56 PRACTICE OF MEDICINE. 



expectoration of a somewhat saline, glairy, thin fluid. If the disease 

 be of a mild type, the expectoration, in two or three days, becomes 

 thicker, more abundant, tenacious, and less irritating ; and as amend- 

 ment advances, the sputum increases in quantity, but is more opaque, 

 tenacious, and deeper coloured, being frequently greenish-white. 

 With these changes, the constriction, pain, and soreness, are miti- 

 gated : the pulse becomes less frequent ; the skin cooler and moist ; 

 and the urine less scanty, paler, and deposits a sediment. 



STHENIC, OR TRUE BRONCHITIS. 



Symptoms.' — This form of bronchitis may succeed the catarrhal, 

 if neglected. It is ushered in by chills, or sometimes complete 

 rigors ; which are soon followed by quickened and laborious respi- 

 ration ; oppression of the chest ; sometimes a dull pain on coughing ; 

 quick, full, and often strong pulse ; pain in the forehead, back, and 

 limbs ; foul, loaded tongue ; constipated bowels, and high-coloured 

 urine. As the diseases progresses, the frequency of the pulse, the 

 cough, expectoration, and general febrile symptoms increase, as well 

 as the tightness and soreness of the chest. Sometimes there is a 

 very sharp, though transient, pain extending over the whole chest, 

 particularly after fits of coughing. When the cough is violent, the 

 patient feels also pain and weakness about the attachments of the 

 diaphragm, along the borders of the false ribs, and in the back. The 

 febrile and other symptoms are aggravated towards night, which is 

 generally sleepless and disturbed. In extreme cases of this affection, 

 collapse, with diminished expectoration, purple lips, orthopnoea, quick, 

 depressed pulse, cold perspirations and extremities, with threatening 

 suffocation, occur early. 



ASTHENIC BRONCHITIS. 



(^Peripneumonia notha, or Suffocative Catarrh. — Bronchorrhea.) 



The disease which has received these names is an extensive in- 

 flammation of the bronchial mucous membrane, in a weak constitu- 

 tion with very great secretion of mucus. This copious secretion is 

 the great source of danger, 



*' There are four cases," says M. Laennec, " in which catarrh 

 may become suffocative — 1, in old persons; 2, in persons affected 

 with oedema of the lungs ; 3, in the dying ; 4, the acute catarrh 

 may sometimes assume this character even in adults and children. 



"1. In old perso7is. — This affection, which is almost always 

 mortal, occurs principally in winter, and in consequence of the super- 

 vention of an acute catarrh on a chronic mucous catarrh, or phleg- 

 morrhagy. It is liable to occur to old people with diseased heart, 

 and with chronic catarrh, if they catch cold. If of any continuance, 

 oedema of the lungs supervenes and hastens the fatal termination. 



