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
SYMPTOMATOLOGY.--The most common form of acute bronchitis, by many
writers styled catarrhal bronchitis, acute bronchial catarrh, etc.,
presents considerable variety of symptoms, according to the extent of
the membrane involved and the intensity of the inflammatory process. As
a general rule, the disease commences with slight chilliness or unusual
sensitiveness to slight changes of temperature, accompanied by a sense
of soreness and oppression behind the sternum and sometimes across the
whole chest, with a frequent and rather dry, harsh cough. In many cases
there is during the first day or two coincident congestion of the
membrane lining the nostrils, fauces, and larynx, causing sneezing,
with some feeling of soreness in the throat and hoarseness, also a
heavy dull pain in the head, much increased by coughing. By the second
day a moderate general fever has supervened, characterized by dryness
and moderate heat of the skin, flushed face, slight increased frequency
and fulness of the pulse, more sense of oppression and soreness in the
chest, with a continuance of harsh, dry cough, which often causes
soreness in the epigastrium, radiating laterally in the direction of
the attachments of the diaphragm to the inner surface of the ribs. On
the second or third day the inflamed membrane begins to be less dry and
the paroxysms of coughing bring up a scanty expectoration of a
tenacious, somewhat frothy mucus, which gradually increases until about
the fourth or fifth day, when it becomes more opaque, sometimes
yellowish, and much more easily expectorated. At the same time that the
expectoration changes to a more opaque condition, the general febrile
symptoms begin gradually to abate, and the cough is accompanied by less
sore pain both in the chest and head.
In the milder class of cases, the decline in all the general symptoms
is so rapid that by the seventh or ninth day, convalescence is
established. But in the more severe cases the more important symptoms
may continue through {170} two weeks, and convalescence not be complete
until the end of the third week. And in some of the cases the
inflammation does not disappear on the subsidence of the febrile
symptoms, but degenerates into a chronic form, causing a continuance of
cough, with some muco-purulent expectoration and slight soreness in the
chest, through an indefinite period of time. The disease is most likely
to take this course when it occurs in young persons having a scrofulous
diathesis, or in connection with eruptive fevers or pertussis, or in
the aged afflicted with rheumatism.
During the active stage of ordinary cases of bronchitis the urinary
secretion is diminished in quantity, redder than natural, and deficient
in chloride of sodium, and the bowels are inactive. But after the
crisis of the disease is passed, as indicated by the character of the
expectoration, the renal and intestinal discharges soon return to their
normal condition.
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