The bronchitis of the early stages of the illness is often troublesome and is usually the expression of the rash on the bronchial mucosa, which the bronchitis causes to disappear. It is always imperative to venti late the room, and that the patient he not harmed by doing so (as by draught). It is further necessary to modify the attacks of coughing with small doses of codeine. Expectorants are not called for in the dry form of bronchitis, where there is much secretion as in capillary bron chitis or in the closing stage of pneumonia. Ipecac or some other expectorant, will render good service.
With pneumonia or failing heart. it is well to employ heart tonics early, such as infusion of digitalis, caffeine, the tincture of strophanthus, or injections of camphorated oil may be tried. If there be much lassi tude and prostration alcohol must be used. Of course this can be ad ministered only in moderate quantities, either cognac or Malaga wine mixed with other fluids may be given to nursing infants drop by drop or to older children by the teaspoonful at a time. It is also well to administer a light white wine in the form of a wine soup. It is quite inexcusable on the grounds of temperance to exclude alcohol, that great saver of tissue waste, from the physician's armamentarium, even if its efficacy is accomplished only at the cost of inhibiting the action of the vagus nerve. The harmful effects of alcohol, as with any other medicines, arise only from the long continued consumption of large quantities.
The nausea produced by medication, as often formerly occurred for instance in capillary bronchitis or in the closing stage of pneumonia, should on account of the heart always be avoided with the utmost caution.
An important part of the treatment in the bronchitis and pneu monia. of measles is hydrotherapy. As to whether this form of treat ment can cut short, or form a barrier to the disease is very doubtful.
The changes in the rash (livid discoloration and washed out ap pearance) already spoken of, such as often appear in the course of severe heart and lung complications, and called by the laity "relapsing measles," the popular mind readily ascribes to the hydrotherapy. Unfortunately at times the lung conditions increase, in spite of scientific treatment mostly however it is where the activity of the heart and the general condition have been overlooked, and even the most serious symptoms (as for instances cyanosis of the mucous membranes and the peripheral parts of the body as well as coldness) remain unnoticed.
A cool pack to the nape of the neck (a towel wrung out of water at 25° to 2S° C. (77° to S2° F.) and covered with a larger bath towel), may in many cases not only reduce the temperature, but by it. the general condition may be improved, and pain and difficulty in breath ing alleviated. By three applications at intervals of twenty minutes a favorable lowering of temperature will readily be obtained, whilst in other cases, where the fever is not so high, but the other symptoms are troublesome, a longer continuance of the applications (two to four hours) is desirable. When these are to be frequently repeated a pre vious anointing the skin of the part is well as a preventative against eczema. If dyspricea and prostration increase and there be deficient expectoration, warm baths (35° C.; 95° F.) with a cooler douche, carefully used, are often beneficial. Hyperannia and diaphoresis, and thereby a relatively greater radiation of heat from the skin can be increased by mustard baths (50-100 Gin. per bath) or as Heubner suggests, by wrapping in mustard water kilogram to 1-1 litres of warm water). While these means are employed in weakly and reduced children, I should advocate blood letting in the form of leeches or venesection where one has to deal with strong Drell nourished children, in preference to all other methods.
The inhalation of oxygen, in many cases, especially in severe bronchitis, brings about an improvement, of the subjective symptoms and a lessening of the respiratory frequency.
The tuberculous affections of the resp:ratory tract, glands, brain and skin, etc., must be combated by sufficient nourIshment under favorable climatic and hygienic conditions, with mental and physical rest.. Creosote and its derivatives may be administered in moderate quantities. With local tuberculous processes iodine and the inunction treatment are to be employed before the time for surgical interference. For the simple inflammatory adenitis the application of moist warm poultices of five to ten per cent-. of ichthyol ointment are successful.