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RESPIRATORY

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Originally appearing in Volume V04, Page 636 of the 1911 Encyclopedia Britannica.
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RESPIRATORY See also:

SYSTEM: See also:Pathology; and See also:PNEUMONIA). When this takes See also:place all the symptoms already detailed become greatly intensified, and the patient's See also:life is placed in imminent peril in consequence of the interruption to the entrance of See also:air into the lungs, and thus to the due aeration of the See also:blood. The feverishness and restlessness increase, the cough becomes incessant, the respiration extremely rapid and laboured, the nostrils dilating with each effort, and See also:evidence of impending suffocation appears. The See also:surface of the See also:body is See also:pale or dusky, the lips are livid, while breathing becomes increasingly difficult, and is attended with suffocative paroxysms which render the recumbent posture impossible. Unless speedy See also:relief is obtained by successful efforts to clear the See also:chest by coughing and expectoration, the patient's strength gives way, somnolence and See also:delirium set in and See also:death ensues. All this may be brought about in the space of a few days, and such cases, particularly among the very See also:young, sometimes prove fatal within See also:forty-eight See also:hours. Acute See also:bronchitis must at all times be looked upon as a severe and even serious ailment, but there are certain circumstances under which its occurrence is a See also:matter of See also:special anxiety to the physician. It is pre-eminently dangerous at the extremes of life, and mortality See also:statistics show it to be one of the most fatal of the diseases of those periods. This is to be explained not only by the well-recognized fact that all acute diseases tell with See also:great severity on the feeble frames alike of infants and aged See also:people, but more particularly by the tendency which bronchitis undoubtedly has in attacking them to assume the capillary See also:form, and when it does so to prove quickly fatal. The importance, therefore,of See also:early See also:attention to the slightest evidence of bronchitis among the very young or the aged can scarcely be overrated. Bronchitis is also See also:apt to be very severe when it. occurs in persons who are addicted to intemperance. Again, in those who suffer from any disease affecting directly or indirectly the respiratory functions, such as See also:consumption or See also:heart disease, the supervention of an attack of acute bronchitis is an alarming complication, increasing, as it necessarily does, the embarassment of breathing.

The same remark is applicable to those numerous instances of its occurrence in See also:

children who are or have been suffering from such diseases as have always associated with them a certain degree of bronchial irritation, such as See also:measles and whooping-cough. One other source of danger of a special See also:character in bronchitis remains to be mentioned, viz. collapse of the See also:lung. Occasionally a See also:branch of a bronchial See also:tube becomes plugged up with secretion, so that the See also:area of the lung to which this branch conducts ceases to be inflated on See also:inspiration. The small quantity of air imprisoned in the portion of lung gradually escapes, but no fresh air enters, and the See also:part collapses and becomes of solid consistence. Increased difficulty of breathing is the result, and where a large portion of lung is affected by the plugging up of a large bronchus, a fatal result may rapidly follow, the danger being specially great in the See also:case of children. Fortunately, the obstruction may some. times be removed by vigorous coughing, and relief is then obtained. With respect to the treatment of acute bronchitis, in those mild cases which are more of the nature of a See also:simple See also:catarrh, little else will be found necessary than confinement in a warm See also:room, or in See also:bed, for a few days, and the use of See also:light See also:diet, together with warm diluent drinks. Additional See also:measures are however called for when the disease is more markedly See also:developed. Medicines to allay See also:fever and promote See also:perspiration are highly serviceable in the earlier stages. Later, with the view of soothing the See also:pain of the cough, and favouring expectoration, mixtures of tolu, with the addition of some opiate, sitth as the See also:ordinary paregorics, may be advantageously employed. The use of See also:opium, however., in any form should not be resorted to in the case of young children without medical See also:advice, since its See also:action on them is much more potent and less under See also:control than it is in adults. Not a few of the so-called " soothing mixtures " have been found to contain opium in quantity sufficient to prove dangerous when administered to children, and caution is necessary in using them.

