TREATMENT OF BRONCHIAL CATARRH. 79 



flaps like a pair of loose breeches against their bones, who for months 

 suffer from bronchial catarrh, and who are often supposed to be tuber- 

 culous. Expectorants and derivatives are useless here ; but if we place 

 such children upon a well-selected diet, giving them milk and under- 

 done meat, if we prescribe cod-liver oil and salt baths, the results are 

 often brilliant. The children recover, and nothing but the pigeon- 

 breast remains to recall to mind the serious illness of childhood. 

 Again, we have found the malady to be a very common one in ad- 

 vanced life, but particularly so among a class of people of about fifty 

 years of age, " high livers," who drink freely of wine, sit all day, assim- 

 ilating much material, and consuming but little ; with haemorrhoids and 

 a voluminous paunch, who evince a great tendency to chronic affections 

 of the abdomen, as well as to chronic bronchial catarrh. It were folly to 

 confine such a person to his room, and set him to taking Seltzer-water 

 and milk, sulphuret of antimony or senega. Let him rather institute a 

 proper proportion between assimilation and consumption of nutriment, 

 cause him to take exercise, forbid spirituous liquors, and set him upon a 

 sparing vegetable diet. Finally, let a patient of this class betake him- 

 self to Marienbad, Karlsbad, or Kissengen. In such cases, but only in 

 cases like them, the alkaline chalybeates have a beneficial effect, not 

 upon the cough alone, and other symptoms of catarrh of the bronchi, 

 but upon the corpulence and the haemorrhoids. 



Among the exciting causes, mechanical obstacles at the mitral valve, 

 which impede the venous circulation of the bronchi, sometimes admit 

 of palliation. When the catarrh depends upon insumcience of the 

 mitral, the action of digitalis is uncertain, but its effect is very evident 

 where the hyperaemia is due to its contraction. In the latter case, by 

 retarding the action of the heart, time is afforded to the auricle to dis- 

 charge its entire contents into the ventricle, the engorgement of the 

 pulmonary vein subsides, and with it the bronchial catarrh to which it 

 has given rise. 



Bronchial catarrh, caused by the collateral fluxion to the lung in 

 malarious fever, requires quinine. The collateral fluxion into the bron- 

 chial arteries, produced by the pressure of a dropsical effusion upon the 

 abdominal aorta, may demand tapping ; the more so, as the diaphragm 

 which in these cases is pushed upward into the chest, compresses a 

 portion of the lung. After having once witnessed the striking ameliora- 

 tion effected by tapping, perhaps even the complete subsidence of a 

 bronchial catarrh, which a few days before was the patient's most griev- 

 ous affliction, we shall never permit any case of catarrh whatever to be 

 aggravated by collateral fluxion, the result of pressure upon the abdom- 

 inal aorta by accumulated fecal matter or by gas, the removal of which 

 is still more easy. A teaspoonful of the pulvis liquiritiae compositus. 





