COMMON CATARRHAL BRONCHITIS. 55 



BRONCHITIS. 



Bronchitis is an inflammation with altered secretion of the mu- 

 cous membrane of the bronchi. There are several varieties of this 

 disease, arising from its extent, or from the state of the constitution, 

 or complications with which it is associated. It may present itself 

 under three forms — viz., the primary, secondary, and complicated. 

 The primary form is that in which the first morbid influence seems 

 to be exerted on the respiratory mucous membrane, and in which 

 any fever present must be regarded as symptomatic. In the secon- 

 dary variety, on the other hand, the disease depends on the pre-ex- 

 istence of some other malady ; especially disease of the heart, fever, 

 and the exanthemata. The complicated form accompanies other 

 diseases of the lung, — such as pneumonia, pleurilis, pulmonary 

 hemorrhage, tubercle, &c. 



According to the habit of body and vital energy of the patient, 

 and the extent to which the inflammatory action advances along the 

 bronchial tubes, acute primary bronchitis may be subdivided into 

 three forms : — 1st, common catarrhal bronchitis, in which the larger 

 bronchi and trachea are aflected, constituting catarrh ; 2d, sthenic, 

 or true bronchitis, which is of a highly inflammatory character, and 

 in which the mucous and sub-mucous tissues of the smaller bronchi 

 are also affected ; and, 3d, asthenic bronchitis, where, owing to de- 

 pressed vital energy, the inflammation assumes a low type, and is 

 attended with excessive secretion. 



COMMON CATARRHAL BRONCHITIS. 



Symptoms. — This is the most common form of the disease, and is 

 commonly known as severe cold. It seems to affect the whole sur- 

 face of the respiratory mucous membrane ; from the nose, and frontal 

 sinuses, downwards. It is evidently a constitutional disorder ; and 

 begins with shivering, headache, and feverishness, with pain and 

 weight in the frontal sinuses (gravedo)^ and dryness, irritation of 

 the Schneiderian membrane, sneezing, and snuffling, (cwyza.) 

 Then follow slight sore throat and hoarseness, and the irritation 

 extends down into the chest. But in some instances the irritation 

 commences primarily in the trachea and large bronchi, and is 

 attended at first with a sense of roughness, and a constant desire to 

 clear the throat. This is accompanied, or succeeded by titillation of 

 the larynx, exciting a dry, hard cough ; hoarseness, with a sense of 

 tightness across the chest ; and sometimes ^in on coughing or on 

 making a deep inspiration, and soreness and heat behind the sternum, 

 and between the shoulders, which are the great signs of bronchial 

 irritation. The constitutional symptoms are, great lassitude, pains in 

 the back and limbs, cold chills, quick pulse, dry skin, and high-coloured 

 urine. The cough, which was at first dry, is soon attended with the 



