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As the result of intensive studies of 9ctte respiratory infection in military populations-from 1941 to 1946, an entity termed "acute respiratory disease" was described by the Commission on Acute Respiratory Diseases (1-4). This syndrome, for convenience, was termed "ARD," and this designation will be employed hereafter. ARD is an acute febrile respiratory infection of short duration with both constitutional symptoms and localized respiratory symptoms characterized predominately by cough and hoarseness (1, 2). In addition, irritated throat, nasal obstruction, and chest pain were frequent complaints. Epidemiological investigation (1) as well as human transmission experiments (3, 4) indicated that the incubation period of this infection was five to six days, and that during convalescence there developed an homologous immunity but not heterologous resistance to common cold or primary atypical pneumonia (4). It was postulated as a result of these investigations (1-4) that ARD was an entity distinguishable from other acute respiratory illnesses such as common cold, streptococcal pharyngitis and tonsillitis, and primary atypical pneumonia, and that it was caused by a single filterable agent, probably a virus, or a closely related group of agents. Attempts to isolate an agent in experimental animals and chick embryos were not successful.Although ARD has not been recognized in epidemic form in civilian populations, similar infections such as non-streptococcal pharyngitis and grippe-like illnesses not caused by influenza vi-I

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The incidence and severity of postoperative sore throat was evaluated in six groups of 20 patients each after elective orthopedic surgery. Groups I to V had tracheal intubalion with Portex disposable polyvinylchloride tracheal tubes and group VI had mask anaesthesia. All groups were exposed to heated humidified gases. Tracheal tubes in groups l-Ill were uncuffed and lubricated with four per cent lidocaine jelly (group I), four per cent lidocaine hydrochloride anaesthetic solution(group I1)or normal saline (group Ill). Patients in group IV had unlubricated tubes with large residual volume cuffs, patients in group V unlubricated tubes with small residual volume cuffs and patients in group VI (mask anaesthesia) had the lowest incidence and severity of postoperative sore throat while those in group I had the highest incidence and most severe postoperative sore throats. Patients in group V had a lower incidence and severity of postoperative sore throat than patients in all other groups, except group VI. Postoperative sore throat was equally common and severe in patients in groups II. III, and IV. The data indicate that, with the use of heated humidified gases, tracheal intubation with either cuffed or uncuffed tubes produces a greater incidence and severity of postoperative sore throat than mask anaesthesia. In addition, our findings suggest that lubrication of tracheal tubes provides no advantage in terms of reducing postoperative sore throat and, depending on the lubricant, can increase the incidence and severity, Finally, our results demonstrate that the tracheal tube causing the least incidence and severity of postoperative sore throat is one with an unlubricated low residual volume cuff.

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