Bronchitis

Bronchitis. Inflammation of the mucous membrane lining the bronchial tubes. The prevalence of bronchitis in this country is testified to by the fact that more deaths are returned as being due to it than to any other form of disease. It must be remembered, however, that in many instances when death is attributed to it, the bronchial mischief is merely a complication superadded to some other disorder. Diseases of the heart and kidneys are especially apt to terminate fatally in this way, so in children are measles and whooping-cough; again, gouty and tubercular subjects are particularly liable to bronchitic attacks. Further, when bronchitis becomes chronic, changes of a permanent character are set up in the lungs, and in patients so affected the fatal attack is only the last link in a long chain of diseased processes. In fact, uncomplicated bronchitis is very rarely fatal, save in children and old people.

The disease often dates from exposure to cold, and the inhalation of irritant materials is doubtless a predisposing cause, but perhaps the most important factor is the existence of a tendency to bronchitis. The fact that each attack causes subsequent attacks to be of more and more frequent occurrence, causes immense importance to attach to the treatment of the first manifestations of the disease.

The symptoms are first general and secondly local. The general symptoms are those of fever; headache, chilliness, rise of temperature, accelerated pulse, thirst and loss of appetite, furred tongue and constipation. The general disturbance is more marked in acute than in chronic attacks. The local symptoms are cough and difficulty of breathing. The cough is at first dry, and then attended with mucous, and finally with muco-purulent expectoration. The secretion which accumulates in the tubes gives rise to the wheezing character of the breath sounds, and on the application of the stethoscope rhonchus and crepitation or mucous rales are heard. If the lungs become increasingly involved, lividity results from deficient aeration of the blood, perspirations break out, delirium and coma supervene, and the patient may die asphyxiated. Usually, however, after the lapse of a day or two, the breathing becomes more easy, the sputum gradually diminishes in amount, and the disease is at an end.

The most dangerous variety of acute bronchitis is that in which the smallest tubes are chiefly involved. This capillary bronchitis, as it is called, is most apt to affect children, and is often accompanied by little or no expectoration.