From the outset of the attack the employment of fomentations, or especially a See also:

turpentine stupe, gives great relief, and occasion-ally in the non-specific form this treatment, combined with a See also:good dose of See also:calomel and salts, may render the attack abortive. Some relief is always obtained by inhalations, and theoretically, an acute specific bronchitis should be successfully treated by inhalation of antiseptic and soothing remedies. In practice, however, it is found that the strength cannot be sufficiently strong to destroy the bacteria in the bronchial tubes. However, much relief is obtained from the use of See also:steam atomizers filled with an aqueous See also:solution of See also:compound See also:tincture of See also:benzoin, See also:creosote or guaiacol. A still more practicable means of introducing volatile antiseptic See also:oils is the globe nebulizer, which throws oleaginous solutions in the form of a See also:fine See also:fog, that can be deeply inhaled. Menthol, eucalyptol and See also:white See also:pine See also:extract are some of the remedies that may be tried dissolved in benzoinol, to which See also:cocaine or opium may be added if the cough is troublesome. When the bronchitis is of the capillary form, the great See also:object is to maintain the patient's strength, and to endeavour to secure the See also:expulsion of the morbid secretion from the fine bronchi. In additon to the remedies already alluded to, stimulants are called for from the first; and should the cough be ineffectual in relieving the bronchial tubes, the See also:administration of an emetic dose of sulphate of See also:zinc may produce a good effect. During the whole course of any attack of bronchitis attention must be paid to the due nourishment of the patient; and during the subsequent convalescence, which, particularly in elderly persons, is apt to be slow, tonics and stimulants may have to be prescribed. Chronic bronchitis may arise as the result of repeated attacks of the acute form, or it may exist altogether independently. It occurs more frequently among persons advanced in life than among the young, although no See also:age is exempt from it. The usual See also:history of this form of bronchitis is that of a cough recurring during the colder seasons of the See also:year, and in its earlier stages, departing entirely in summer, so that it is frequently called " See also:winter cough." In many persons subject to it, however, attacks are apt to be excited at any See also:time by very slight causes, such as changes in ; the See also:weather; and in advanced cases of the disease the cough is seldom altogether absent.

The symptoms and auscultatory signs of. chronic bronchitis are on the whole similar to those pertaining to the acute form, except that the febrile disturbance and pain are much less marked. The cough is usually more troublesome in the See also:

morning than during the See also:day. There is usually See also:free and copious expectoration, and occasionally this is so abundant as to constitute what is termed bronchorrhoea. Chronic bronchitis leads to alterations.' of structure in the affected bronchial tubes, their mucous membrane becoming thickened or even ulcerated, while occasionally permanent See also:dilatation of the bronchi . takes place, often accompanied with profuse foetid expectoration. In See also:long-See also:standing cases of chronic bronchitis the See also:nutrition of the lungs becomes impaired, and dilatation of the air-tubes (See also:emphysema) and other complications result, giving rise to more or less See also:constant breathlessness. Chronic bronchitis may arise secondarily to some other ailment. This is especially the case in See also:Bright's disease of the kidneys and in heart disease, of both of which maladies it often proves a serious complication, also in See also:gout and syphilis. . The See also:influence of occupation is seen in the frequency in which persons following certain employments suffer from chronic bronchitis. Hirt has shown that the inhalation of See also:vegetable dust is very liable to produce bronchitis through the irritation produced by the dust particles and the growth of organisms carried in with the dust. Consequently, millers and See also:grain-shovellers are especially liable to it, while next in See also:order come, weavers and workers in See also:cotton factories. The treatment to be adopted in chroni c bronchitis depends upon the severity of the case, the age of the patient and the presence or See also:absence of complications. Attention to the See also:general See also:health is a matter of See also:prime importance in all cases of the disease, more particularly among persons whose avocations See also:entail exposure, and tonics with See also:cod-See also:liver oil will be found highly advantageous.

The use of a respirator in very See also:

cold or See also:damp weather is a valuable means of See also:protection. In those aggravated forms of chronic bronchitis, where the slightest exposure to cold air brings on fresh attacks, it may become necessary, where circumstances permit, to enjoin confinement to a warm room or removal to a more genial See also:climate during the winter months.

End of Article: RESPIRATORY

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