Bronchitis in Older Children.—Bronchitis in older children comes on abruptly, with fever and cough. The child may complain of headache and pains in the chest or other parts of the body. It may begin with a chill or chilly feelings. These children "raise" with the cough. The expectoration may be quite profuse; at first it is a white, frothy mucus, then yellow, and later a yellowish green; it may be slightly tinged with blood.
There is a mild form of bronchitis in these older children where the serious symptoms are absent. The children are not sick enough to go to bed, but they appear to have a "heavy cold" with, at first, a tight, hard cough, which is usually worse at night. Later the cough turns loose and the same expectoration occurs as in the severe type. It is these cases of mild bronchitis which do not receive the proper care and treatment that develop into the so-called "winter cough," which lasts for months.
Treatment.—(See page [497] under heading, "Catching Colds.") Children who acquire bronchitis easily and frequently, should be built up. Cod liver oil should be given all winter. The sleeping apartment of these children should not be too cold, but it should be well aired through the day and well ventilated throughout the night. Flannel night clothes should be worn and the feet should be kept warm always. Mild attacks of "cold in the head" should be treated vigorously and not neglected.
The following "Don'ts" may be profitably studied when your child or baby has bronchitis:—
Don't keep the windows tightly closed; fresh air and good ventilation are absolutely necessary to the patient.
Don't use a cotton jacket or oil silk.
Don't wrap the child up in blankets and shawls.
Don't carry the child around; keep it in bed.
Don't dose the child with syrupy cough mixtures.
Don't overheat the room.
Don't let friends bother or annoy the baby.
Don't reduce the diet unnecessarily.
The child should be put to bed. The temperature of the room should be 70 degrees F. all the time. The windows should be opened top and bottom according to the weather, and the room should be well aired every day, the patient being taken to another room while it is being done. The child should have its usual night clothes on, nothing more. If the child is not very sick and insists on sitting up, a bath robe can be worn but it should be always removed when it sleeps. It is advisable to change the position of the baby from time to time. Have it rest on one side, then on the other, as well as on the back. Give a dose of castor oil at the beginning of the sickness and keep the bowels open during the disease.
Diet.—The diet will depend upon the severity of the disease. If the fever is high and the cough persistent, the strength of the food of nursing infants should be reduced. We can reduce the strength of the food by giving the child a drink of cool boiled water before each feeding and shortening the length of each feeding. Older children may be given toast, milk with lime water, cocoa with milk, broths, gruels, custards, cereals and fruit juices.
Inhalations.—The value of inhalations in bronchitis is very great. The ordinary croup kettle, which can be bought in any good drug store, is the best method of giving them. Full directions come with each kettle as to the best way to use it. The best drug to use in the kettle is creosote (beechwood). Ten drops are added to one quart of boiling water and the steaming continued for thirty minutes. The interval between steaming is two hours and a half in bad cases day and night. In mild cases the night treatments can be dispensed with. Sheets rigged up over the top and sides of the crib, in the form of a tent, is the most desirable way to give the inhalations.
External Applications.—Counter-irritation by means of mustard pastes are the best applications. They should be put back and front—one on back and one on the chest, overlapping at the sides beneath the arms. They should cover the entire body from the waist line to the neck. These pastes are made as follows:—Mix the mustard (English) and the flour in the following proportions, using a quantity according to the size of child and area to be covered; one tablespoonful mustard to three tablespoonfuls of flour. Mix with lukewarm water until a paste is formed, not too thick and not too thin. Spread on a cloth (put plenty on) and cover with one layer of cheesecloth and place the cheesecloth side next the skin. In order to guard against burning the skin it is advisable to rub the skin with vaseline, before and after putting on the paste. The paste should be left on until the skin is uniformly red. It may be applied from two to four times in the twenty-four hours according to the severity of the case. Mustard pastes are most effective during the first two or three days of the disease.