BRONCHITIS, Acute.
There is little indication for active drug treatment in acute catarrh involving the upper portions of the respiratory tract in otherwise healthy subjects. Where the patient persists in going about and attending to his ordinary duties, the physician should be careful not to prescribe the remedies indicated where the affection is more severe arid where the patient is confined to his room. Thus diaphoretic remedies, sprays and inhalations render the patient more susceptible for the time, and should he expose himself immediately afterwards, a mild attack of nasopharvngeal tracheal or bronchial catarrh may be converted into one of capillary bronchitis. A hot bath at bed-time, followed by a large Mustard poultice and one dose of Morphia, gr., upon lying down, will give relief during the night and sometimes will shorten the attack. For administration during the day, when there is much unnecessary coughing, 3 or 4 mins. of Liquor Morphin2e and To of Vin. Ipecac. may he given every few hours. Attempts to abort the attack upon the first appearance of nasal symptoms by large doses of Quinine, Morphia, Carbolic Acid, &c., or by snuffs and sprays are generally futile, but the vaccine treatment referred to later on is often highly successful.
When the catarrh, though limited to the larger bronchi, is more severe and is ushered in by some feverishness and dry, harassing cough, with sense of constriction and rawness in the chest, or where the affection is bronchitis of the middle-sized tubes from the first, the patient must be confined to his bed or to his room, which should be kept at an even ' temperature little over F., and the air should be rendered moist by the vapour of hot water. For this purpose the ordinary bronchitis kettle placed upon the fire is best, or a few feet of tin tubing attached to the spout of any kettle will do. The numerous petroleum arid spirit-lamp contrivances so much used should be strongly condemned. The un wholesome products of combustion escaping into the confined dry air of the room aggravate the cough, and add to the bronchial irritation, and it is not an unusual event to find the cough cease when they are discontinued.
Much benefit has been obtained in the treatment of acute bronchitis and all forms of catarrh of the upper air passages by inhaling a fine spray containing Adrena]in. Zuelzer states that its action in some cases is really marvellous when asthma is present.
Diluents should be administered, and there is nothing more grateful than home-made lemonade mixed (just before being swallowed) with kali water, the resulting Citrate of Potash formed by the combination being a valuable diaphoretic and expectorant. Sweet Spirits of Nitre in drachm doses is a good diaphoretic at this stage, or the following mixture may be prescribed : It. Pot. Bicarb.
Tr. :Iconiti naiu. xx. Aquae Misce.
Capiat cochlearia duo magna cum cochIcare 11110 magno succi lintonis quanta (pimple horn.
In the early stage the chief indication is to alter the dry, swollen and congested condition of the bronchial surface, and " to cause the tubes to sweat,'' and there is no remedy equal to small and repeated doses of Tartar Emetic, which may be administered after the first 24 hours combined with Morphia to great advantage, thus: H. Antim. '1 art. gr. j.
Liquor. Morph. Tart. 5iss. l'ini Ipecac. 5ij.
Aquo Camph. ad :vj.
Fiat nzistura. Sumat cochleare mag. tertia quaque horn.
A large poultice of Linseed and Mustard should he applied to the front of the chest to cause thorough redness of the skin, and when it becomes so irritating- that it can no longer be borne with comfort, it should be replaced by a layer of warm cotton-wool, and another poultice of the same kind applied to the back between the shoulders, after which a warmed extemporised jacket of cotton-wool or Gamgee tissue may be worn or Thermogene applied if the skin he not too tender. The poulticing may be continued throughout the attack be applying plain Linseed poultices every 2 or 3 hours after the Linseed and Mustard have caused redness should there he much constriction of the chest or dyspncea.