Bronchitis is an inflammation of the mucous membrane of the bronchial tube and its branches. It may be acute or chronic; it may involve one side or both; it may affect the larger or only the minor portions of the tube, or it may involve the whole bronchial system.
The most frequent occasions (usually called causes) for bronchitis are colds, improperly treated or neglected, or irritating inhalations of smoke, dust, gas or fumes. Becoming chilled after being heated may result in an attack if there is an injurious degree of toxemia. Certain trades tend to the production of such irritation to cause bronchitis: stone-cutting, milling, carpentering, paper-hanging, etc. Inhalation of tobacco smoke or tobacco dust is one of the most prolific causes. Living in overheated quarters with the air insufficiently moistened is somewhat common in American city dwellings, and such conditions may lead to bronchitis.
Acute bronchitis results from an accumulation of toxins in the body, making it necessary for the body to call upon the mucous surfaces of the respiratory tract for additional elimination. Aside from the causes already given, acute bronchitis may accompany other acute diseases.
The symptoms are quite abrupt, the condition itself beginning with a sudden fever, often accompanied by a chill. Fever sometimes, however, is absent. Cough is the most prominent symptom. This may be frequent and hard with no expectoration, especially for the first two or three days. There usually is soreness back of the breast-bone. Gradually the cough becomes somewhat productive, there being a tenacious mucous accumulation which is expelled with considerable difficulty. Its presence in the bronchial tube causes a wheezing or humming sound upon breathing. The cough may be so frequent and severe as to result in headache, dizziness, nausea and perhaps vomiting.
The cough gradually lessens after a few days and is more productive, the expectorated matter being thick and more or less greenish, a mixture of mucus and pus. The condition frequently causes bronchopneumonia in children and old persons, through extension to the lung tissue, when neglected, improperly treated, or when the toxemia is so extreme that the body needs the increased surface of the lungs for elimination. Within a week these bronchial symptoms usually disappear in mild cases, and within two weeks in the more severe cases, though the trouble may linger on for a month or more. Considerable depends upon the patient’s inherent vitality and recuperative powers and upon the strictness with which proper treatment is carried out.
Chronic bronchitis may be either chronic from the beginning or may result from frequent or repeated attacks of acute bronchitis. The inhalation of dust or smoke is one of the most frequent causes. Cough and expectoration are the leading symptoms, the cough being quite obstinate, especially in the morning and evening and during the night. It often prevents sufficient sleep for the patient to recover quickly. The cough may cause vomiting. There may or may not be any substance expectorated. What is brought up may be tinged with blood. During the summer the symptoms may subside or disappear entirely, only to return upon the appearance of cold weather.
Treatment. In acute cases it is necessary to remove any cause of direct irritation of the bronchial tubes. Usually when properly treated an acute case will subside in a few days. The “fruit fast” is very helpful in these cases and should continue until the temperature has been normal for twenty-four hours. The daily enema should be given, with plenty of water to drink. Fresh air is very important, but a cold wind over the patient should be avoided. A blanket-pack will help materially in the general efforts of the body toward elimination. Every two or three days the general pack may be substituted for the local pack to the chest. Hot compresses or heat by a therapeutic lamp over the upper chest will be very soothing in case the cough is very distressing. After any hot treatment there should be a cold application for a minute or so, then careful drying and adequate covering. A “sun-bath” over the upper chest by a sun lamp will help greatly in this condition. After the symptoms have subsided, the patient may gradually return to a diet more ample in quantity and consisting of any natural food desired. Of course, the quantities should be only gradually increased. There is no definite curative diet needed after the acute condition has subsided, though the fruit and strict milk diet would be very valuable at this time.
Chronic bronchitis makes it necessary to treat the entire body, because the condition is not local, but is due to a systemic toxemia, with the selection of the bronchial mucous membrane for the point of elimination when the other channels of elimination are functioning insufficiently to take care of the encumbrances. In these cases the repeated complete fast or fruit diet will be of great value, continued for from three to eight or ten days depending upon the strength and vitality of the patient and the effects of the fast. The milk diet is a very excellent diet to follow a fast or to use between these repeated fasts. It is especially recommended if the patient is below normal in weight and vitality. If the patient is normal or above normal, the milk diet may be used with benefit, but with a reduction in the amount of the milk sufficient to maintain normal weight or permit of a slow loss in weight.
In this chronic condition, steam-baths or other sweat-baths once or twice a week will be very helpful. They should of course be followed by a cold or cool bath and vigorous friction. The hot shower bath, in which the water is allowed to play alternately upon the upper back and the upper chest, terminated with a decidedly cool or cold shower, is an excellent treatment. Cold chest packs covered by dry flannel so that warmth is re-established; local heat to the upper chest followed by cold applications; hot compresses; steam inhalations; massage and spinal manipulation, are all of considerable benefit, and any of these may be used.
The patient should engage in walking, and practice moderate deep breathing as much as possible within reason, if it is necessary to improve the general vitality. Water should be drunk copiously, as a rule. Plenty of bulk must be in the diet for adequate bowel activity, or the enema or special aids, such as agar-agar or mineral oil or their emulsions, should be used.
Gradually increasing amounts of general exercise are of great benefit, but is important that the patient secure plenty of relaxation. Too much exercise or exercise of too strenuous nature is apt to increase the coughing. Natural sun-baths and air-baths should be obtained frequently. It should not be necessary for a person with bronchitis to change climate, though sometimes a warm dry inland climate is most advantageous in cases where there is much expectoration. Where there is a non-productive cough, the sea-shore may be of benefit. But regardless of a change in climate, if one does not live in a way to keep the systemic toxemia down to a minimum there is not likely to be a permanent cure.
The diet to follow generally should consist largely of the most natural foods obtainable – ^green and root vegetables, cooked and raw, fruits, whole grain cereals, milk in some form and nuts or cottage cheese for the chief protein. Meats should be used very moderately, and all refined sugars and their products should be avoided. Only a very moderate amount of fat, such as cream, butter and olive oil, and of starches should be used, until one becomes able to indulge quite freely in physical activity.
The cough of both acute and chronic bronchitis can as a rule be greatly relieved by teaspoonful doses of equal parts of honey and lemon juice taken every two or three hours.