This is an acute inflammation of the mucous membrane lining the air tubes in the lungs. It is generally quite a serious disease.
Physical Signs. The sound upon percussion is generally good. If there be any dullness, it is commonly in the lower and back part of the chest. This occurs only in ,Capillary Bronchitis."
The breathing murmurs are sometimes more, sometimes less intense than natural. Occasionally they are almost extinct.
In the early stage, sibilous and loud rattles.
In the more advanced stage, mucous rattle.
Now and then sub crepitant rattle accompanies the inward drawn breath.
General Symptoms. The disease begins with chills followed by fever; tightness across the chest, difficulty of breathing, hoarseness, loss of strength, costive bowels, and a quick and hard pulse. Water runs from the eyes and nostrils, and there is a dry, harsh, croupy cough.
After a few days, mucus begins to be raised. This expectoration gradually becomes more copious, and is opaque, yellowish, or greenish, and occasionally streaked with blood. This mucus is very ropy and adheres to the vessel.
There is more or less pain in the chest; pain across the forehead, which is increased by coughing; and a pale and anxious countenance.
In severe cases, the tightness across the chest is extreme, with a sense of suffocation, causing the patient to call for the opening of the windows. There is great difficulty of breathing; a paleness and lividity of the cheeks and lips; a loud wheezing and rattling in the throat, followed by cold sweat, insensibility and death.
In children the disease comes on like a common cold, attended by a sore throat, a great desire to drink, but a disinclination to take food. But two or three swallows of drink can be taken at a time for want of breath. The phlegm is frequently vomited up spontaneously.
Observations. The loud and sibilous rattles are produced by similar causes, namely, the passage of air along tubes whose interior is dry and rough from inflammation, or whose caliber is contracted or altered in form by the swelling of the membrane, effusion upon its inner surface of a tough, mucous substance, or a pressure upon its external surface of tubercles, swollen glands, aneurismal tumors, etc. The two sounds differ mainly in the key upon which they are pitched, the sonorous, or low keyed, coming from the larger tubes; the sibilous, or high keyed, from the, , smaller, just as the low notes of an organ come from the large pipes, and the high notes from the small ones.
Causes. It is generally brought on by a sudden cold, by changes of the weather, and by inhaling irritating substances. It is a secondary result, too, of scarlet fever, measles, small pox, hooping cough, and the remittent fever of infants.
Treatment. In mild cases, give warm balm or flax seed tea, hot lemonade, or other similar drinks, at the same time soaking the feet in hot water, and, on retiring to bed, apply bottles of hot water to the, feet and sides, to produce sweating. If the bowels be costive, some gentle physic, as rhubarb and magnesia, or salts and senna, may be taken.
Chloride of ammonia in teaspoonful doses diluted in water and citrate of potassium in 10 to 20 grain doses, or better still, a mixture of
Chloride of ammonia,....3 drachms or teaspoonfuls.
Citrate of potassium,...4 Ò Ò
Compound licorice mixture,..3 ounces.
Shake the bottle.
Take of the above, one teaspoonful diluted with water every three hours.
In the case of infants, an emetic of wine of ipecac, or compound tincture of lobelia, should be given, and followed with slippery elm ,and flax seed tea. The compound tincture of lobelia, with tincture of veratrum viride, may be continued for a time as an expectorant.
In more severe cases, both of adults and children, an active emetic is required, perhaps the compound powder of lobelia is as good as any. This must be followed with tincture of veratrum viride, in full doses, so as to reduce the pulse at once, and keep it down to the, natural standard. This is one of the very best articles in this complaint, and will generally very much lessen its violence and duration.
If there is much difficulty of breathing, the air of the room must be kept moist, as recommended in croup.
The room should also be kept warm, decidedly warmer than in the case of other fevers.
A gentle perspiration should be kept up by small closes of compound tincture of Virginia snake root, and by frequently bathing the surface, or else by tincture of veratrum.
Mustard should be applied to the chest, and to the soles of the feet.
The cough may be managed by preparations (104), (106), (110), freely given.
The diet should be confined to barley~. water, toast water, apple water, rice water, and a solution of gum Arabic.
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