Licence: Public Domain Mark
Credit: The bronchial catarrh of children / by James Carmichael. 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.
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![prossible or irregular the iiidicatio]i is clear for their administration, and frequently at the same time it may be desirable to give a few drops of tinct. of digitalis. Brandy on the whole is the most useful stimulant, generally preferable to wine. It should be given in small doses, frequently repeated, along with food, and its effects carefully noted. If wine be used, the time-honoured sack whey is as good a form as can be selected. I should like next to allude to external applications. Acute bronchial catarrh in children is generally relieved by riibefactioii of the chest, and local diaphoresis produced by suitable means. By keeping the cutaneous capillary circulation in a state of activity, we have a ready and direct means of relieving the congested condition of the pulmonary circulation. Eubelaction may be produced by the application of sinapisms, care being taken not to continue this too long in case vesication takes place, which is apt in infants to result from their too potent or prolonged application. Mustard is one of the most ready and efficient means at our disposal, and as a rule it is best applied in the forms of the ordinary cataplasma sinapis, of the strength of one part of mustard to four or live of linseed meal, made into a jacket poultice, and kept on till the skin is well red- dened, from fifteen or twenty to thirty minutes, until the •necessary effect is produced. Eubefaction may be produced also by the application of diluted lint, ammoniee or lint, terebinthinae, in which case the liniment should be painted over the entire chest, which is afterwards encircled with cotton-wool. Having produced rubefaction of the cutaneous surface, our endeavour should be to keep up the activity of the skin and avoid any revulsion or chill. The time-honoured poultice of linseed or other emollient sub- stance applied in the form of a jacket is a means of doing this, but I think neither the most convenient nor suitable fur the purpose in the majority of cases. My objections to linseed poultices in young children are that they are heavy, dirty, and unctuous, and do not keep up the action of the skin so well as other applications to be hereafter noted. Another objection to poultices is that, except in hospital, or in private practice, when you have the advantage of a skilled nurse, it is difficult to get them properly made and applied. A poultice badly made and improperly ap- plied, and allowed to get cold, is worse than useless. Another objection is, that in young children, who are constantly moving, and require perhaps to lie in the nurse’s arms, the poultice is apt to get crumpled up and lumpy. I am quite sure I have seen the most evil results in private practice from the careless applica- tion of poultices, and I consider it to be the duty of the practi- tioner, if he think it desirable to order them, to see that they are properly made and applied. It is not sufficient to write a prescription and order a poultice, but to see the details of treat- ment carefully carried out in every respect. The practice that I](https://iiif.wellcomecollection.org/image/b21695222_0022.jp2/full/800%2C/0/default.jpg)
