Treatment—The person should be confined to a moderately warm room, the air of which is kept moist by a constant stream of steam from a kettle. A particular kind of kettle—the bron chitis kettle—may be used for this purpose. (See APPLIANCES FOR THE NURSERY, Plate XXXI.) Large warm poultices should be applied to the chest. The bronchitis may be confined to one side, or may affect both. This is determined by listening to the breath sounds. If it is limited to one side the hot applications should be placed on that side only. The poul tices may or may not contain mustard, accord ing to the severity of the attack. Let the bowels be opened by a dose of medicine, castor-oil, senna, or seidlitz- powders ; and let the food consist of milk, warm broth or soup free of vegetables, beef-tea, &c. This in an ordinary case is sufficient. After mucus has begun to come away it may be aided by a mixture of syrup of squills and ipecacuanha (see PRESCRIP TIONS -- COUGH MIXTURES). But let people beware of the ordinary cough mixtures, chloro dyne cough mixtures and the like. They are very valuable in many cases, but they ought to be given with great discrimination. In some cases of bronchitis, where the tubes are loaded with mucus, the constant coming up of which maintains a harassing cough, cough mixtures containing chlorodyne or laudanum will greatly relieve, but at the expense of letting the discharge accumulate in the tubes to block up the lungs. If any preparation of opium is given at all, it is only in the early stage, when the cough is vio lent and excessive, and dry, that is, unaccom panied by spit. Then it may be given in 8 to 10 drop doses, with 10 drops ipecacuanha wine, repeated every three or four hours. It should never be given when the breathing seems obstructed, and the skin and lips have the least suspicion of blueness; indeed its administration should be left entirely to a medical man. Ipecacuanha may, however, be given in repeated small doses, and specially when the spit is thick and tough. Stimulants are frequently necessary,, but are to be given only according to medical advice.
Chronic may exist in a chronic form either as a result of an acute attack, as a consequence of long-continued irri tation, or as a complication in other diseases. Diseases of the heart or kidneys, for example, or gout, are frequently associated with it. It is
mostly in adults, those in middle and advanced life, that it occurs, but it is found also among the young, though it is probably continued in them owing to some bad ,constitutional con dition.
Its main symptoms are cough, shortness of breath, and spit. It is particularly apt to attack a person in winter, or during a season of bad weather, continuing until the return of warmer weather, a new attack coming on with the succeeding winter, forming the condition known as winter cough. Foggy weather is particularly disagreeable to a subject of chronic bronchitis, a short exposure to the fog usually occasioning the cough and shortness of breath within a very short time. The intervals of good health become shorter, and the duration of each successive attack longer, till perhaps the person is seldom free from some sign of the disease, which is easily aggravated. In such confirmed cases the person becomes markedly rounded in the shoulders, and the chest as sumes frequently more or less of a barrel shape. This is partly due to a condition called emphysema, in which parts of the lungs be come unduly expanded to compensate for other parts rendered more or less unfit for their duty. The discharge from the bronchial tubes of chronic bronchitic patients varies, sometimes being very abundant and watery, or thick and yellowish, sometimes being very scanty. In some cases it is very badly smelling. As a result of the condition of the lungs, other organs frequently suffer—the heart, liver, and kidneys —and death in the end may be due, not only to the lungs becoming more and more unfit for work, but also to the complications, to exhaus tion, &c.
Treatment.--The patient should be exposed as little as possible to any considerable change of temperature, and should not go out into the early morning air or night air. Wet and cold feet should be specially guarded against. The body should always he warmly clothed, flannel being next the skin. The room in which the person sleeps ought to be moderately warm. Good, nourishing diet in moderate quantity is necessary. Small doses of stimulants are often valuable, but the need of them must be decided on in each case on its merits, and by a com petent person, not according to the person's notions. Tonic medicines are required. The ammonia and senega mixture mentioned under