This is an infectious inflammation, characterized by an exudation from the blood vessels, the formation of new connective tissue, and the growth of bacteria. The disease involves the walls of the bronchi and the air spaces surrounding the inflamed tubes. It is frequently called capillary bronchitis and catarrhal pneumonia. It is the ordinary pneumonia of children, and is frequently seen in young people.
It comes on primarily, but is often secondary to measles, whooping. cough, etc.
Symptoms. In the very young, the only symptoms are fever, prostration, and rapid breathing. There is no cough, no physical signs, but the disease is, almost always, fatal within a few days' time.
There is a great difference in the invasion of the disease in different cases, the severer cases being ushered in by one or more convulsions, by rapid rise of temperature, vomiting, difficulty in breathing, and delirium; the milder cases beginning with lower temperature, moderate prostration and shortness of breath.
The height of the temperature is, as a rule, in proportion to the severity of the disease. Temperatures of 105' and over are usually fatal. The pulse reaches 150 to 170 in adults, and even higher in children, so high, in fact, that it cannot be taken. The respiration varies from 40 to 80. Sleeplessness, restlessness, and even delirium are frequently present. The face is flushed, the tongue coated, and oftentimes diarrhea ,a and vomiting occur. Cough is usually present, and in the young the sputum is swallowed. The urine is frequently albuminous and contains casts.
Between the second and fifth days the signs of consolidation and pleurisy appear, i. e., dullness on percussion, bronchial breathing and bronchophony with crepitant rattles.
The duration of the disease in children varies: of the fatal cases the majority die within the first fortnight. The cases which recover vary from one to three weeks, though many persist for six and eight weeks. The softening and absorption which occurs in all pneumonias that recover occupy a much longer period in broncho pneumonia than in lobar pneumonia.
Many cases of broncho pneumonia are complicated by cerebral symptoms of convulsions, delirium, stupor, vomiting, etc., even before any marked lesions in the lungs appear; as these subside the lung symptoms appear. Many cases are protracted for a long time, and though they may terminate favorably at last, yet they are apt to run into a chronic hardening of the lung which lasts for years; or they recover with a permanent consolidation of the lung. Some die of exhaustion.
Treatment. The use of hot fomentations and poultices over the chest and the administration of small doses of ipecac and aconite at short intervals soothe the bronchitis and pain.
For the cerebral symptoms, phenacetin and the bromides are very useful. Aconite and digitalis are usually employed when the pneumonia stage comes on. As a rule stimulants are not required in children, in whom the disease most frequently occurs.
In convalescence, iron, quinine, cod liver oil~ oxygen and a change of air are to be recommended.
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