Bronchitis is a much more frequent disease than inflammation of the lungs; indeed, it is one of the most common complaints both of infants and of children, while inflammation of the lungs is comparatively a rare disease. Bronchitis is not nearly such a dangerous disease as inflammation of the lungs.
The symptoms.—The child for the first few days labors under symptoms of a heavy cold; he has not his usual spirits. In two or three days, instead of the cold leaving him, it becomes more confirmed; he is now really poorly, fretful, and feverish; his breathing becomes rather hurried and oppressed; his cough is hard and dry and loud; he wheezes, and if you put your ear to his naked back, between his shoulder-blades, you will hear the wheezing more distinctly. If at the breast, he does not suck with his usual avidity; the cough, notwithstanding the breast is a great comfort to him, compels him frequently to loose the nipple; his urine is scanty, and rather high-colored, staining the napkin, and smelling strongly. He is generally worse at night.
Well, then, remember if the child be feverish, if he have symptoms of a heavy cold, if he have an oppression of breathing, if he wheeze, and if he have a tight, dry, noisy cough, you may be satisfied that he has an attack of bronchitis.
204. How can I distinguish between Bronchitis and Inflammation of the Lungs?
In bronchitis the skin is warm but moist; in inflammation of the lungs it is hot and dry: in bronchitis the mouth is warmer than usual, but moist; in inflammation of the lungs it is burning hot: in bronchitis the breathing is rather hurried, and attended with wheezing; in inflammation of the lungs it is very short and panting, and is unaccompanied with wheezing, although occasionally a very slight crackling sound might be heard: in bronchitis the cough is long and noisy; in inflammation of the lungs it is short and feeble: in bronchitis the child is cross and fretful; in inflammation of the lungs he is dull and heavy, and his countenance denotes distress.
We have sometimes a combination of bronchitis and of inflammation of the lungs, an attack of the latter following the former. Then the symptoms will be modified, and will partake of the character of the two diseases.
205. How would you treat a case of Bronchitis?
If a medical man cannot be procured, I will tell you what to do: Confine the child to his bedroom, and if very ill, to his bed. If it be winter time, have a little fire in the grate, but be sure that the temperature of the chamber is not above 60° Fahrenheit, and let the room be properly ventilated, which may be effected by occasionally leaving the door a little ajar.
Let him lie either outside the bed or on a sofa; if he be very ill, inside the bed, with a sheet and a blanket only to cover him, but no thick coverlid. If he be allowed to lie on the lap, it only heats him and makes him restless. If he will not lie on the bed, let him rest on a pillow placed on the lap; the pillow will cause him to lie cooler, and will more comfortably rest his wearied body. If he be at the breast, keep him to it; let him have no artificial food, unless, if he be thirsty, a little toast and water. If he be weaned, let him have either milk and water, arrow-root made with equal parts of milk and water, toast and water, barley-water, or weak black, tea, with plenty of new milk in it, etc.; but, until the inflammation has subsided, neither broth nor beef-tea.
Now, with regard to medicine, the best medicine is ipecacuanha wine, given in large doses, so as to produce constant nausea. The ipecacuanha abates fever, acts on the skin, loosens the cough, and, in point of fact, in the majority of cases will rapidly effect a cure. I have in a preceding Conversation[[224]] given you a prescription for the ipecacuanha wine mixture. Let a teaspoonful of the mixture be taken every four hours.