CONTENTS. LXVII. A Cold, its Nature, Conditions, Results, and Treatment, LXVIII. Catarrho-Malarial Fever, LXIX. Auscultation in Laryngeal Diseases, LXX. Addison's Disease, with a Clinical Case, LXVII. A COLD, ITS NATURE, CONDITIONS, RESULTS, AND TREATMENT. BY B. F. DAKE, M.D., PITTSBURG, PA. In the discussion of this subject I propose to separate it into several convenient divisions, viz.: First, its mechanical and physical, or what we might term, its philosophical consideration; second, its physiological third, its pathological; and fourth, its therapeutical. Philosophically considered, a cold, in its primary form, is but a mechanical condition, resulting from the ordinary application of material and physical forces. The disturbed condition of the harmony and normal operations of vital forces and functional activities consequent to this intrusion upon the unity of vital action, constitutes the substance of our second division, the physiological; while the resultant outgrowth and conditions, morbid changes, etc., induced by this disturbed functional action, presents the pathological aspect of the case. And the modifications of these morbid conditions and restoration of functional activities back to the normal condition, constitutes the therapeutical consideration of the subject. Hence, it will be seen, that what is so tritely called "only a cold" is, when taken in all its relations, a matter of much significance. In a state of absolute health, we have all the functions of the system performed according to uniform laws of physical and vital action. Any departure from this normal operation constitutes the first condition of morbid action, or disease. Health, then, is a normal condition of the vital functions and forces of the system. Any departure therefrom constitutes disease. Primarily, a cold may be considered as a non-vital (abstract) physical condition-the loss of heat, and the consequent and inevitable contraction of matter, obedient to this universal law. Now, in this primary stage, there is no impression made upon the functions of the system, and if this force be at once withdrawn, the system reacts, as we say, and all goes on well again; it is but the ebb and flow, without any change in the current directions, and there is no morbid action; it might have acted upon inorganic and unvitalized matter the same; it is but a physical condition, non-vital. But let us proceed a step further. In a normal condition of the vital forces the oxidizing processes of the circulation bring to the superficial capillaries of the system all the fulness of the arterial blood. Here, at the skin, certain elements which it possesses in ordinary excess, and of which it is the duty of the sudoriferous ducts to dispossess the system, are thrown off in what is known as insensible perspiration. Any influence which tends to disturb the ordinary conditions of vital and functional action, will produce, if continued, disease in some form. A contraction of these capillaries of the skin, thereby shutting off a free and full supply of the circulating fluid at any point, is one means of accomplishing this result, and hence a source of disease. Now, if any considerable amount of surface be exposed to the unusual and prolonged action of cold from without, this condition is fulfilled; the capillaries contract, and the blood being with its heat-bearing, oxidizing influences unable to come to the surface capillaries, the skin cools down, and there follows a check of this insensible transpiration. Here commences the physiological conditions-the first disturbance of the functional activities. Now, the superabounding elements of the circulation, no longer able to find a wonted exit through these sudoriferous ducts and the skin, are thrown back upon the circulatory system, with all the redundancy and irritative elements of intended excretion, and there is a fulness and oppression experienced, that at once gives the evidence of malaise and approaching vital depression, only relieved, and that in part, as nature in her ever conservative efforts attempts to compensate for this departure in functional |