CHRONIC BRONCHITIS. 63 



flammation, to promote expectoration, and to soothe irritation. The 

 child should be confined to the house if the weather is inclement ; it 

 should have no meat ; the bowels should be kept open ; an emetic 

 of vin. ipecac, should be given about every other night, or whenever 

 the chest appears much loaded with phlegm ; a grain of calomel 

 and a warm bath at bed time may be given if there is much fever- 

 ishness : and if any inflammatory symptoms arise they must be 

 combated by leeches. 



Frictions to the spine are beneficial throughout ; olive oil, and oil 

 of amber ; soap liniment and laudanum are useful materials. 



When the acuteness of the complaint is over, tonics, especially 

 quinia and sulphate of zinc, and change of air, are the best means 

 of getting rid of the dregs of the disorder. Various other remedies 

 have been recommended in this disease, such as opium, hyoscyamus, 

 belladonna, hydrocyanic acid, acetate of lead, sulphate of zinc, 

 arsenic, nitrate of silver, ammonia, ether, musk, camphor, can- 

 tharides, &c. Many of these have enjoyed considerable reputation, 

 but are too dangerous for nursery use. Tartar emetic ointment has 

 been rubbed into the back ; but it is too severe for children. 



CHRONIC BRONCHITIS. 



The chief s^jmptoms of chronic bronchitis are, cough, shortness 

 of breath, and expectoration of various kinds of mucus. 



Causes. — This complaint is very common, especially in old people. 

 It may, like other chronic inflammations, be a consequence of one 

 or more acute attacks ; or it may, especially in old people, depend 

 on that congestion which is infallibly produced in the lungs by disease 

 of the heart. When habitual, and attended with much expectora- 

 tion, it is called humoral asthma. 



The sounds heard by auscuUation in simple cases, consist of the 

 crepitation and bubbling of mucus in the air-tubes of various 

 sizes. 



Sometimes this malady presents all the outward marks o? phthisis ; 

 wearing cough ; profuse purulent expectoration ; wasting, night 

 sweats, (fee. But yet so long as no important organic change has 

 occurred, it is quite curable. The diagnosis must be guided by the 

 circumstance, that in chronic bronchitis there is no solidification of 

 the upper lobes of either lung ; no pectoriloquy, or signs indicating 

 a cavity or vomica. 



Morbid appearances. — The mucous membrane after death may 

 be of various shades of redness ; often deep purple ; but this is not 

 constant. It may be ulcerated ; but this^is extremely rare. It may 

 also be thickened. But the most curious effect of long-continued 

 cough, and difliculty of breathing, is dilatation of the bronchi ; which 

 is caused apparently by the accumulation of mucus, impelled by the 



