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Symptoms.-There is rarely any pain, or, at most, an occa sional uneasy sensation under the breast bone. If the cough be violent and frequent, there may be also some soreness at the iower part of the chest, on both sides. The general health is not usually affected, so long as the disease remains limited to the bronchial mucous membrane. The expectoration varies considerably in dif ferent cases. It is often profuse, whitish, and viscid ; at other times thick yellow, while in still other cases it may be almost solid greenish, and streaked with blood. At times a considerable quan tity of matter escapes in the expectoration. In many instances this disease of the bronchial tubes is associated also with catarrh of the nasal passages ; it also results from organic disease of the heart.
In many cases it seems to be the direct effect, like the catarrh in the head, of sudden and rapid changes of a variable climate. It does not contain any element of danger to life, unless, indeed, in the aged; but it may result in the development of other lung troubles, such as asthma, all of which together may materially shorten the patient's life by the constant annoyance to which he is subjected. Treatment.-The treatment of chronic bronchitis must consist of attention to general health, as much as in remedies addressed directly to the lungs; indeed, there are cases in which the only hope of cure, or, indeed relief, lies in a change of climate. The locality to be sought, in the hope of relieving chronic bronchitis, must be warm, dry, and free from sudden and violent changes of temperature. All other measures which contribute to the improve ment of the general health will also materially hasten relief from this disease. If it be impossible to avoid extremes of temperature, the greatest care should be observed that the body be warmly clothed throughout the year. In a cold climate, woolen or silk garments may be worn next to the skin ; and it is advised to wear over these, during cold weather, a garment of chamois leather or buckskin. At any rate, it will be found judicious at least to wear flannel next to the skin throughout the year.
Measures addressed directly to the chest may consist, first, ol local applications, and second, of cough remedies. Benefit may often be derived from the application of various remedies directly to the skin ; thus, three drops of croton oil, mixed with the same quantity of olive oil, may be applied to the chest every night by means of a camel's hair brush ; or tincture of iodine may be applied in the same way, for the same purpose. The medicines that may be administered have for their object the loosening of the mucus and the restoration of the membrane to its natural condition. It is impossible to give any one prescription which shall be applicable to all cases of chronic bronchitis, because the condition of the patient, as well as the condition of the bronchial tubes, varies ex tremely in different cases. It may be said, in general terms, that if there is but little expectoration, if the patient is troubled with a dry, hacking cough, much benefit may be derived from some med icine which will allay the irritation. For this purpose the following prescription may be used :
Dilute hydrocyanic acid, - Half a drachm.
Sulphate of morphia, - - - Half a grain.
Syrup of tolu, ----- Two ounces.
Of this, a teaspoonful may be taken every three hours. If the mixture cause any feeling of nausea the amount of syrup can be diminished to one ounce, the other ounce being filled up with wrater. If there be much secretion, with considerable difficulty in expectoration, the following may be given :
Chloride of ammonium, - Four drachms.
Paregoric, ------ Two ounces.
Syrup of squills, - Two ounces.
Mix ; take a teaspoonful every two hours.
Most patients suffering from chronic bronchitis experience great relief during the warm weather, and suffer again during the fall and winter. Such individuals are, of course, benefited by residence in a warm climate during the winter. Chronic bronchitis itself is not so injurious or dangerous as to compel the patient to employ extraordinary measures for its relief; hence, such patients are usually content to suffer the annoyance year after year, until they become quite habituated to it. Yet, such persons should remember that a chronic bronchitis often brings in its train a series of other evils, which cannot be indifferently endured and neglected. Not the least of these ills to which chronic bronchitis often serves as an introduction, is consumption. In view of these facts, it behooves the individual to take the matter early, even before it seems absolutely necessary, for if he wait, it is often impossible to repair the damage done.
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