| No. 3. Rx. | Acidi carbolici, | (0.50 grams) gr. viij; |
| Glycerinæ, | (30.0 c.c.) fluidounce j; | |
| Tincturæ opii camphoratæ, | (60.0 c.c.) fluidounce ij; | |
| Aquæ, | (60.0 c.c.) fluidounce ij. |
M.—Sig. Give 4 cubic centimeters (fluidrachm j) or 1 teaspoonful before each mealtime and at bedtime, giving the quinia a little after the meals.
If more anodyne influence is required to procure rest at night, 16 milligrams (gr. ¼) of codeine may be added to the teaspoonful of carbolic acid mixture given at bedtime. If, as sometimes happens in cases of acute bronchitis, both of the catarrhal and capillary varieties, the inflammation invades some of the lobules of the lungs, as indicated by undue rise of temperature, greater expansion of the wings of the nose during inspiration, with short expiration, and diminished resonance with fine crepitation over limited portions of the chest, I have found the most certain and speedy relief to follow the application of a blister over the seat of the pneumonia and the internal use of the following formula:
| No. 4. Rx. | Ammonii chloridi, | (12.00 grams) drachm iij; |
| Antimonii et potassii tartratis, | (0.13 grams) gr. ij; | |
| Morphiæ sulphatis, | (0.20 grams) gr. iij; | |
| Extract, glycyrrhizæ fluidi, | (30.0 c.c.) fluidounce j; | |
| Syrupi, | (90.0 c.c.) fluidounce iij. |
M.—Sig. Give to adults 4 cubic centimeters (fluidrachm j) or 1 teaspoonful, mixed with a tablespoonful of water, every three or four hours until some relief is obtained, and then at longer intervals. For children the doses must be diminished in proportion to the diminution of age. Quinine and laxatives may be used in these cases under the same indications as in uncomplicated bronchitis.
In the severe attacks of capillary bronchitis in young children many writers recommend emetics, and subsequently nauseating doses of antimony or ipecacuanha. But I have not seen sufficient benefit result from emetic doses of these agents to compensate for the early prostration, and sometimes continued gastric irritability, which they induce. I prefer the proper application of leeches at the very beginning, followed by emollient applications to the chest, and the same remedies internally as already mentioned, aided, perhaps, by an earlier use of quinine and digitalis if the cardiac action becomes weak and frequent. In all this class of cases, however, much caution should be exercised in regard to the use of opiates, either alone or in combination with other remedial agents, lest their narcotizing influence should diminish the force and frequency of the respiratory movements too much, and encourage the accumulation of the inflammatory products in the smaller bronchi to such a degree as to produce apnoea or death by the exclusion of air from the alveoli or air-cells of the lungs. And yet just enough of these quieting agents to diminish excitability and allay excessive restlessness is as desirable in children as in adults.
In the plastic or pseudo-membranous form of bronchitis it is an object of much importance, in the first stage, to limit the amount of plastic exudation, and later to hasten the loosening and disintegration or discharge of such layers of false membrane as may have formed on the bronchial mucous surface. For these purposes alterative doses of calomel may be given alternately with the doses of the formula containing the liquor ammonii acetatis already given (see Formula No. 1) during the first twenty-four hours, and subsequently pretty full doses of the iodides of sodium or potassium or of the bicarbonates. In acute cases in children, when the symptoms indicate that the false membrane is loosening and the dyspnoea is great, an emetic that will induce prompt and free vomiting may hasten its expulsion and afford much relief.
In the cases which have been described as rheumatic bronchitis of the more acute or active grade I have seen the most prompt and satisfactory degree of relief follow the administration of the following combination of remedies in the early stage:
| No. 5. Rx. | Sodii salicylatis, | (25.00 grams) drachm vj; |
| Glycerinæ, | (15.00 c.c.) fluidrachm iv; | |
| Vini colchici radicis, | (25.00 c.c.) fluidrachm vj; | |
| Syrupi scillæ compositi, | (45.00 c.c.) fluidounce iss; | |
| Tincturæ opii camphoratæ, | (60.00 c.c.) fluidounce ij. |
M.—Sig. Give 4 cubic centimeters (fluidrachm j) every three or four hours in a little additional water.