160 



THE TREATMENT OF DISEASES. 



Sometimes it is transparent and watery, but quite as frequently it is thick and 

 yellow. It varies greatly in quantity, and is usually difficult to expel. Occasionally, 

 after a violent bout of coughing, it is tinged with blood ; but there is never any 

 real spitting of blood as there is in consumption. 



Shortness of breath is always a very prominent and distressing symptom. 

 So short is the breath that often the patient can walk only a few yards, especially 

 in the cold air. He finds it very hard work to get up-stairs, and is usually quite 

 unfitted for an active life. The breathing grows worse at night, so that he cannot 

 sleep unless with the head propped up with several pillows. He is troubled, too, 

 with bad fits of shortness of breath, which generally come on at night, last several 

 hours, and constrain him to sit up in bed. Sometimes the breathing is difficult only 

 on exertion, but it like the cough is in most cases made much worse by fogs, 

 east winds, or damp. 



Wasting is not a prominent symptom as it is in consumption, but still there is 

 nearly always some loss of flesh in winter, which is gradually regained as summer 

 returns. In bad cases the legs may swell. The sufferer from chronic bronchitis 

 usually leads a most miserable existence ; for nearly six months out of the twelve 

 he is practically an invalid. 



The best method of treating chronic bronchitis is by means of a spray. By a 

 very simple apparatus a liquid can be "atomised," or converted into fine vapour. 

 This process is probably familiar to most of our readers, for it is often used for the 

 diffusion of scent. By inhaling the spray, the drug can be brought into immediate 

 contact with the lungs, the part on which it is required to act. There are several 

 kinds of spray apparatus sold by instrument makers, but " Richardson's " is the one 



most commonly used for this 

 purpose. It is very simple, 

 and the accompanying figure 

 requires but little explanation. 

 The bottle is about two-thirds 

 filled with the liquid it is 

 desired to atomise, and on 

 squeezing the india-rubber ball 

 (A) several times in succession 

 the spray issues from the 

 nozzle (B). A small tap (c) 

 is usually placed just behind 

 the nozzle, and must of course 

 be open. The second india- 

 rubber ball (D) acts simply as 

 a reservoir, and serves to make the jet uniform. The end of the tube (E) is covered 

 with linen, or has a little piece of sponge attached, to filter off any particles that 

 may be floating about in the liquid and might block up the apparatus. The best 

 substance for spraying in chronic bronchitis is ipecacuanha wine. It is too strong to 

 be used alone, and it should be diluted with twice the quantity of water. It is as 

 well to use tepid water, as the spray is then pleasanter to inhale. At first the nozzle 



Fig. 1. RICHARDSON'S SPRAY APPARATUS. 



