409 



BRONCHITIS. 



BRONCHITIS IN ANIMALS. 



secretion changes its character, loses its acrid nature and becomes more 

 bland, but still remains transparent. In an indefinite time, in general 

 in two or three days, still further changes take place ; its bland charac- 

 ter remains, but its colour is altered ; it gradually assumes a greenish 

 tint ; it then passes to yellow, and finally becomes of a bright brim- 

 stone hue. As the disease proceeds the condition of the membrane is 

 changed ; for aa the bland fluid is formed the morbid thickness and 

 firmness of the membrane diminishes, and it gradually returns to its 

 healthy condition. 



The redness, swelling, and firmness of the membrane, together with 

 its altered secretions, are then local signs visible to the eye which 

 denote the inflammatory condition of the membrane in coryza and in 

 cyuanche tonsillaris and pharyngea. The membrane being in part 

 manifest to our senses in the situations in which these diseases have 

 their seat, we can observe the morbid process that goes on, and mark 

 its different stages. It is probable that a perfectly analogous process 

 goes on when portions of this membrane which are placed beyond our 

 view are inflamed. When the inflammation is seated in the larynx 

 the membrane cannot be seen. That the particular portion of the 

 membrane which lines the larynx is in a state of inflammation is a 

 matter of inference derived from the disturbance of the function of 

 the organ, namely, the function which relates to the formation of the 

 voice. But when inflammation descends further into the trachea, the 

 bronchial tubes and their ramifications, not only are we altogether 

 unable to see the condition of the membrane, but as the functions of 

 those tubes are so simplified as to be mere conduits of air, the only 

 indication we can obtain that they are in a state of disease must arise 

 from the disturbance of that single function, namely, difficulty of 

 breathing. Certainly there will be combined two other symptoms, 

 namely, cough and expectoration ; but these are common to various 

 other diseases of the lungs, and consequently cannot be diagnostic, that 

 is, distinctive : while difficulty of breathing is common to every disease 

 of the lungs and heart which has arrived at a certain degree of intensity. 

 When inflammation is seated in these distant portions of the mucous 

 membrane of the air passages, it is impossible to arrive at any certain 

 knowledge of the specific disease from the symptoms or the signs of 

 disordered function only. 



It has been shown that inflammation of the mucous membrane of 

 the air-passages has two consequences, first, a swelling of the mem- 

 brane, and secondly, a change of its secretions; the local signs by 

 which the inflammation of the bronchi and of their ramifications is 

 ascertained and discriminated from all other diseases, have reference to 

 these two conditions. 



When the inflammation of the mucous membrane of the bronchial 

 tubes is considerable, the swelling of the membrane may be so great 

 as completely to close that portion of the tube in which the inflamma- 

 tion is seated. The consequence must be that the respiratory murmur 

 [AUSCULTATION] cannot be heard in that portion of the lung which the 

 tube supplies, since no air can pass the obstructed point ; accordingly, 

 on applying the ear, or the stethoscope [STETHOSCOPE] to the chest it 

 is found, especially in severe affections of this kind, that the respira- 

 tory murmur is absent in various portions of the lungs. This absence 

 of the respiratory murmur is however common to several other 

 affections of the lungs. Hence percussion must be called to the aid of 

 auscultation. By striking the chest [PERCUSSION] it is found that the 

 sound elicited is natural in bronchitis, while in almost every other 

 affection of the lungs it is dull where there is no respiratory murmur. 

 The reason of this difference is, that in bronchitis the cells are filled 

 with air, so that a natural sound is elicited by percussion ; but the 

 obstruction occasioned by the swelling of the inflamed membrane 

 confines and prevents the renewal of the air, and consequently the 

 respiratory murmur is lost ; while in other affections attended by 

 absence of the respiratory murmur the air-cells are impermeable, either 

 from their consolidation or compression, and then the sound, on percus- 

 sion, is invariably dull and fleshy. If on the other hand the inflamed 

 membrane be not so much swollen as completely to close the tube, then 

 another and a totally distinct sound is produced a whistling sound, a 

 Bound always observed to accompany an indistinct respiratory murmur, 

 on account of the diminished calibre of the bronchial tube. 



Moreover, when the swelling of the membrane diminishes, the nature 

 of the sound is again entirely changed. It now becomes a loud, deep, 

 and sonorous wheezing, the intensity of which in sufficient to cause a 

 vibration upon the parietes of the chest, distinguishable by the hand ; 

 at the same time the respiratory murmur becomes more distinct, 

 denoting that the bronchial tubes are more open ; finally, the deep 

 sonorous wheeze assumes a still deeper bass, merges into the respiratory 

 murmur, mixes with it, and gives it a roughness which is termed 

 nuJjh respiration. 



On the other hand, where the secretion re-appears and is in excess, a 

 wheezing sound is produced, which is loud and noisy in proportion to 

 the quantity of fluid poured into the tubes. This sound, when it is 

 formed in the trachea, can be heard through the medium of the air 

 alone ; but the application of the stethoscope, or the ear, to the surface 

 of the chest is necessary when it is formed in the bronchial tubes. 



