A system of practical medicine. By American authors. Vol. 3 : $b Diseases of the respiratory, circulatory, and hæmatopoietic systems
Science
A system of practical medicine. By American authors. Vol. 3 : $b Diseases of the respiratory, circulatory, and hæmatopoietic systems
Medicine -- Practice
It is probable that similar results
will be obtained by all who will take the trouble to record the whole
number of cases, instead of simply the number of deaths. The statistics
of mortality in relation to this disease are deceptive, not only in
regard to relative susceptibility of the human system to attacks at the
different periods of life, but also in regard to the ratio of mortality
of the disease itself. It is generally conceded that the chief
mortality from this disease occurs during infancy or early childhood
and in old age, cases rarely terminating fatally in youth or the more
active period of adult life. Careful examination of cases will show
that this fatality at the extremes of life is owing mainly to the
greater tendency of the inflammation at those periods to extend
directly from the bronchioles into the lobules of the lungs, thereby
complicating the bronchitis with lobular pneumonia; and in more than
half the cases reported under the head of bronchitis the fatal result
was caused by the pneumonia instead of the bronchitis.
[Footnote 1: See _Reynolds's System of Medicine_, Amer. ed., vol. ii.
p. 318.]
[Footnote 2: See _A Practical Treatise on the Diseases of Children_, by
J. F. Meigs, M.D., and William Pepper, M.D., 4th ed., p. 189.]
Neither recorded facts nor my own clinical observations show any
decided difference in the susceptibility of the sexes to attacks of
bronchial inflammation.
Those occupations which confine the parties pursuing them much indoors,
and at a temperature either too warm or too cold, strongly predispose
to attacks of inflammation of the membrane lining the respiratory
passages. Habitual exposure to a warm, confined air invites free
exhalation from both the bronchial and cutaneous surfaces, with
increased susceptibility, and {166} consequently renders the individual
more susceptible to all external impressions. Habitual passive exposure
indoors to a low temperature represses the exhalations and causes the
retention of some of the products of tissue-change which by their
presence in the blood render the individual more liable to attacks of
inflammation on the supervention of any exciting cause. For the same
reasons the habitual wearing of too much warm clothing on the one hand,
or too little on the other, predisposes to attacks of bronchial
disease. Another error of importance is the unequal adjustment of
clothing to different parts of the cutaneous surface. In children
especially we often see an abundance of warm clothing over the whole
body, while the legs and feet and neck have but a single covering, and
sometimes none. And even adult women often go out loaded with warm
clothing, while their feet and ankles are protected only by thin shoes
and stockings. All those occupations that surround the workmen with an
atmosphere filled with irritating gases, floating particles of stone,
metal, or charcoal, or with the dust from grain and many vegetable
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