits the body in general. The diseased throat, however, may be injured by this practice, as no form of vocal culture can remedy a mechanical interference in its action. The method of singing is also of the utmost importance; an erroneous one may not only injure a promising voice, but may also have a bad effect on a normal throat. The subject of register requires careful consideration. The placing of the voice in the wrong register is fruitful of evil; the ambition of the singer to reach a few notes higher or lower than her range may also work severe injury to the throat.
The throat may be improved or strengthened by any of the forms of exercise, especially the out-of-door, which have been advised for the health in general. In addition to this, breathing exercises are of special value. These consist of taking deep inhalations through the nose, holding the breath for a few seconds and then gently expiring it, the body in the meanwhile being free from all restraint from tight clothing. The practice of this exercise for five minutes mornings and evenings will have a remarkable effect in developing the chest and throat.
In order to anticipate serious complications, children should be taught to allow their mothers to examine their throats freely and without resistance. I feel especially the importance of this subject, as I have frequently seen children almost sacrificed on account of the nervous dread of having their throats examined, or by their inability to control themselves. The method is exceedingly simple: the child is placed facing a bright window, and the handle of a spoon placed on the tongue and so depressed that the posterior part of the throat can be distinctly seen. At first this may be difficult, but the child soon becomes accustomed to the manipulation and the throat may then be examined without difficulty. Another advantage of this procedure is that the mother becomes familiar with the normal appearance of the throat, and can easily note any change due to disease.
In view of the important function of the nose in warming, cleaning, and moistening the inspired air, the greatest care should be taken to teach children to breathe through the nostrils. When only a portion of the air enters through the mouth, the irritation is not as marked as when all the air is inhaled in this manner, but it nevertheless develops a condition of chronic irritation which is easily recognized by one familiar with its appearance, and which may lead to important complications. In many cases, mouth breathing is not due to habit, but to some obstruction in the nostrils or throat. These cases form a proper subject for the consideration of the physician. After the removal of any existing obstruction, children will sometimes, from force of habit, continue to breathe through the mouth, but this can usually be overcome by attention and firmness on the part of the parents.