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Cold as a Cause of Disease.

In the language of the common people, to "catch cold" is a simple and common accident contingent upon exposure to chill or draught, or to abrupt changes of the temperature. Pathologically it has been passed over, as too common to deserve scientific attention. While the condition was once universally believed to be a cause of local congestion, and subsequent inflammation, it is now the rule to attribute these conditions to germs, overlooking the congestive phenomena induced by cold.

The effect of exposure of the surface of the body to cold, is the induction of a more or less abrupt contraction of the surface capillaries, producing a temporary anemia of the skin, general or local. Two results follow this, both pathological. The first is the suppression of the excretion of the glands of the skin, and the second is the occurrence of an engorgement—a congestion-in some organ beneath the skin or deeper, without the essential reaction.

There is thus a disturbance in the equilibrium of the circulation proper. When one part of the body is emptied of blood, the' blood remaining, in the circulation is necessarily forced into another organ or part. If the proper reaction takes place this local engorgement is only temporary, the tendency being strongly towards the reestablishment of a natural equilibrium.

If from any reason any organ or part has not at that time its normal tone-its normal resisting power-the engorgement will cause irritation, the congestion will quickly assume an acute, active form, destruction of tissue takes place, the local and general heat are increased, and the result is an acute inflammation. This is a natural consequence. It is the same with any organ in the body. The probabilities are that at no distant time public opinion will be that those characteristic pathological germs which in many cases are claimed to be the cause of disease will be thought to exist not as the cause, but as the result of a disease under the circumstances described.

The local congestion induced, and the retention of toxic excretory products, are both to be contended with in the treatment of a patient for cold.

Heat is the direct antagonist of cold, and to the conditions induced by it. Heat stimulates the glands of the skin immediately, causes relaxation and promotes excretion. Heat stimulates the capillary circulation in the deeper organs, producing dilation to permit of a free outflow of blood. It stimulates the blood to pass through both the venous and arterial capillaries and to carry with it what broken down tissue up to that time has accumulated, and to bring in the oxygenized principle through the arterial capillaries, which will restore the broken down structures. Cold on the other hand, while preventing the accumulation of abnormal heat to a degree for the time being, only increases the congestion more and more, and locks up the morbific material in the diseased parts.

Rationally and physiologically the application of heat, and the determination of the active free hyperemia in the presence of heat, is necessary to the complete restoration of an inflamed organ, and to the re-establishment of the normal general equilibrium in the circulation. This theory is directly opposed to the continued application of cold, which is so commonly advocated. Bier, a German investigator, has recently brought out his theory for curing chronic local disease, by inducing hyperemia, and because the theory was "made in Germany" the profession are flocking to it in a perfect stampede. It amounts to nothing more than the proper application of heat with constriction in some cases, and the entire rejection of persistent cold application. It confirms the opinion I have stuck to, in the face of violent opposition, for years. I have developed the essential facts of the Bier theory in the editorial which follows this.

Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.

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