Besides these local signs or symptoms derived from the altered 

 condition of the immediate seat of the disease, there are others derived 

 from the disturbance of the system in general. These general or 

 feverish symptoms are lassitude, indisposition to motion, chilliness, 



often amounting to shivering, pains in the limbs, and more especially 

 in the back and loins ; dullness and heaviness of the mind, or inability 

 to carry on the intellectual operations with the usual vigour. The 

 pulse is rapid and weak, and the urine scanty and limpid. These symp- 

 toms are soon followed by irregular flushes of heat, sometimes occur- 

 ring at one part of the body, sometimes at another, alternating with 

 the cold and intermingling with it, so that the patient feels frequently, 

 in consequence of the rapidity of these changes, the two different 

 sensations in the same place and almost at the same instant. The skin 

 at length becomes universally hot, and commonly dry; headache 

 comes on ; there is more or less thirst ; the pulse continues rapid, 

 but becomes full ; and the urine, which is still small in quantity, is 

 now high-coloured. Then perspiration succeeding to the dry condition 

 of the skin, the functions are again restored in a greater or less degree 

 to their natural condition, and there is a corresponding remission of 

 the symptoms. After this remission there is commonly an accession 

 of the febrile attack, usually in the evening. 



The causes which predispose to this disease are whatever causes 

 diminish the general vigour of the system, such as great fatigue, excess 

 of every kind, long exposure to a humid atmosphere, and so on. The 

 great exciting cause is cold, especially when combined with moisture. 



With regard to the treatment when the disease is in its mild form 

 nothing is required but confinement to the house in a uniform tempe- 

 rature in a warm room ; demulcent and diaphoretic medicines to 

 determine to the surface ; mild aperients, and the abstinence from all 

 stimulating food and drink. When the feverish symptoms have 

 subsided, when all uneasiness of the chest is gone, and the cough is 

 slight, some light tonic, as any of the ordinary bitters, will assist in 

 restoring the strength of the patient, and in preventing a relapse. 



When the disease is in its severer form, and dyspnoea, from an over- 

 loaded heart, is present, blood-letting is indispensable. The quantity 

 of blood taken must of course be in proportion to the intensity of the 

 disease and the strength of the patient, but it must be in sufficient 

 quantity to relieve the heart. Antimonials exhibited in decided doses 

 immediately after the blood-letting, commonly prevent the necessity of 

 any further depletion. The best preparation of antimony is the tartar 

 emetic, given in solution, to the extent of from a quarter to one grain 

 every second or third hour. The vomiting induced by the first doses 

 commonly subsides or becomes slight after the third or fourth dose. 

 Occasionally, however, this remedy produces so much irritation in the 

 stomach and the system in general that it cannot be given in the 

 quantity necessary to render it efficient ; then ipecacxianha forms an 

 excellent substitute, the powder of which may be given in doses of 

 from one to two grams every three or four hours. When the fever 

 subsides, the difficulty of breathing and oppression at the chest con- 

 tinue, blisters are highly advantageous. The cough, in itself teasing 

 and exhausting, and often aggravating every other symptom, must be 

 allayed by oily emulsions, barley water, linseed tea, &c. ; and if these 

 fail, and the cough continue so violent as to prevent rest, opium must 

 be given to the extent necessary to subdue it. The opium should 

 always be combined with diaphoretics, so as to determine to the skin, 

 the same titn3 that irriutfon is allayed. The bowels should be kept 

 moderately open during the whole course of the disease ; and there is 

 no remedial measure of greater importance than the maintenance of the 

 apartment steadily and invariably, day and night, at the same point, 

 a point which will insure a moderate degree of warmth, from 65 to 

 70. A great degree of heat is a most pernicious stimulus ; cold is the 

 great exciting cause of the disease, and any considerable alternation 

 from heat to cold, or from cold to heat, is of itself sufficient to counter- 

 act the beneficial operation of the most efficient remedies the most 

 skilfully combined. 



(Laennec on Diseases of the Chest; Lectures on the Diseases of tlic 

 Lungs, &c,, by Dr. T. Davies ; Art. Bronchitis ; Dr. Copeland's Diet, of 

 Pract. Med.; Watson's Lectures on, the Practice of Physic.) 



BRONCHI'TIS IN ANIMALS, or inflammation of the bronchi or 

 air-tubes of the lungs, is a very serious disease among quadrupeds. It 

 is occasionally confined to the lining mucous membranes of these 

 passages, but it more frequently spreads to the lining membrane of 

 the windpipe and larynx, and to a greater or less degree involves the 

 substance of the lungs. 



Horses. It is not a common disease in the horse, but it is easily 

 recognised by an interrupted wheezing sound in the breathing that can 

 be heard at some distance ; a tendency to coldness in the extremities, 

 distinct from the somewhat increased heat of catarrh and the deathy 

 iciness of inflamed lungs ; a pulse quicker than either in catarrh or 

 the early stage of pneumonia, not so hard as in pleurisy, but more so 

 than in catarrh or inflamed lungs ; the nostrils dilated, and the respi- 

 ration strangely quickened, being often more rapid than the pulse ; a 

 haggard countenance ; an almost perfect inability to move, from fear 

 of suffocation ; a cough exceedingly painful ; a purulent discharge 

 from the nostrils of a grayish-green colour, which soon becomes fetid 

 or mingled with blood ; the breath hot ; and no expression of pain m 

 any particular part indicated by looking at the side or flank. Pieces 

 of hardened mucus, or organised membrane, are also frequently 

 coughed up. 



Bronchitis is sometimes a primary disease, but it is oftener the 

 consequence of a neglected catarrh or long-continued but slight in- 

 flammation of the lungs. It is occasionally epidemic. Every affection 



