[Reprinted from The MEDICAL News, November 25, 1893.] 
A COMMON ETIOLOGY IN THE I NFL AM M AT OR Y 
DISEASES OF THE RESPIRATORY 
TRACT. / 
BY EDWIN J. KUH, M.D., 
OF CHICAGO, ILL. / 
While the literature of recent years shows 
sporadic instances in which writers emphasize the 
infectious nature of those inflammatory troubles of 
the nose, throat, and chest commonly ascribed to 
“taking cold,” I am aware that it has not become 
part and parcel of the medical consciousness that 
these diseases are “caught” in a different manner 
than tradition and our grandmothers would have us 
believe. Self-observation (see “ Etiology and Cure 
of Asthma ” in the Journal of the American Medicai 
Association, January 29, 1887) and observation of 
others have taught me that all the muffling and 
clothing in the world would not prevent those sus- 
ceptible to “colds” from “catching” them, if a 
protection of the body-surface were considered a 
sufficient prophylaxis against these affections. It 
cannot of course be doubted that when chronic 
affections of the respiratory tract preexist, exposure 
to rapid changes in temperature per j<?can aggravate 
existing conditions. But the primary affection, it 
seems, is always inhaled. Such circulatory changes as 
must occur in the respiratory tract when the vessels 2 
of the skin contract through “taking cold” are 
evidently a predisposing factor to infection; but 
that is probably all. 
We all know how immune we become against 
“ colds ” in the severest climates and in spite of most 
careless exposure, where the air is pure; and we also 
recognize how susceptible we again become when 
we return to our city home. 
With that cerebral squint, which O. W. Holmes 
has been pleased to dwell upon, we attempt to ex- 
plain affections without exposure, with the words, 
“ I must have taken cold.” 
The surgeon knows that pus implies infection, but 
the throat-specialist and the family doctor have not 
yet yielded to the inevitable and logical analogy 
in their fields of work. Wherever there is pus 
there has likely been infection; there is no rea- 
son why this proposition should not hold good 
for the mucous membranes as well as in other tis 
sues. A typical acute coryza will, as a rule, run its 
course as unalterably as a typhoid fever. The same, 
generally speaking, may be claimed for the acute 
pharyngeal, laryngeal, and bronchial affections. 
In private conversation it has been frequently 
retorted: “The cold is primary, the infection may 
follow as a complication.” This would be an argu- 
ment, if the infection did not constantly occur 
without exposure to cold. The history of the de- 
velopment of our knowledge in regard to pneumonia 
should silence that objection. 
Although this article is not bolstered with bacteri- 
ologic tests, it seems a safe and necessery conclu- 
sion from the point of analogy and observation to 3 
assume that the inflammatory causes of coryza, 
amygdalitis, laryngitis, tracheitis, and bronchitis 
are inhaled. The omnipresence of organic dust, 
laden with bacteria, is the simplest, most constant 
and most forceful agent in the causation of those in- 
flammations. No explanation for the appalling mor- 
tality from pneumonia in our large cities, frequently 
competing in numbers with that from tuberculosis, 
offers so perfect a solution as the theory of the dust- 
origin of that disease. The refuse from those same 
streets and alleys from which we turn in disgust is 
blown into our fashionable thoroughfares and in- 
haled. The utter disregard of these conditions 
makes our public buildings (court-houses, schools, 
theaters, radway stations, office-buildings, large re- 
tail stores, etc.) foci of infection. It is fairly 
gambling with a child’s health and life to send it to 
school where provisions for pure air (in the sense of 
asepticity) are an unheard-of and at present unrealiz- 
able postulate. 
The publication of the discovery of the tubercle- 
bacillus is entering upon its twelfth anniversary; 
and yet how slowly has this most positive knowledge 
in medicine stimulated us as a body of professional 
men to common and legislative prophylaxis. We 
are, it seems, too much interested in individuals and 
not enough in communities. 
The remedy against dust-borne diseases of the re- 
spiratory organs would consist in pavements that do 
not easily pulverize, in honest street-cleaning, and 
in sufficient sprinkling, in rich and poor quarters, 
to prevent the raising of dust.