CHAPTER X. DISEASES OF THE LUNGS AND PLEURA. Acute Bronchitis.
Remember that in typhoid and malaria it is an early symptom. Remember that influenza, measles, and whooping-cough are accompanied by acute bronchitis. Remember that substernal soreness and in the region of the attachment of the diaphragm is common, and is due to cough. Remember that fever is frequently present, and may reach 102° or 103° F., but usually lasts only a few days. Remember that cough is 'tight' in early part of attack, due to tenacious, scanty mucus adhering to swollen mucosa of the tubes. Remember that sibilant or sonorous rales are heard during this period of dry cough. Remember that the larger the bronchi affected, the less are generally the signs caused by the bronchitis. Remember that the percussion sound over the thorax is never altered by uncomplicated bronchitis. Remember that blowing sounds are never heard in bronchitis, but that the vesicular murmur is heard, and the only alteration is that it is sharp and loud (puerile), and there is prolonged expiration.
<Callout type="important" title="Important">Cyanosis and increased respiratory rate in dyspnea that are not relieved by the cough indicate the process has involved the small tubes — capillary bronchitis.</Callout>
Remember that mucous, bubbling rales appear when the cough loosens. Bronchial fremitus may be felt on palpation.
<Callout type="risk" title="Risk">Cyanosis and increased respiratory rate in dyspnea that are not relieved by the cough indicate the process has involved the small tubes — capillary bronchitis.</Callout>
Remember that cyanosis and increased respiratory rate in dyspnea that are not relieved by the cough indicate the process has involved the small tubes — capillary bronchitis. Remember that the epigastrium and hypochondriac region are retracted during inspiration in capillary bronchitis, in contradistinction to the normal inspiratory bulging.
Remember that percussion sound is not altered. If dull areas are found, it signifies bronchi- pneumonia or atelectasis. Therefore examine such a chest daily for this important change in percussion.
Remember that bronchial breathing heard on auscultation is never present in any form of bronchitis.
<Callout type="tip" title="Tip">Treatment should be adjusted based on the stage of the disease, from dry to mucous.</Callout>
Spirals are found in the sputum in capillary bronchitis; also Charcot's crystals. Treatment. In mild cases, hot foot bath, a mustard plaster to the chest, applied over the sternum and extending out to nipple line on either side. The plaster should not remain on long enough to blister. A glass of hot lemonade at bedtime will suffice in mild cases. For the severer forms a hot bath at night on going to bed. When Turkish baths are taken, one must go directly from the bath to bed, because any exposure after such a bath is exceedingly dangerous.
Bowels should be moved freely by saline. The atmosphere of the room should be moist. This may be done by steam from boiling water. This is better if salt (NCI) and soda are added to it. The cough may be relieved by opium, or, better, codein. In the dry stage the secretion of mucus must be stimulated.
<Callout type="gear" title="Gear">Mustard plaster can be used for mild cases.</Callout>
IJ Codeinse phosphatis gr. v-gr. viij Liquoris anunonii acetatis 3 iv Syrupi ipecacuanhse o ij Syrupi pruni virginianse 3 iv Aquae q. s. ad 5 iv Misce et fiat solutio. Sig. : Teaspoonful every two hours.
Or: IJ Ammonii carbonatis 3 ij Ammonii iodidi 5 iij Syrupi glycyrrhizse § ij Syrupi tolutani 5 i j Misce et fiat solutio. Sig. : Teaspoonful every two or three hours in water.
The above combinations are particularly useful in capillary bronchitis.
IJ Ammonii chloridi, Sodii salicylatis aa 3 ij Tincturae hyoscyaminse 3 vj Misturse glycyrrhizse comp. q. s. ad o iij Misce. Sig. : Teaspoonful every three hours.
Or: IJ Codeinse phosphatis gr- iv Ammonii carbonatis gr. jcxx Tincturse hyoscyaminse 3 iv Syrupi pruni virginianse 3 vj Aquse camphorse q. s. ad § ij Misce. Sig.: Teaspoonful every two hours.
166 DISEASES OF THE LUNGS AND PLEURA. Or: 3 Vini antimonialis 3 ij Spiritus setheris nitrosi 3 iv Liquoris ammonii acetatis § ij Tincturse camphorse compositse . . . . 3 ij Aquae q. s. ad 5 iv Misce. Sig. : Tablespoonful every three or four hours. To be used with tense pulse, fever, and dry, hot skin.
With the establishment of secretion, the medication should be changed. This is now the time for squills and senega, but they are contraindicated until this stage is reached.
IJ Infusi senegse 5 iv Ammonii carbonatis gr. xxxi j TincturiB scillas 3 iiss Spiritus chloroformi 3 ij Aquae q. s. ad 5 viij Misce et fiat misturae. Sig.: 2 tablespoonfuls every four hours.
Or: IJ Tincturae veratri viridi Til xx Vini antimonialis 3 iv Tincturae opii camphoratae 3 iiss Liquoris ammonii acetatis 5 ij Misce. Sig.: Teaspoonful in little water every two, three, or four hours.
Or: IJ Camphorae gr. j Extracti belladoimae gr. %-gr. ^ Quininae sulphatis gr. ij Pulveris ipecacuanhse et opii gr. j Misce et fiat capsula No. I. Dentur tales No. XV. Sig.: Capsule hourly for four doses, then every three hours.
ACUTE BRONCHITIS CHRONIC BRONCHITIS.
Key Takeaways
- Recognize the symptoms of acute bronchitis, including fever and coughing.
- Use mustard plasters for mild cases of bronchitis.
- Adjust treatment based on the stage of the disease.
Practical Tips
- Use a humidifier to keep the air moist during an attack of bronchitis.
- Stay hydrated by drinking plenty of fluids, especially warm liquids like lemonade or tea.
- Avoid exposure to cold drafts and maintain a warm environment.
Warnings & Risks
- Be cautious with opium-based medications as they can be addictive and have side effects.
- Do not use adrenalin (epinephrine) in cases of arteriosclerosis, as it can cause severe complications.
- Avoid exposure to smoke or other irritants that could worsen the condition.
Modern Application
While many of the treatments described here are outdated and may pose risks, understanding the symptoms and recognizing when professional medical help is needed remains crucial. Modern techniques like antibiotics for bacterial infections and antiviral medications for influenza have improved treatment outcomes significantly. However, the importance of proper hydration, maintaining a clean environment, and recognizing severe symptoms has not changed.
Frequently Asked Questions
Q: What are the early signs of acute bronchitis mentioned in this chapter?
The early signs include substernal soreness, fever that may reach up to 103°F, and a tight cough due to tenacious mucus adhering to the swollen mucosa.
Q: What is the recommended treatment for mild cases of acute bronchitis according to this chapter?
For mild cases, a hot foot bath, a mustard plaster applied over the sternum, and a glass of hot lemonade at bedtime are suggested.
Q: How can one differentiate between capillary bronchitis and uncomplicated bronchitis based on symptoms mentioned in this chapter?
Capillary bronchitis is indicated by cyanosis and increased respiratory rate that are not relieved by coughing, while uncomplicated bronchitis does not show these signs.