Page:The American Cyclopædia (1879) Volume III.djvu/318

 312 BRONCHITIS BRONDSTED by suffocation or apncea. Happily, the affection is rare. It is limited in its occurrence chiefly to children and aged persons. Its duration in fatal cases is from twelve hours to five days. The symptoms denote an affection compromis- ing notably the respiratory function. The res- pirations are rapid, in children sometimes being from 60 to 70 per minute. The action of the heart is accelerated. Lividity of the lips and face becomes marked in fatal cases. The suffering from a sense of the want of breath, or dyspnoea, is intense. The physical signs enable the physician to discriminate this affection from other affections involving, like this, notable disturbance of respiration. Over both sides of the chest there is found the aus- cultatory sign of the presence of liquid in the small bronchial tubes, namely, the subcrepitant rale ; and with the presence of this sign there are absent the signs representing the morbid physical conditions which belong to the several affections from which this is to be differentia- ted, pneumonia and pleurisy with effusions being the most prominent of these. In cases of capillary bronchitis, bloodletting may be re- sorted to with advantage, if it be not contra- indicated by the feebleness of the patient. With the same qualification, emetics are indi- cated in young children, with a view to pro- mote expectoration. Revulsive applications (sinapisms or stimulating liniments) to the chest are to be employed, together with poul- tices or the water dressing and an oiled muslin or silk jacket. If available, the inhalation of oxygen gas should be resorted to. Breathing warm vapor facilitates expectoration, and hast- ens the resolution of the inflammation. Finally, the strength of the patient is to be supported by nourishment and alcoholic stimulants. In- fluenza. Thus for bronchitis has been consid- ered as a sporadic disease. An epidemic affec- tion commonly known, in different countries as influenza, and by French writers as la grippe, is characterized by bronchial inflammation. Its occurrence from time to time has been no- ted by medical writers for several centuries. It is an epidemic remarkable for its extensive and rapid diffusion, sometimes extending with- in a brief period over many different and wide- ly separated countries. Influenza differs from ordinary acute bronchitis in the frequent ex- tension of the inflammation to the frontal and maxillary sinuses, the lachrymal ducts and con- junctiva, and the Eustachian tube ; but more especially it differs in a greater amount of con- stitutional disturbance. It is, in fact, to be re- garded as a general or constitutional disease, of which the bronchitis is the local manifestation. Like all epidemic diseases, this has doubtless a special cause, and this cause undoubtedly is in the atmosphere. The special cause, however, is independent cf appreciable atmospheric changes. Of the nature, source, and mode of diffusion of the cause we have no positive knowledge ; but we are equally ignorant of the special causes of many, and indeed of most epi- demic diseases. That these diseases depend on organic entities is a supposition which at the present time many regard with favor ; but this remains to be proved or disproved by further researches. During some epidemics of influ- enza, a vast number of persons are simultane- ously affected. Generally the affection is mild ; but it occasions some fatality among the aged and feeble. . The fatality, however, is in gene- ral due to complications which occur, and of these capillary bronchitis and pneumonia are especially apt to cause death. Diphtheritic Bronchitis. A variety of bronchitis is charac- terized by a fibrinous exudation, or a deposit of lymph on the inflamed mucous surface, form- ing what is known as a false membrane. This is called bronchitis with fibrinous exudation, or pseudo-membranous or diphtheritic bronchi- tis. It occurs in a certain proportion of cases. of diphtheria, and also of the affection known as pseudo-membranous laryngo-trachitis or true croup. Irrespective of these pathological con- nections, it constitutes a very rare variety of bronchitis. The fibrinous exudation or false membrane may extend to a greater or less dis- tance along the bronchial tubes. It is some- times expectorated entire, presenting complete casts of the bronchial subdivisions from which it was thrown off. A specimen in the museum of the Bellevue hospital medical college, pre- sented by Dr. Stephen Rogers of New York, shows solid casts, composed of concentric lay- ers of flbrine, formed in the bronchial tubes of an entire lobe, extending to those of minute size. The patient from whom -this specimen was obtained repeatedly expectorated casts of the same description. Occurring in adults, independently of diphtheria or membranous laryngitis, this variety of bronchitis rarely de- stroys life. The presence of the exudation can- not be determined prior to its appearance in the matter of expectoration. When the char- acter of the disease is ascertained, the indica- tions for treatment do not differ materially from those in ordinary bronchitis ; but the in- halation of warm vapor or spray is useful as a means of promoting the separation and expec- toration of the false membrane. BRStfDSTED, Pcder Olnf, a Danish archaeolo- gist, born near Horsens, Jutland, Nov. 17, 1780, died in Copenhagen, June 26, 1842. He ex- plored Greece in 1810 in company with other savants, and was appointed in 1813 professor at the Copenhagen university, and in 1818 agent of his government at Rome. He afterward ex- plored Sicily and the Ionian islands, and after his return to Copenhagen in 1832 officiated as director of the royal cabinet of antiquities, as professor, and lastly as rector of the universi- ty. He left many writings, mostly in German, prominent among which are : Eeitrage zur dilnitchen Geschichte cms nordfranzosischen Manuscripten des Mittelalters (Copenhagen, 1817-'18); Untermchungen in Griechenland (Paris, 1826-'30); Denkwitrdigkeiten aus Grie- chenland (Paris, 1833).