gQ PKACTICE OP MEDICINE. 



catarrh The other changes remarked in chronic bronchitis are, 

 thiclcening, softening, but rarely ulceration, of the mucous membrane; 

 in chronic cases, dilatation of the bronchi. In only two mstances 

 has M Andral detected ulcerations m the bronchi. 



Brv catarrh.— This name is given by the French to a not uncom- 

 mon variety of bronchitis; in which there is great dyspnoea, and 

 intense congestion of the membrane, with sibilus or dry sounds ; but 

 the ordinary secretive stage is very slow to come on. I is also 

 known by the name of bronchial congestion, and often follows the 

 inhalation of acrid vapours. , , i,„j . 



Treatment.— In simple catarrhal bronchitis, confinement to bed , 

 inhalation of steam; an aperient ; a warm bath ; a few grains of 

 Dover's powder with a little antimony at bed time; some demulcent 

 for the cough; and low diet, are usually sufficient. , ^ , , , 

 When acute bronchitis occurs in a robust habit, a moderate bleed- 

 ing is decidedly indicated; but, as in other mucous mflammations 

 we'must regard general depletion more as a means for reducing the 

 febrile excitement, and preparing the patient for local treatmen than 

 for cutting short the disease. The bowels should next be attended 

 to, and freely acted upon by mild aperients. After general bleeding 

 and purgatives, local depletion will be found extremely benefica; 

 and Dr. Stokes recommends " that in severe cases the patient should 

 be cupped under the clavicles, or betvveen the scapute, ora "umber 

 of leeches be applied under the clavicles, or into the axilte After 

 moderate depletion, it will be right to use some antiphlogistic reme- 

 r^-and asVrcJrv is not so beneficial in inflammations of mucous 

 as ^f serous membranes, tartar emetic is to be preferred It should 

 be given in small doses at regular intervals-say gr.i 4tis hous in 

 s:iu'tion with a drachm of sy r. papaveris and some f-tmed water, and 

 be continued until it causes nausea, and lowers the heaits action 

 In some cases, after the system is brought under its influence, he 

 ^sease yields suddenly ; the oppression and wheezing cea e, the 

 cough tecomes trifling, the lividity disappears, the pulse falls, and 

 the respiration, with the exception of a slight crepitation, which is 

 occaSonally heard, is healthy, pure, and equal. In others, a copious 

 secretion is produced, with great relief. ,,.,,, j 



Some practitioners prefer°ipecacuanba as less hkely to purge and 

 weaken. ^ Emetics are extremely useful in bronchitis, part»="!^;'y " 

 I'he asthenic form, and in the sthenic variety after bleeding ;m 

 chUdren Xei^ exhibition is attended with the best results. For 

 ch d en ipecacuanha should be preferred; for aged persons the 

 su Dhate of zinc ; and, for the robust adult, tartarized antimony 



Wten the inflammatory action and febrile heat have been subdued 

 blisters are of much service, and may be applied either between the 

 shoulders or on the breast. A large warm poultice to the chest is 

 also useful, especially for children. 



