Diseases Of The Respiratory System
( Originally Published 1936 )
HOW BRONCHITIS AFFECTS MOTHER AND OTHER ADULTS
WHEN an adult has a bronchial cough, it is usually simple infection following an infection of the upper respiratory passages, the nose and throat. A cold in the chest, in fact. The adult does not have nearly as many other conditions which cause bronchial coughs as does the baby, which we described earlier.
In adolescence or young adult life coughs may be caused by tonsils or adenoids that are chronically infected, or by a long palate which hangs into the back of the throat and tickles the vocal cords. But these things are not so likely to happen in full maturity.
Affections of the vocal cords themselves or the voice box (larynx), may cause a cough which is ascribed to bronchitis and neglected for that reason. There are such things as little papillomata or warts on the vocal cords. These can easily be removed by a competent throat specialist.
Of course, one of the great dangers of neglecting a bronchial cough in an adult is that it may not be bronchitis at all, but tuberculosis in an early stage, and if a cough of this nature hangs on too long, it certainly indicates a careful examination to discover whether tuberculosis is present in the lungs.
Another condition which may cause continuous coughing is infection of the nasal sinuses, with the dripping of infected material into the chest.
Sometimes people cough violently for a long time, and finally bring up a little stone or stony material. These are called "broncholiths," and are due to the ulceration of a calcified lymph node through the wall of the bronchial tube into its cavity. The condition is not serious although it may be very alarming, and after the stone has been disgorged the condition usually promptly clears up.
People who cough for a long time after an attack of pneumonia and bring up thick, nummular sputum have, probably, a secondary infection of the pleura which surrounds the lungs, and the formation of pus in the pleural cavity. This condition is called an "empyema" and sometimes the pus burrows its way through the lung substance and enters a bronchial tube.
Finally, it must never be forgotten in adults that coughs are sometimes merely the symptoms of hysteria, and are due to habit. I would hate to say that mother had ever had this kind of a cough, but it is possible that father or brother has it, and that they cough simply to call attention to themselves (subconsciously) or (equally subconsciously) to annoy the rest of the family.
AFTER CORRECT DIAGNOSIS TREAT BRONCHITIS AT HOME
Most cases of acute bronchitis are treated at home by home methods. Which is perfectly proper provided you are sure that the case is one of bronchitis.
The underlying principles of the treatment of bronchitis, however, are fairly simple, and should be observed no matter what particular remedies are used. The first thing to be remembered is that it is a self-limited disease, the acute stage of which should be over in two or three days, and the entire course of which should not run longer than two weeks.
During the first stage, the greatest discomfort comes from infection itself and absorption of toxic materials, with the associated symptoms of slight fever, chilly sensations, lack of appetite, sense of constriction in the chest, headache and costiveness.
The best treatment for these is rest in bed and methods which will bring about elimination and relaxation. This, therefore, is the stage in which hot mustard foot baths, sweats induced by aspirin and a hot bath, hot water bag in bed, are most effective. Elimination by the use of a cathartic such as castor oil or Epsom salts also is in order. The best way to treat the lack of appetite is to give it time. Food is unnecessary and should not be forced at this time, except, perhaps, hot lemonade and rock and rye.
During the second stage, the secretions loosen up and cough and expectoration are troublesome. The patient, on the whole, feels better, but may be considerably annoyed by tenacious sputum and excessive secretion.
The old standard remedy for this stage is ammonium chloride dissolved in some syrup such as syrup of wild cherry, syrup of tolu, or syrup of white pine. The syrups themselves are soothing to the throat and prevent the irritating, continuous cough which comes from habit and irritation of the vocal cords. A cough is a protective symptom, but to be so it should bring up some secretion from the chest. When it becomes purely habit it should be controlled.
Another method of treating this stage is by the use of inhalations. These can be either menthol and camphor or compound tincture of benzoin, or many other aromatic substances.
The technique of inhalations is important, because most of them when fixed with a kettle, paper cone, etc., are likely to be awkward and to irritate the skin of the nose and lips. The best method is to get a large rubber tube and an ordinary metal pitcher. Put steaming hot water in the pitcher, throw the aromatic medicine on top of this, cover the top of the pitcher with a towel, and stick the rubber tube into the mouth of the pitcher.
The tube should, of course, not reach the surface of the water. Then put your mouth over the exposed end of the tube and breathe the fumes directly into the chest. This prevents the irritation of the skin referred to above.