A medical handbook : for the use of practitioners and students / by R.S. Aitchison.

Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: A medical handbook : for the use of practitioners and students / by R.S. Aitchison. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    101/402 (page 83)
    posed broncho-pneumonia are really cases of true spasmodic asthma, as shown by their rapid recovery and their frequent recurrence. The family history is also important as regards the diagnosis of asthma in children. Kidney disease should be remembered, and the possibility of asthma being due to this cause. [Hay asthma or hay fever is sometimes described as a separate affection, the symptoms being caused by the irritation of the mucous membranes, similar to that which occurs in asthma. There is severe coryza with frontal headache and general malaise, and sometimes the irritation e.xtends to the bronchial tubes, producing slighter forms of asthma. It is peculiar to certain individuals, and apt to resist treatment ; but a short sea trip always results in recoveiy.] In the treatment of true spasmodic asthma, yi'?^;-to eight drops of a I per cent, solution of nitroglycerine, in water, is the most effectual remedy for relief of the spasm in adults, care being taken to watch the heart's action. The dose may be repeated in three or four hours if there be no depression from its use, and it may be con- tinued cautiously, at regular intervals, should the paroxysms render it necessary. Three to five drops of nitrite of amyl dropped upon blotting-paper and inhaled, may be tried in place of the above. Fifteen to thirty grains of chloral hydrate, with forty grains of bromide of potassium, may be given at the same time, or in place of the nitroglycerine, when it is deemed unadvisable to use it; or one- twelfth to one-fourth of a grain of morphia may be used hypo- dermically. Inhalations of ether or chloroform may be tried, and large doses (fifteen grains) of iodide of potassium are recommended. Stimulants are often necessaiy, and digitalis may be used along with these remedies when the heart threatens to fail. Strong coffee to drink, or the smoking of cigarettes of stramonium, belladonna, &c., or the burning of nitre-paper, sometimes affords relief; and ten drops of either ipecacuanha wine, or of tincture of lobelia, in water, every five minutes, until some nausea is induced, may sen^e to lessen the feeling of oppression. The treatment after relief of the spasm is much the same as in bronchitis. The diet is important—light and easily digested animal food being ordered, while starchy foods, sweet stuffs, and even milk, should be avoided. Arsenic, quinine, and iodides are indicated in the treatment of chronic cases, between the attacks. The asthma of children (chill and bronchitis ) is best treated by change, and by sound hyaienic considerations. For hay asthma, antiseptic douches or sprays may be tried, if the sea-side or a short sea voyage is unattainable. Tainting the mucous membrane of the nose with a solution of cocaine may be of service and in obstinate cases, destruction of the Schneiderian membrane by the electric cautery, may effectually cure the disease. ' Aeute Bronchitis. — The pathological changes in acute bronchitis begm with redness and swelling of the mucous mem- brane of the air-passages. The bronchial tubes soon become filled