The "empty bronchus" treatment by posture in the bronchiectasis of children / by William Ewart.

  • William Ewart
Date:
1908?]
Catalogue details

Licence: Public Domain Mark

Credit: The "empty bronchus" treatment by posture in the bronchiectasis of children / by William Ewart. Source: Wellcome Collection.

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    (1) The costo-abdominal elastic belt should be worn during the night as well as the day, for its virtue is active for good during each breath that is drawn. If this were neglected, the loss of advantage to a child during the ten hours’ night sleep might be easily reckoned up in figures to an important total. The belt itself, made of waterproof material, easily washed and dried, has its buckles in front, and at one or both sides an insertion of a lacing of indiarubber cord or tubing. It is mainly abdominal, extending some way below the umbilicus, and upwards not quite as far as the costal arch. But I have found it useful to attach to it in the back a lower thoracic elastic band, one or two inches wide, also buckling in front, which, being quite separate except over the spine, where it is continuous with the belt, can be carried obliquely over the costal arch, and its buckle fastened to the night- gown by a safety-pin at any level desired. Its pressure can thus be regulated nicely so as to be just sufficient to stimulate the costo-abdominal breathing. I have explained elsewhere the probable mechanism of the advantage accruing to the upper costal breathing from wearing the abdominal belt. The recurring stimulation of the dia- phragm with each expiration by the artificial elastic recoil of the abdominal contents calls reflexly into action some of the apparatus for extraordinary respiration, and in particular the upper costal muscles, whilst it directly amplifies in a marked degree the inspiratory excursions of the diaphragm. It goes without saying that judg- ment is requisite in dealing with so active a therapeutic agent. (2) The nocturnal treatment.—This should be made as effectual as possible. Everything depends upon the declivity of the inclined plane being effective, not, as might happen, illusory. In the first place, as the distance from the diaphragm to the larynx is so short in a little child, the angle of the inclined plane must be relatively greater. In the “ bronchiectasis cot,’ which I have to describe, the foot end of the ‘ fracture-bottom” must
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