CORYZA.
Coryza, snuffles, or cold in the head, is one of the earliest and most common affection, of the young infant. Sometimes the first that is known of it is, that the infant’s nose is stopped up, so as to hinder its respiration while at the breast. The swelling of the mucous membrane of the nares, and especially the accumulation of the secreted mucus, not only hinder the little sufferer from breathing through its nose, as is its wont in nursing, but occasion also during its sleep the peculiar snuffling sound, similar to snoring in adults, which gives to this disorder its popular name. In some cases there is a considerable flow of mucus; and all the symptoms resemble those seen in the epidemic influenza of older children. Here the Euphrasia deserves attention, in addition to the remedies commonly used, since it will often be found to corresponded in a remarkable manner with the totality of the symptoms.
In other cases there appears to be “something more than a simple inflammation of the Schneiderian membrane, since it either secretes a very tenacious mucus in extreme abundance, or becomes coated with a false membrane, which sometimes extends even to tonsils and palate. Cases of this kind are usually associated with extreme depression of the vital powers, and received on this account the name of Coryza Maligna. I have no doubt of their identity with diphtheria, of which they constitute the form as known nasal diphtheria. West. In addition to the Kali bichromicum, those two more recently proved remedies, Cubebs and Arum triphyllum, (*Hahnemannian Monthly, vol. II. pp. 213 and 459.) will be suggested to the Homoeopathic practitioner, to whom the totality of the symptoms of each case is every thing, while the name by which the disease may be designated is of small account.
Where the coryza tends to become chronic, and to maintain itself in spite of the indicated, remedies, we must look still deeper into the nature of the case, if not before. Since this very disposition to persistence evidences some constitutional taint, either scrofulous or worse, which had not otherwise been discoverable. Indeed, chronic coryza fully developed and established, wants only the intolerably offensive odor of the discharge to become a veritable ozaena. This latter will of course consist in an ulcerated state of the mucous membrane of the nares; and may be purely scrofulous in its origin, or dependent upon some more or less remote syphilitic taint in the system. The history of the case and the attendant symptoms will usually show the nature of the affection; and in his diagnosis the physician may sometimes be assisted by observing in spots the minute traces of a characteristic, cooper-colored eruption. By thus adapting his remedies to all the conditions and symptoms of the case, he may well hope, in a short space of time, to remove the primary affection of the nasal mucous membrane of the young infant, which if not thus early eradicated will presently extend itself to the adjacent mucous surfaces and become a much more formidable and intractable kind of disease.
Calcarea c. This medicine may be appropriately given after Chamomilla, when that remedy seems indicated but fails.
Carbo veget. If the coryza return in the evening.
Chamomilla. When there is watery or mucous discharge. The child is quieted, and in fact relieved by carrying it up and down the room.
Dulcamara. The child gets worse at every cold change in the weather, or from exposure to cold air.
Kali bichromicum An invaluable remedy when the discharge from the nose is tough and stringy; sometimes it seems to extend to the throat and to cause choking.
Mercurius. The nostrils are red, raw and ulcerated.
Nux v. The catarrh is worse at night, particularly towards morning, or in the morning. Through the night the nose is very dry.
Pulsatilla. Coryza much worse every evening; better every morning.
Sambucus n. The nose seems perfectly dry and completely obstructed.
Sticta p. There is a constant irritation in the nose, to blow it, but no discharge.
Tartar e. Obstruction of the nose, and at the same time much rattling in the bronchia.
CATARRH OF THE BRONCHIA.
The catarrh of the bronchia, to which infants are remarkably liable, may appear simply as an extension of the above-described coryza or cold in the head. This affection may arise from slight variations of temperature; and it may appear simply from sympathy of the respiratory mucous membrane with the irritation of teething; and in this connection it occurs sometimes in alternation with attacks of diarrhoea. And the same disposition to alternation bronchial catarrh may also be observed on the still broader scale of the different reasons of the year. In the summer months, and also the September, the atmospheric and other morbid influences almost invariably tend to develop disorder in the bowels; while in the earlier months of spring, in the later months of autumn and during the winter, the same morbid influences would manifest themselves in bronchial catarrh, or in some more positive inflammatory disorder, not only of the respiratory mucous membrane, but also of the subject tissues and organs.
