very early cases, the disease may often be cut short by free diaphoresis (hot teas, and if necessary, the simultaneous administration of aspirin).
In acute bronchitis, it is proper to keep the patient in a room with an equably warm atmosphere. Rest in bed is necessary when fever is present, or even when there is only an evening elevation of temperature. Whenever the atmosphere of the room is excessively dry, as is especially the case during the time when the rooms are heated, sion must be made for a necessary amount of moisture by evaporation of water, particularly in cases of infants. For this purpose, in severe forms and especially in those frequently- associated with catarrhal laryngitis, the croup bronchitis-kettle (see Fig. 79, page 358) is useful. The trunk of the patient is covered with a woolen or, better still, flannel jacket. It also suffices to cut two holes for the arms in a suitable piece of flannel. For the relief of the cough and stimulation of the secretion the drinking of alkaline rnuriatic waters, marshmallow tea, with the addition of extract of malt, is of service. Older children may be given inhalations of common salt (12 to 15 Gm. (3-34 dr.) to 1 litre (1 quart) of water). Mild cases recover nithout further treatment.
Hydrotherapy is most efficacious in high temperature, severe bron chitis, or long continuance. In febrile bronchitis compresses saturated with water at the temperature of the room, are applied to the chest and changed every one or two hours: in older children, when the tempera ture is high, every half hour, or, for a short time even every quarter of an hour. Rubber tissue is not used for this purpose. Patients with high temperature and severe constitutional disturbances may be given tepid baths, 27° R. (93° F.) for infants, 25° R. (89° F.) for older children, front 4-6 minutes morning and evening. In cases of great restlessness and fever during the night, a cold compress applied from the arrn-pits to the middle of the leg for fifteen minutes is of value. As the temperature declines the compresses are changed only every two or three hours, gradu ally going over to lukewarm. (Compare with temperature of baths and packs and also with what is stated on page 360.) In acute afebrile bronchial catarrh -warm compresses are used from the beginning and are changed every two or three hours during the en tire day, or only one compress is applied for about three hours each morning and evening. Friction of the skin and of the body with dry
or cold wet cloths when the compresses are changed is of utility. In cases of feeble constitution, cool skin or cold rooms (among the poor), it is well to introduce rubber tissue between the wet chest compress and the covering.
After removal of the compress the body must be covered with a dry woolen jacket. Frequent changes of position and taking up out of bed is necessary in young infants for the purpose of increased aeration of the lungs.
lIethod of Applying the Compress.—The application of the chest. compress must be first demonstrated and supervised by the physician. One or two towels or a diaper arc folded four or eight times in such a manner that the breadth reaches from the axilla to the umbilicus, and the length somewhat exceeds the chest circumference. It is tlten dipped either in cold or hot water, firmly wrung out, and quickly- spread smoothly on a previously prepared flannel blanket (for which purpose the baby shawls are well adapted), and the whole quickly wrapped around the chest of the patient from behind, as high as possible in the axilla, per mitting the arms to remain free. With sonne practice this is readily done without renioval of the infant's shirt. At first the free ends of the wet cloth, and afterwards those of the dry, are crossed on the front of the chest and the blanket firmly fastened with safety-pins. The outside blanket should extend for one or two finger-breadths beyond that of the underlying wet cloth so that nothing can be seen of the wet cloth. The compress must be made so that the moisture does not penetrate the outside covering. When the compresses are to be changed continuously tveo cover blankets are required so that each one may be thoroughly dried during the intervals. If warm compresses are desired, the cloths are immersed in hot water, spread out, and immediately applied as soon as they have cooled off to the desired temperature. For the purpose of an impermeable covering, BiIlroth's batiste or something similar, between the outside cover and the wet cloth, is advisable.