Catarrh

Catarrh (from the Greek words hata, down, and rheo, to flow) is a term applied to an inflammation of mucous membranes, acccompanied by a running or discharge. Thus it is common to speak of nasal, pharyngeal, laryngeal, bronchial, gastric, intestinal, and vesical catarrhs. The word catarrh is, however, used in a more special sense to denote an inflammation affecting primarily the mucous membrane of the nasal cavities; this mucous surface is particularly exposed to sudden changes of temperature, and few persons pass through a winter in temperate climates without suffering from nasal catarrh, which thus comes to be spoken of as catarrh par excellence. Inasmuch, however, as nasal catarrh has a special designation allotted to it, viz. coryza, it seems inadvisable to limit the application of the word catarrh in this way. An important exciting cause of catarrhal inflammation is cold, either applied directly to the mucous surface involved, or resulting from exposure of the body generally to cold and damp, the effects of the "chill" manifesting themselves in one or other mucous surface. When once the tendency to catarrhal inflammation is set up in a particular mucous membrane, that part of the body is especially apt to become affected as the result of exposure. Thus in one person a cold "flies to the head," producing the ordinary nasal catarrh or coryza; in another person bronchitis results; in another laryngitis, and so on. In some cases the intestinal tract even may be affected by catarrh as the result of a chill.

The course of a catarrhal inflammation can be accurately studied in the Schneiderian membrane (as the mucous membrane of the nasal cavities is called) from its accessibility to inspection. In coryza or catarrh of this membrane there is seen to be redness and swelling. The nose feels stuffed up, not in the initial stage from excessive secretion, for the mucous surface is abnormally dry, but from mere tumefaction of the mucous lining; the contact of cool air or of any irritant readily provokes sneezing, showing the increased irritability of the inflamed and tender surface; there is a slight rise in the temperature of the body, accompanied by a feeling of chilliness, or by actual rigors, and the pulse is quickened. The dry swollen mucous membrane then commences to secrete an irritating fluid, at first thin and watery, then becoming viscid and yellowish; in other words the initial "serous" discharge subsequently takes on a "muco-purulent" or "purulent" character. The catarrh is seldom limited to the Schneiderian membrane, it often extends to the frontal sinuses, giving rise to a sense of weight and oppression over the eyes; or it passes along the lachrymal sac to the conjunctiva, causing conjunctivitis with the coursing of tears down the cheeks; or it may involve the pharynx, or be followed by an attack of bronchitis.

The majority of cases of simple nasal catarrh run their course in two or three days' time, and the particular plan of treatment the patient happens to have adopted is, of course, credited with the cure of the disease. Hence the multitude of infallible specifics for a cold in the head. It is possible that a catarrh may be checked in suitable cases at the outset by promptly enforcing retirement to bed and inducing perspiration by administering some diaphoretic drug. Such cases are certainly few and far between. Much can be done, however, in the way of placing the patient under the most favourable conditions for facilitating the natural process of recovery. The very fact of catching cold implies that the general health is not what it should be, and trivial as the complaint usually is, it is most desirable that every effort should be made to prevent a simple malady from being converted into a serious one by mismanagement and neglect. Confinement to the house should be the first condition of treatment, and in most cases the patient had best go to bed. Diet should be light in the initial stages, but as soon as the appetite begins to return, good feeding will help to hasten recovery. If the cold is not better after two or three days of such treatment, medical advice should be procured. The worst feature of the infallible cures is that they lead to the neglect of ordinary precautions. People are naturally unwilling to lie up, and yet they feel that they ought to do something, so they go through the day's work in the ordinary way, and take from time to time a sip of something or other to soothe their consciences. This is a mistake; if a cold is worth treating at all, it is worth lying up for, and if a man succeeds in rapidly throwing off a cold without giving up his ordinary work, it redounds to the credit of his constitution rather than to that of some vaunted specific. The plan of starving a cold and that of reducing liquids to a minimum in the hope of cutting short the discharge are both unpleasant forms of treatment, and it is very doubtful whether they ever do good. Certainly in all but the mildest forms of catarrh they are productive of harm.