The constant symptoms of Chronic Bronchitis are cough, some shortness of breath, expectoration of altered mucus. The variable symptoms, those which are frequently of the most importance, as determining the slight or the serious character of the disorder, consist in the quantity and quality of the matters expectorated, and the presence or absence of wasting and of hectic fever.

A person advanced in years has what he calls a slight cold in the winter. He coughs, and expectorates a certain quantity of grey or transparent mucus. In the summer his cough diminishes, or ceases altogether. The next winter the same thing happens again; and each successive return of the colder seasons of the year brings back in increasing severity the cough and the expectoration: and if you listen to the breathings of such persons, while the cough is on them, you will hear a crackling sound at the lower part of their lungs.

But Chronic Bronchitis may take place at any age, as a sequel to the acute: just as active inflammation of other parts of the body is liable to degenerate into the chronic form; and such cases are sometimes very equivocal and deceptive, and appear far more formidable than they really are, and will frequently recover, after they might be supposed, from the symptoms, to be in almost the last stage of pulmonary consumption; and it is generally in cases of this kind that cures are performed by those who boast that they can cure consumption.

Chronic Bronchitis is, in some cases, as incapable of being cured, and as surely and progressively fatal, as tubercular Phthisis itself, and even more so than some of the forms of Phthisis. So long, however, as no organic change has taken place in the air tubes, or in the mucous membrane lining them, these chronic forms of Bronchitis that look like Phthisis in their general symptoms are capable of cure. When the membrane, and the tube which it lines, become altered in structure, and pour forth a fluid which has all the qualities of pus, hectic fever generally is present, and the chronic disease tends, slowly perhaps, but surely to death. There are some cases of Chronic Bronchitis which are especially remarkable, on account of the great quantity of the bronchial secretion; so great that the patients appear to die principally from the daily exhausting drain thus made upon the system. Occasionally the patient will cough up pieces of false membrane which had formed in the smaller air tubes, and has from time to time become separated. These will sometimes resemble bunches of worms, or the branching roots of a small plant. Two cases are reported of men in the prime of life, brothers, who were troubled at times with expectoration of blood, which frequently came in great gushes: at length, at the end of about three weeks, a quantity of the false membrane was brought up, and the bleeding stopped. One of these gentlemen, a barrister, expressed a belief that the complaint was caused by a stove in his chambers; the heated atmosphere caused by which always produced a slight feeling of constriction and distress within his chest.

Treatment

When there is any fever present, the patient must abstain from anything likely to increase it, and the food, although nourishing, must be of a light and unstimulating character. He may take the following mixture, several times during the day, diminishing the dose if it should produce any feeling of sickness:

Antimonial Wine...........................Half an Ounce.

Ipecacuanha Wine.........................Half an Ounce.

Paregoric.....................................One Ounce.

Oxymel of Squills.........................One Ounce.

Water sufficient to make Half a Pint.

For an adult, one or two teaspoonfuls for a dose.

He may also take two of the following pills at bedtime:

Powdered Squills.................................24 Grams.

Extract of Poppies [not Opium].............24 Grains.

Castile Soap.......................................12 Grains.

Make into 24 Pills.

Blisters may be applied from time to time, on the chest, or between the shoulders; and the feet and legs should be put into hot water before going to bed.

After the feverish symptoms are subdued, and the cough is loose, with considerable expectoration, the following mixture will probably tend to limit the discharge:

Compound Tincture of Benzoin, [Friar's Balsam],One Ounce.

Paregoric....................................One Ounce.

Tincture of Tolu...........................Half an Ounce.

Powdered Gum Arabic...................Half an Ounce.

Syrup.........................................One Ounce.

Water sufficient to make Half a Pint.

The Gum Arabic is to be rubbed up with the Syrup till thoroughly mixed and smooth, then the Friar's Balsam and the Tincture of Tolu; then the Paregoric; and lastly the water. A grown person may take one or two teaspoonfuls several times a day, and younger patients in proportion.

Dr. Clifford Allbutt strongly recommends the "Wild Cherry Bark in Chronic Bronchitis. An infusion maybe made by pourings pint of cold water upon half an ounce of the Bark in coarse powder; let it stand for twelve hours, stirring it occasionally: then strain it off. A little Syrup of Orange Peel, or a few lumps of sugar may be added, if the patient wishes. A wineglassful may be taken three times a day.

Copaiba Balsam, (commonly called Balsam of Capivi), is strongly recommended by some authors. To most people, however, the flavour is unpleasant: this may be disguised by rubbing up the Balsam with Gum Arabic or Yolk of Egg, and then adding Syrup and Cinnamon water. The dose is twenty or thirty drops three times a day.

When the pulse is quiet and the skin cool, advantage is said to have been derived from taking the Sulphate of Iron in two or three grain doses, in Compound infusion of Roses, three times a day.

Boiled chicken, fish, light puddings, with perhaps a little boiled mutton, will be the most suitable food. When the weather and the patient's strength permit, change of scene, and gentle exercise in a carriage will be beneficial.

There is a mixed form of pulmonary disease, occurring in old persons, which has been called Peripneumonia Notha, (Bastard Peripneumony). It may be described as Chronic Bronchitis, occurring in old persons, and very apt to be converted into Pneumonia, or to get very much worse in winter, or upon any accidental exposure. This is a common complaint of persons advanced in life. The disease has often the appearance only of a more violent catarrh; and after the employment of proper remedies is usually relieved by a free and copious expectoration. In other cases, however, the feverish and catarrhal symptoms are at first very moderate and even slight; but, after a few days those symptoms suddenly become considerable, and put an end to the patient's life when there was very little appearance of danger. There is no special treatment necessary, but the symptoms must be treated as they arise, according to the directions previously given.