Bronchial catarrh, in little children and very young infants, may result from a primary and essential morbid condition, and constitute the whole disease. It is in this latter point of view, and the one which more frequently occurs in little children, that we principally consider this disorder here. Like simple catarrh in old people, this affection occurs most frequently in those who are delicate and weakly; and the more delicate the patient the more profuse is the discharge. Nor is this contradicted by the fact that very fat or fleshy and leucophlegmatic infants are peculiarly liable to this catarrh, and to suffer severely from it, even to be very dangerously affected by it.
In the consideration of the danger of this affection, is seat and exact extent will require especial attention. For so long as the catarrh is evidently restricted to the large bronchia, the disorder which it occasions is by no means severe. And in fact many attacks are either self-limited and transient, or pass off under the influence of the simplest domestic treatment. But when the catarrh, extends to the bronchial divisions of the second order, to those which are medium sized, the disorder assumes a gravity much greater than that presented by similar cases in adults. But when the catarrh extends still further and involves the ultimate ramifications of the air-passages, the danger is extreme; since, in addition to the serious impediment to the vital function of aeration, offered by such more or less complete closing of the air-cells, such infiltrated of the minuter bronchia is almost necessarily followed by a true lobular pneumonia. And, besides all this, the profuse secretion is itself exceedingly debilitating.
Study the remedies indicated under Bronchitis.
BRONCHITIS.
In the preceding section, under the head of Catarrh, was described what by modern pathologists would be termed the sub- acute form of bronchial inflammation. In this form there is little fever, but much catarrhal secretion; and the disorder principally invades the delicate and the weakly The acute form of bronchial inflammation, that which is generally understood by bronchitis, displays at first more fever; upon the subsidence of this the catarrhal secretion may make its appearance a critical discharge. This form of disease is the one which oftener attacks children apparently robust; and in some, whose constitutions are far from being so good as they seem, the disorder runs a very rapid course, and is succeeded by a mucous secretion, dangerous in proportion to its abundance, and abundant in proportion to the plumpness and apparent heartiness (and real weakness) of the child.
The disease results from exposure to a low or damp temperature, or from a sudden transition from heat to cold; sometimes it appears to prevail epidemically. Sometimes also it appears as a complication of epidemic eruptive fevers, especially measles. It commences with the ordinary symptoms of cold in the head, such as sneezing, running at the eyes and nose, hoarseness, cough, dry, hot skin, and accelerated pulse. In fat a severe attack of bronchitis usually consists in an extension into the air-passages of inflammation originally commencing in the form of influenza. The child cries when it is put to the breast or attempts to swallow; it is disturbed by frequent fits of coughing, which is at first short and dry, but soon becomes wheezing and rattling, and it appears oppressed with tightness of breathing. As the inflammation extends more and more through the ramifications of the bronchia, the febrile symptoms become more developed and the skin burning, hot and dry; the pulse it is rapid; there is considerable restlessness, painting of the breath, tossing of the head about from one side to the other, flushing of one or both cheeks, the cough being constant with little or no expectoration, and on putting the ear to the chest sibilant or whistling, with harsh mucous or subcrepitant rales are heard at different parts, proving the extension of the inflammation throughout the whole chest. The symptoms are aggravated towards evening; and as the disease subsidies, the respiration becomes more free and the cough loose and easy, the sound of the cough itself being the only guide in this respect in young children, since the phlegm is always swallowed. When the disease occurs in the most acute form, the catarrhal symptoms are frequently absent and the attack sudden; on the other hand, a low form of sub-acute bronchitis, which has originated in a slight catarrh or influenza, often constitutes a protracted and dangerous variety of the disease.
