Chapter 7 - Diseases of the Chest
Consumption - First Stage
Consumption - Second Stage
Consumption - Third Stage
Causes of Consumption
Bacterial Invasion
Classes of Bacteria
Exciting Causes of Consumption
Treatment of Consumption
Diet in Consurnption
Acute Bronchitis
Chronic Bronchitis
Swelling of the Lungs
Pulmonary Apoplexy
Air in the Chest
Water in the Chest
Lungs and Their Diseases - Diagram
Charts of Various Lung Diseases - Diagram
Typhoid Pneumonia
Broncho Pneumonia
Other Forms of Lung Inflammation
Hay Fever
Thyroid Gland

7.12 Chronic Bronchitis

Chronic Bronchitis.

This is an inflammation of the mucous membrane of the air tubes, which continues a great length of time, without any sudden or remarkable changes.

Physical Signs. The percussion sounds are similar to those of acute bronchitis. When a bronchial tube is dilated, we sometimes have dullness around the dilated part.
The breathing murmur is always accompanied by a mucous, sonorous, or sibilant rattle, sometimes by a subcrepitant.
When dilatation of the tubes exists, the intensity and duration of the sound of the ingoing breath is decreased, of the outgoing increased.
In this state of the tubes, we also have cavernous breathing, bronchophony, sometimes pectoriloquy, and bronchial or cavernous cough.

General Symptoms. A cough is generally present, which is increased in wet weather, and by every slight cold. This comes on in paroxysms; is generally worse in the morning; and is relieved by raising freely. The matter raised is generally yellowish, but sometimes whitish and sticky; and in the latter stages is thick, and sometimes very much like that of consumption. Indeed, the disease often ends in bronchial consumption.

Remarks. The breathing is bronchial or cavernous when the dilated portion of the tube is empty; if it contain fluid, the mucous rattle will be heard.
Dullness on percussion will exist if a dilated tube press upon the surrounding portion of lung so as to condense or make it solid.
Dilatation of the tubes occurs only in chronic bronchitis of long standing. Its physical signs are much like those of a cavity in advanced consumption. The examiner may learn to distinguish them by considering that in consumption, dullness precedes the cavity, while in bronchial dilatations, the cavity precedes dullness.
The dilatation or swelling out at some point of a bronchial tube is caused by obstructions to the passage of air through it, just as an India rubber tube, partially closed up at a given point, will bulge out just in front of the obstructed place, when air is forcibly blown through it, and just as the left ventricle of the heart enlarges when the blood is obstructed in its passage through the aortic valve.

Causes. It often occurs as the result of acute bronchitis, and also of measles, hooping cough, etc. But taking cold, and damp and changeable weather, are more frequently its causes. It most often follows chronic inflammations of the throat, which, being neglected, gradually creep down the windpipe into the tubes, and become very obstinate in their character.

Treatment. Medicinal inhalation is one of the best remedies for this complaint. The inhaling powder has, in many cases, great efficiency. The dose is about what can lie on a ten cent piece. It should be used once a day, in an instrument represented in the cut.

This instrument I had constructed for my use. It consists mainly of a glass tube and a receiver, the latter being something like a tube vial, pierced with fine holes around the lower end. The powder is poured into the receiver, which is placed in the larger tube, and twirled between the thumb and finger while inhaling.
When the powder cannot be easily got down into the tubes in the lungs, as often happens, the inhalation of medicated vapor will do better. If the expectoration be difficult, the expectorant inhalant, described under Consumption," should be used; if the expectoration be too profuse and free, the astringent inhalant must be taken.
The cough preparations recommended for consumption, also (113), (112), will be the proper ones in this complaint.
The daily alkaline bath, and brisk friction, are particularly serviceable.
Out door exercise is almost as necessary in this disease as in consumption.

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