The course of the affection varies. The condition greatly improves during the warm season, and becomes aggravated during autumn and winter, when new harmful influences are active. If the disease persists for many years, there is danger that a dilatation of the lung-vesicles may occur, and that enlargement of the heart may develop.
The best preventive against bronchial catarrh is to avoid carefully all harmful influences which are known to produce the condition or which favour its occurrence. Rooms which are filled with dust, smoke, or irri tating gases should be avoided, and a healthy, dry place of residence selected. The hardening of the skin to the influences of variations of tem perature is of inestimable value. Sec HARDENING.
Although experience teaches that acute bronchial catarrh usually runs a favourable course, it should be borne in mind that this is still more the case if the affection is carefully treated. If fever develops, much time may be saved, and much suffering avoided, by remaining at home, preferably in bed. and securing the advice of a medical practitioner. The majority of people live in hopes that Nature will cure " such little colds," and sometimes they believe they overdo matters by taking hot drinks and getting into a perspiration. Such domestic remedies are often sufficient to check a mild, beginning bronchitis, but in many cases they fail ; and it is rarely wise to assume the responsibility, especially when children or elderly people show the manifestations of bronchial irritations.
The treatment of chronic bronchitis often presents many difficulties, particularly when the patient is unwilling or unable to withdraw from the harmful influences which caused the affection, or which are aggravating it. The prospect of ultimate recovery is present only if the patient leads a fitting, rational life. The irritants to be feared and to be avoided are smoke and dust, alcohol and tobacco. A change of residence is often advisable. A sojourn in the health-resorts along the south coast is often helpful, not because remedies are to be obtained in these places which are not available elsewhere, but because many patients only in this manner will be able to enjoy a perfect bodily rest, away from the harmful influences that prevail at their homes. The actual treatment should be left to the physician, since it is not always merely a question of combating cough and expectoration ; the main thing is often to cure or alleviate the original disease which causes the cough (such as heart defects, kidney diseases, gout, and alcoholism). If these causative affec tions can be improved, the result is usually an essential recovery from the bronchitis.
BRYONIA.—The dried root of Bryonia alba, a cucumber-like plant growing in Europe. The root contains one or more active glycosides, which are extremely bitter, and which have a very active cathartic action. Bryonia
has been used as a cathartic from time immemorial. It causes copious, watery stools ; and in large doses poisoning with violent abdominal pains, sweating, reduction of temperature, and death from collapse.
BUBO.—An inflammation and enlargement of the inguinal glands, brought about by the entrance of infectious substances into the lymph channels. They manifest themselves as painful tumour formations in the groin, and follow contaminated wounds and injuries of the lower limbs, or more especially certain sexual diseases, primarily soft chancre, gonorrhoea, arid simple inflammation of the prepuce. Non-painful swellings in the region of the groin occur in cases of hard chancre. Sec VENEREAL DISEASE. The swellings of the glands of the groin in soft chancre show a decided ten dency to suppuration. It is possible that these may recede, if the patient 'mains quiet and applies cooling poultices ; but if suppuration and softening have occurred, perforation takes place at one or several points in the external skin (formation of fistula), unless an operation be previously performed.
If the condition is still further neglected, especially in Nveakly and scrofulous persons, numerous fistulous ulcers form which undermine the skin and are difficult to heal. The fistulous canals which penetrate the skin in several places discharge a thin, putrid pus. If surgical aid is not rendered, the continued suppuration and the loss of substance connected with it lead to a long-lasting sickness which, in the course of time, will exhaust the strength of the patient.
Prevention of swelling of the glands of the groin is hest accomplished by a corresponding hygienic conduct in the existing inflammatory affection responsible for the condition ; above all, by rest and scrupulous cleanliness, and by the earliest possible diminution of the infectious character of a venereal ulcer by medical treatment. A painful inflammation of the in guinal glands once being present, the patient should keep quietly in bed, and apply cooling poultices until the physician arrives. After softening has set in, it is advisable to lance the swelling as early as possible. If necessary, this should be followed by extirpation of the affected glands, as this will essentially shorten the course of the disease and prevent further complica tions. The application of bread-poultices, ointment-bandages, etc., often practised after the ulcers are opened, is very inadvisable.
Attention may finally be called to the fact that, in soft chancre, it often occurs that there arises at the site of the opened bubo a new, large, chancrous growth (chancrous bubo), which sometimes destroys extensive portions of the skin. The surest preventive against this disagreeable consequence is energetic, operative treatment, consisting in extirpation of the affected lymph-glands.