Topical treatment by direct inhala tions from No. 65 Davidson atomizer, connected with an air-tank of about thirty pounds' pressure. The tip intro duced into the mouth and the patient is instructed to make as prolonged an aspiration as possible, to inhale gently and repeatedly, drawing it into his lungs. Formulae found most useful: menthol, 1 to 2 per cent.; ereasote, 1 per cent.; camphor, '/, to 1 per cent.; eucalyptus, 2 per cent.; pine-needles, 2 per cent.; in albolene or benzoinal. Average quantity to be inhaled is 2 drachms, after which the patients begin to gag. Kuh (Chicago Med. Recorder, Mar., '93).
The treatment of bronchitis divides itself into modification of the function of the bronchial mucous membrane so as to alter the secretion, and also with the object of combating congestion to facilitate expectoration, to calm the cough, and to improve the general health. The chief agents which, after absorption, are eliminated by the re spiratory passages, consist in greater part of balsams, of plants containing essential oils, sulphur and its com pounds, and the iodides. Of the first class in particular are tar, balsam of benzoin, turpentine and terpiue, eucalyptol, and creasote. The incon venience attending all is that they ex ercise an irritant influence upon the stomach. Copaiba, though rarely em ployed, nevertheless is found to be very efficacious.
Turpentine is usually employed in capsules holding 3 or 4 minims, but ter pine has quite largely taken its place. Creasote aids in getting rid of the secre tion, and acts deleteriously upon tu bercle bacilli. The balsams are usually employed by inhalation.
Eucalyptol may be prescribed in cap sules containing 1 grain and given three or four times a day; it is preferable to turpentine as it is not so apt to produce disturbance of stomach and kidneys. Lyon (Revue de Thor. Medico-Chin; Then Gaz., May 15, '97).
In the treatment of senile bronchitis strychnine and ammonium carbonate are in the first rank. In acute exacerbations of chronic bronchitis ammonium carbon ate, in 5- or 10-grain doses, given in 2 or 3 ounces of milk, is of great service.
For chronic bronchitis and convales cence from the acute form, strychnine sulphate, in from to 'I,, grain, every three to six hours, not only does quite as much as the ammonium salt, but, in addition, is a more powerful stimulant to the right heart. To disinfect the ex pectoration, creosote carbonate, in 20 drop doses, given in 2 ounces of sherry, repeated every four hours until puru lency disappears, is effective. Ordinary creosote should never be given to the aged. With copious secretion and diffi cult expectoration this is the drug of choice. The use of opium or any of its alkaloids is most strongly condemned. Wilcox (Amer. Jour. of Med. Sciences, May, 1900).
In bronchitis, as in the case of collec tions of pus, the object of treatment is to facilitate the draining away of the exudation. Often in the early morning the bronchitis brings up a large quantity of sputum by the help of more or less persistent coughing. At this time the patient should lie as flat as possible for a couple of hours, so as to assist the draining of the secretion into the large bronchi, and hence its expectoration.
The patient can expectorate by turning the head to one side. After a few days the foot of the bed may be raised 3 or 12 inches. In suitable cases in two to four weeks there is a considerable dimi nution in the sputum. This mode of treatment is adapted to cases of chronic bronchitis which have led to a cylindrical or sacculated bronchiectasis in the lower lobes of the lung. It is of no avail in eases of diffuse, and especially recent, bronchitis, with general secretion, or in cases of abscess-cavities communicating laterally or incompletely with the bron chi, or of cavities with irritating con tents. Quincke (Berl. klin. IVoch., June 13, '98).
The diet should be nourishing and should be strictly regulated to the condi tion of the digestive organs. Excess of starches is to be avoided because of their tendency to cause flatulence and con sequent mechanical interference with respiration. In cases associated with gout the question of diet is one of ex treme importance.
Fetid Bronchitis.
This form is only differentiated from others by the odor of the sputum. In many cases this is due to retention of the secretion in bronchiecta tic cavities. (See BRONCHIECTASIS.) Symptoms.—Fwtid bronchitis begins as an ordinary bronchitis, which later as sumes the purulent form; or it may be ingrafted upon a chronic pneumonia, a bronchiectasis, or even a suppurative pleuritis that has perforated into the lung. The early symptoms are those of simple bronchitis. The pulse is rapid and there is continuous fever, but the temperature-record is usually irregular. The change to purulent inflammation may be marked by a chill or a succession of chills. Respiration is accelerated, and the severe cough causes the abundant Respiratory gymnastics, by increasing pulmonary capacity and accelerating the pulmonary blood- and lymph- circula tion, are efficient. External applications to the chest-wall are of doubtful value in the absence of acute exacerbations and of pulmonary or pleural involvement. Systematic daily practice of full, deep inhalations of pure atmospheric air, and the judicious exercise of the deep mus cles of the chest, are of great advantage. (Cassell.) expectoration of an alkaline, semi liquid, putrid sputum, which sometimes amounts to seven or eight hundred cubic centimetres per day. This sputum pos sesses an odor said to be quite charac teristic of the disease, and resembling somewhat that of acacia-blossoms. The disease may terminate favorably, or it may cause death by the development of pneumonia, bronchiectasis, abscess, or gangrene. There seems to he no specific sign or symptom of the affection, unless it be the peculiar odor of the sputum, which Lumniczer claims is developed by the growth of the bacilli that cause the disease. (Whittaker.) Death is generally due to exhaustion or through some intercurrent disorder kindred to the major affection.