The Common Cold

by RICHARD GORDON

THE common cold is really a highly popular complaint throughout the temperate regions of the world where it is endemic. It has all the attractions of an illness and none of the disadvantages, for it never kills anyone and always gets better within a fortnight. Meanwhile it acts as a magnet for sympathy in midwinter, when sympathy is needed the most; it grants a week’s leave from the office at a time when holidays are miserably balanced between recollection and anticipation; and as it makes no difference to the prognosis whether treatment is given or not, each cold offers its victims a delightful exercise in self-doctoring.

The English, who take their ailments less sadly than some of their other pleasures, have now passed more than six years of the free National Health Service with their enthusiasm for treating their own colds wholly undiminished. These home cures generally follow one of three distinct courses, and as each reflects the psychology of the sufferer let us examine them in detail. They are: 1) the Fresh-Air Treatment; 2) the Scientific Attack; 3) the Coddle.

The Fresh-Air treatment is practiced only by those large red-faced men in check suits who look you in the eye, slap their chests, and declare they’ve never owned an overcoat or been to a doctor in their lives, as if claiming freedom from original sin. They have a simple attitude to illness: it’s all “ psychological,” from smallpox to fractured femurs. But they are only human, and in time claimed by both death and colds. The first sneeze affects them like a starter’s pistol: they tear off their ties and waistcoats, stamp round the house throwing open the windows, jump into a cold bath, and upset their wives by doing breathing exercises all night in bed. The discomfort in which they wallow for a fortnight makes no difference to the course of the disease, but by rendering their surroundings unfit for human habitation they rarely manage to infect anyone else.

The Scientific sufferer takes a much calmer view of his cold. He is generally a precise, clerkish man, who files the medical articles from the Reader’s Digest and reads the patent-medicine advertisements like a girl looking into a bride-shop window. During the winter he gargles for five minutes with antiseptic night and morning, wears wool next to the skin, and eats sufficient calcium to keep a schoolroom in chalks. As soon as his nose starts to run he calls at the druggist’s and arrives home with his brief case clinking gently with small bottles. He announces to his wife: “Think I’m getting a touch of a cold, m’dear,” as though he were having a baby. He makes for the bathroom and unpacks his bag, which is filled with cough mixtures, fever pills, throat lozenges, nose drops, eye lotions, gargles, and liniments. He sets the bottles carefully on the shelf and works his way through them thoughtfully and solemnly, like a sailor trying out the drinks in a strange port.

This type of invalid follows the directions on the label with scientific precision: if it orders “An eggcupful four-hourly,” he fetches an eggcup; if it says “Rub on the chest till it stings,” he scrapes away until his skin begins to peel, He then has a mustard bath, soaks his feet in salt water, puts on two pairs of flannel pajamas, and goes to bed with The Household Doctor. No physician ever watched the recovery of a wealthy patient more sadly than he notices his own returning health. For, once he has caught his cold, he does not lightly let it go. From October to May he richly justifies the famous mistranslation of voicoi l’anglais avec son sang-froid habituel — here comes the Englishman with his usual bloody cold.

The Coddler is usually a woman, with a far more fuzzy idea of her internal organs than the Scientific sufferer. Since girlhood she has been told that she must Take Care of a Cold or it will turn into Something Else; her life passes in a terror of Germs, which she imagines as small green animals, with red eyes and long teeth, that hide under the dustbin. Before she has blown her nose twice, the Coddler has phoned her husband’s office and all her friends to explain that she has a cold, in the tone of someone announcing that smallpox has just broken out. She then pours herself a large Scotch, lights a fire in her bedroom, piles extra eiderdowns on the bed, shuts the windows, rubs herself all over with camphorated oil, phones out for grapes, calf’s-foot jelly, chicken essence, barley water, Eau de Cologne, and the other prerogatives of illness, shifts the television upstairs, collects all the magazines in the house, and goes to bed. She stays there for a fortnight, her family fetching her egg-and-milk, lightly sprinkled with nutmeg, every other hour.

The interest shown by the English in their colds probably explains why the world’s largest research unit for the disease is to be found at Salisbury, in southern England. This unit works in the Harvard Hospital, which was hopefully set up on the edge of Salisbury Plain by Harvard University at the beginning of the war to study the epidemics expected to sweep across England during the bombing. Although the bombs arrived, the epidemics fortunately did not, and for a long time the chief function of the Harvard Hospital was to entertain visiting British doctors with American rations. It was later taken over by the United States forces, and was presented to the British Medical Research Council and Ministry of Health in 1946.

The hospital has gained much publicity since the common cold investigations began, mainly because the experiments are conducted on human volunteers. The reason for this is simple. It has been known for forty years that a cold can be produced by dropping into the healthy nose bacteriafree filtrates of nose-washings containing virus from people suffering from the disease. Unfortunately, man and the chimpanzee are the only animals known to be susceptible to the infection, and chimpanzees are difficult to come by, expensive to feed, and awkward to keep alive in captivity. It is therefore much simpler and cheaper to use men.

