An Epidemiological Contribution to the Knowledge of the Respiratory Diseases

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Abstract
The results of an inquiry into colds and slight influenza—held by me with the obliging collaboration of 7000 informants in the Netherlands from September 1925 till June 1926—do not contradict the hypothesis propounded in the introduction, that various respiratory diseases depend upon a disturbance in the thermo-regulation, in consequence of which the body becomes receptive to commensal infection.In the first place a proportionally equal number of colds was reported at the same time from the various parts of the country during the period of observation, while the increase and the decrease of these colds ran parallel to the falling and rising of the temperature of the air. Further, when calculating the figures from large and from small families, it was proved that the members of small families have no lesser chance of infection than the members of large families.This joint result tells against the contagiousness of colds in the period of observation.The outbreak in September stood alone; the preceding period had not been marked by a low average temperature but by a series of cold nights. During the following month the occurrence of colds was accompanied by the mortality from old age and by the joint mortality from bronchitis and pneumonia.An increased mortality from pneumonia in March–April, linked up with a moderate lowering of the temperature of the air, was not accompanied by “old-age mortality” and only moderately by “colds” it went together however with an increased mortality from influenza. The influenza cases of the inquiry too had increased by that period of time. So the influenza showed itself as a parasitic infection, which takes its own epidemic course. Still the possibility remains of the virus, at times of reigning influenza, having also widely spread among the healthy. At any rate the idea that catching cold reduces resistance to influenza or pneumonia is supported by the data.The opinion obtained from the results of the inquiry, that most colds and pneumonia, as well as many cases in which old age has been given as the cause of death, are founded on a disturbance of the thermo-regulation, has drawn attention to physiological oscillations of the temperature of the body in relation to that of the temperature of the air. As the thermo-regulating system is not able to fix the temperature of the body completely, even under normal conditions, but allows a certain poikilothermia, it is clear that by a considerable drop in the temperature of the air these oscillations of the temperature of the body become so large that they may cause a disturbance.The prophylaxis of the diseases from catching cold will have to be directed towards the application of “passive” prophylactics (for preserving and supplying heat by imminent cooling), as well as of “active” prophylactics (raising the production of heat by the body).

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