BRONCHITIS. 155 



a very common cause of death amongst rickety children. One attack of acute 

 bronchitis favours the occurrence of another. The occupations which beget a liability 

 to bronchitis are those which involve much exposure to wet and cold or sudden and 

 marked changes of temperature. Employments which necessitate the inhabit! 

 irritating particles floating in the air, such as cotton, steel, or charcoal, favour its occur- 

 rence. It naturally follows that the complaint is commoner amongst those who earn 

 their bread by the sweat of the brow than with the rich and well-to-do. By far the 

 largest number of cases is met with in the autumn and winter months. In summer 

 it is comparatively rare, but from November to March or April it is very common. 

 A sudden change in the weather, or a north-east or east wind, will be sure to 

 bring with it bronchitis. 



The immediate cause of bronchitis is, nine times out of ten, cold in some form or 

 other. It acts in many ways you may get hot running to the station to catch a tniin, 

 and then sit in a draught from the window ; or you may get hot dancing, and then 

 go and cool yourself on the balcony ; or you may get wet through, and neglect to 

 change your clothes, or have no opportunity of so doing. Boots that let in the wet 

 are a fruitful source of bronchitis. Many people get an attack from neglecting to 

 wear flannels or a sufficient amount of warm clothing in the winter ; sleeping in damp 

 sheets has caused many a man's death from bronchitis. If you are subject to this 

 complaint, you cannot be too particular in keeping out cold, although you must be 

 careful not to keep out fresh air as well. Living in a close stuffy room soon weakens 

 and makes any person more than ever susceptible to bronchitis. Children who 

 drivel much, and whose garments covering the chest are constantly moist, are very 

 likely to have bronchitis, so that the greatest care should be taken to keep them dry 

 and clean. London fogs have the credit of being able to excite bronchitis, and with 

 many people they undoubtedly produce great irritation of the bronchial tubes. 



Bronchitis varies very much in its severity sometimes it is little more than a 

 common cold, at others it is so severe as to endanger the patient's life. Usually, to begin 

 with, there is an irritating watery flow from the nose and eyes, and a feeling of fulness, 

 heat, and soreness in these parts, with frequent attacks of sneezing. Very often there 

 is also tension or fulness over the forehead. The throat feels sore and rough ; and the 

 patient has to keep on hawking to clear it. The voice is usually affected, and becomes 

 hoarse and husky, so that it seems quite an effort to talk. The patient feels hot and 

 feverish and out of sorts, but the temperature is usually but slightly elevated. The 

 pulse is a little quicker than natural. Sometimes the limbs ache, and the patient seems 

 to have a cold all over. There is loss of appetite, the tongue is furred, and the bowels 

 are confined. There is a sense of heat or rawness in the chest, particularly beneath 

 the upper part of the breast-bone. Sometimes there is a feeling of tickling which 

 is peculiarly distressing. Cough soon sets in, and usually comes on in fits, either 

 spontaneously or from a draught of cold air, or some other source of irritation. They 

 increase in frequency and severity as the disease progresses, and they are usually worse 

 on first lying down at night or getting up in the morning. There is usually no 

 expectoration to begin with, but this soon sets in ; at first it is very slight, and thin 

 and watery in appearance, but after a time it gets thicker and more copious, and 

 assumes a yellow colour. Sometimes it is so thick that the greatest difficulty is 