About thirty-six volunteers are taken at the hospital, and kept there for ten days at a time. The only qualifications for entrants are that they must be between 18 and 45, and free from serious illness or conditions like hay fever, asthma, and sinusitis. When the experiments were begun in 1946, the doctors had doubts that sufficient volunteers would step forward year after year to keep the investigations going, but this has been the simplest problem that the unit has had to face. In summer, you now have to book your room at the Harvard Hospital far ahead.

I don’t think the volunteers step through the hospital gate in the spirit of John Hunter or Paul Ehrlich, resigned to suffer disease for the common good: to most of them the research unit offers an unusual chance to exchange a fortnight’s comfortable free board and lodging for the risk of catching a cold. Many of the volunteers are students — particularly medical students — for whom the Harvard Hospital solves vacation problems: it gives them somewhere to live; it provides quiet and solitude for concentration; it keeps them away from cricket grounds, golf courses, pubs, cinemas, girls, and other traditional distractions to academic study; it is the only possible way for an undergraduate to save money, in order to enjoy these distractions more richly in the coming term; they receive three shillings a day wages and free beer.

The hospital itself is one of the untidy nests of badly painted wooden huts that were familiar enough in the English countryside during the war. Each of the hunts has been turned into a house large enough to hold a family. It contains a couple of bedrooms, a sitting room, bathroom, and pantry, but is occupied only by two volunteers — no one can complain of claustrophobia. The food is cooked in a central kitchen, brought in vacuum containers, and left on the doorstep in the traditional style for feeding plague victims. The visitors are provided with a radio and an internal telephone line which supports the social life of the hospital, telephonic chess being the favorite local sport.

Most of the volunteers arrive prepared to stick out ten days playing the prisoner in the Tower, but personal restrictions at Salisbury are slight. They are allowed to wander round the grounds, walk in the surrounding countryside, and use the putting green. The only standing regulation is that volunteers must never approach within thirty feet of anyone else. The printed instructions emphasize this rule to the point of explaining that should some emergency strike a hut during the night, the occupants must ring the alarm bell outside the resident doctor’s quarters and then stand back thirty feet before yelling at him “Fire!” “Thieves!” “ Murder!” or whatever is appropriate.

The volunteers are also provided with a large library. The books must be chosen on arrival and cannot be changed because of the risk of crossinfection — which occasionally leads to misfortunes of the type that overtook a shy young student of English who snatched an armful of volumes entitled, as he thought, The Art of Making Fine Poetry, only to find himself locked in for ten days with exhaustive information on the manufacture of high-grade chinaware.

The reason for the volunteer’s being at Salisbury is recalled each morning by a short visit from the doctor and matron. They arrive in sterile masks and gowns, and for the first two days do no more than ask politely after the health of their guests. This period is reserved for the appearance of any colds picked up en route. On the third day, the doctor drops into the volunteer’s nose a solution made up in the laboratory, which may contain active cold virus or may be an inert control fluid. To make cheating more difficult all round, neither the volunteer nor the doctor knows which solution is which. The volunteer is then given a record sheet similar to a score card, containing a list of symptoms like watering of the eyes, sore throat, nasal obstruction, cough, and headache, and sits back and waits. Usually nothing happens. Even if he has been given the active solution, only about 30 to 50 per cent of these inoculations develop into colds.

Eight years’ work at Salisbury has produced no startling discovery about the common cold, but it has accomplished much creditable steady research, It has also disproved most of the facts about colds that we learned in the nursery, with other scraps of distasteful and inaccurate information like “rice puddings are good for you" and “spinach is full of iron.” Do you remember Mother’s horrified voice when you came in from playing pirates in the pond — “Take those sopping wet socks and shoes off at once! Do you want to catch your death?” — or the beating you got for jumping out of a hot bath and chasing the cat in the garden? And the number of things you were warned that caused colds, from removing your long-sleeved underwear before May 31 to sleeping with the windows open (or shut)? All these complications of childhood have luckily been shown at the Harvard Hospital to be groundless. The common cold is an infective disease like diphtheria or influenza, and you catch it from somebody else on the bus.

The research unit laboratory has now succeeded in growing the cold virus on cultures of human embryonic lung, and shortly it will be possible to study it more conveniently in the laboratory and disband the sturdy army of volunteers. Meanwhile, the common cold continues. The Harvard Hospital still has no suggestions for a cure better than my favorite remedy of a bottle of whisky and a hat, which is both simple and effective. This is how it works: On the first sign of a cold, go to bed with a bottle of whisky and a hat. Place hat on left-hand bedpost. Take a drink of whisky and move hat to right-hand post. Take another drink and shift it back again. Continue until you drink the whisky but fail to move the hat. By then the cold is probably cured.