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Bronchitis also often occurs during the course of other diseases, such as scarlet fever, measles and typhoid fever. It may also be induced by the local effect of irritating gases taken into the lungs with the breath. It is more apt to attack individuals who spend their time in close and warm rooms, than in those constantly exposed to the weather.
Symptoms.-Acute inflammation of the bronchial tube usually begins with a cold in the head ; that is, a catarrh of the nose. Thence it extends down the throat and larynx to the bronchial tubes. Thus a variable period, from a few hours to two or three days, may elapse from the beginning of the catarrh in the nasal passages to the establishment of the bronchitis. The inflammation in the bronchial tubes begins with a sense of tightness across the chest, accompanied with a feeling of rawness or soreness. These sensations are aggravated by every act of coughing ; there is at the same time a certain amount of fever, usually slight. The con stitutional disturbance may be so considerable as to prevent the patient from attending to his usual vocation, or may be almost imperceptible. The cough is at first dry, but very little mucus being expectorated. During, and especially at the end of, each act of coughing a painful sensation is felt under the breast bone ; this is also the case upon breathing cold air, or upon drawing a long breath.
After some days the cough becomes " looser ;" the expectora tion becomes easier, more profuse and less painful ; the matter expectorated being frothy, viscid, and often streaked with blood. After three or four days it becomes thick and yellow, or green. By this time most of the disagreeable symptoms have subsided ; the patient is troubled by no other symptoms than the necessity for frequent, sometimes violent, coughing. The usual duration of the attack is twelve to fourteen days, though this period is often pro longed by carelessness or neglect on the part of the patient.
The disease contains no element of danger except to the feeble, whether old or young. In infants, it is always a serious affection, since they are often physically unable to remove, by expectoration, the secretion in the bronchial tubes ; hence, death not infrequently occurs from suffocation. In aged people, too, the disease may also be serious, and for the same reason. In feeble individuals a serious degree of exhaustion, also, may follow long and protracted efforts at clearing the bronchial tubes by the act of coughing.
Treatment.-It is often possible to cut short a " cold on the chest" within twenty four hours, by taking, at bedtime, a hot foot-bath, a glass of hot toddy or lemonade, and ten grains of Dover 's powder. This attempt will, however, be unsuccessful unless made after the first indication that the individual has taken cold - that is, before the sense of tightness in the chest occurs. If this measure be omitted, a brisk saline cathartic, such as the citrate of magnesia, should be given. The pain and soreness in the chest will be relieved by a light mustard-plaster over the breastbone ; the cough may be " loosened " by taking a half-tea- spoonful of the compound syrup of squills every two hours. If this remedy provoke nausea, it may be replaced by the following :
Tartar emetic, - Two grains.
Syrup of wild cherry, -
Water, --.-,- Each three ounces.
Mix ; take a teaspoonful every two hours.
So soon as expectoration becomes easier, the removal of the mucus from the bronchial tubes may be promoted by giving a quarter of a teaspoonful of the syrup of ipecac every hour ; or, if the cough be somewhat violent, the following prescription :
Nitrate of potash, - - Two drachms.
Syrup of squills, - - Two ounces.
Tincture of digitalis, - - Half a drachm.
Gum arabic, - Each two drachms.
Water enough to make six ounces. A teaspoonful of this may be put in a wineglassful of water and sipped every ten or fifteen minutes.
Acute Bronchitis in Young Children requires especial notice, because of the peculiar danger of the disease at this time of life. In consequence of the infant's inability to expectorate the mucus which collects in its bronchial tubes, this matter may accumulate so as to prevent the access of air to the lungs. This accident may be suspected if the child's breathing becomes especially frequent and accompanied by decided movements of the nostrils, and especially if the skin become livid.
The most efficient means of relieving this difficulty in children is the use of mild emetics, such as the syrup of ipecac. The act of vomiting often promotes the escape of mucus from the bronchial tubes, which could not otherwise be effected.
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