156 THE TREATMENT OF DISEASES. 



experienced in getting rid of it. It sticks about the throat and the back of the mouth 

 in the most distressing manner. Sometimes there are little streaks of blood in it, 

 but that arises from the violence of the cough, and too much importance must not be 

 attached to it. In favourable cases, and when energetic treatment is resorted to, the 

 attack runs its course in from three to five days; but if the patient keeps about in the 

 cold air, and takes no care of himself, it may last two or three weeks or even longer. 

 There is usually no cause for anxiety ; but in rickety children, and in those who are 

 ill-nourished, or the subject of some constitutional disease, it often proves dangerous, 

 and a fatal result may ensue. Sometimes the inflammation extends to the smaller 

 bronchial tubes, and it then constitutes a very serious condition. This complication 

 is more likely to occur in children than in adults. The onset of the bronchitis of the 

 smaller tubes, or " capillary " bronchitis, as it is called, is often ushered in by well- 

 marked rigors, severe headaohe, and sickness. Shortness of the breath is always a 

 prominent symptom. It may be limited to quickened and somewhat laborious 

 breathing, with a feeling of constriction and oppression across the chest, or the respira- 

 tions may be extremely frequent and hurried, attended with violent efforts during 

 inspiration and an urgent craving for air. Sometimes there is very great wheezing, 

 which may be heard at some distance from the bed. The cough is almost continuous, 

 but it also comes on in extremely violent, prolonged, and distressing paroxysms, during 

 which the face becomes swollen, red or purple, and the veins swell and the arteries 

 throb and throb again. There is a great deal of expectoration, which is coughed up 

 with the greatest difficulty. There is an exception to this in the case of children, 

 who do not expectorate, or rather swallow what they bring up. 



In capillary bronchitis the constitutional symptoms are always very severe. 

 The temperature may rise to 103 Eahr. or more, and the pulse is quick and full. 

 The symptoms may gradually subside, but very often the lips and face, and even the 

 hands and feet, become blue and cold and livid, as the result of the interference 

 with the breathing, and then there is the greatest danger. Cold clammy sweats 

 break out about the face and upper part of the body, and the exhaustion becomes 

 extreme. It is a pitiable sight to see a little child in this condition. Often enough 

 there is intense thirst and craving for water, and soon the mind begins to wander. The 

 cough ceases, the patient is too weak to expectorate, or too ill to feel the necessity 

 for so doing, and gradually the chest becomes blocked up with the phlegm, and then 

 recovery is almost hopeless. Fortunately, capillary bronchitis occurs in only a small 

 number of cases, and ordinarily the symptoms are far less serious. 



In the milder forms of bronchitis the patient is usually convalescent in from 

 nine to twelve days; but in severe cases of capillary bronchitis it may be three 

 weeks before convalescence is established. There is evidence to show that bronchitis 

 may lay the foundation of consumption. 



Bronchitis, however slight, should never be neglected, because a little care 

 and appropriate treatment may put an end to an attack which might otherwise 

 become very serious, or even lead to a fatal result. A neglected cold may lay 

 the foundation of an incurable disease. The treatment will vary somewhat, accord- 

 ing to the severity of the attack ; but if you err at all be sure that you err OB 

 the side of over-care. In the first place, it is absolutely necessary to stay in-doors. 



