Bronchitis arising from an extreme and sympathetic irritability of the mucous lining membrane of the air-passages, constitutes a very distressing complication in measles. In such cases, where the cough is dry and almost spasmodic, incessant, accompanying every breath, with imminent danger of congestion, Ipecacuanha has given immediate relief. In the severer forms of acute bronchitis, the subsidence of the primary fever is succeeded by a profuse secretion of (tenacious) mucus, which chokes the bronchial tubes and effectually excludes the air from a considerable portion of the air-cells and blood-vessels. The little sufferer is in great danger of perishing, in such cases, from slow suffocation. The countenance becomes livid, the extremities cold and lead-colored, drowsiness supervenes, which may be followed by coma, convulsions, and finally by fatal asphyxia. To the above description of bronchitis, drawn principally from Leadam, it may be sufficient to add, that this disorder in its initial stages may be distinguished from pneumonia, by the external, catarrhal symptoms; subsequently by the distressing and paroxysmal nature of the dry and almost spasmodic cough; by the absence of the shortness of breath; by the wheezing and whistling sounds; and finally by the very copious, sometimes stringy and suffocative secretion of mucus, which in the third stage of the disorder concludes it, by a favorable resolution, or destroys the patient’s life by suffocation.
Aconite. When the fever runs very high; hot skin; much distress and great restlessness.
Arnica. The child cries every time it coughs.
Arsenicum. When there is great prostration; restlessness after twelve at night; it drinks little and often.
Belladonna. The mucous rales are large and crepitous, hoarse cough; much moaning; moaning at every breath.
Bryonia. Respiration much oppressed; dry, cracked lips; cough worse after drinking; constipation of dry, black, burnt-like looking stools.
Calcarea c. Much mucus in the chest. In phlegmatic children large and open fontanelles; much perspiration on the head, so that the pillow is wet for around.
Chamomilla. The child is very cross and fretful; one cheek red, the other pale; must be carried to be appeased.
Cina. Vermiculous symptoms prevail; such as picking the nose; nothing satisfies the child.
Drosera. The fever and the cough, which is very hoarse, are worse after twelve at night.
Dulcamara. The disease has been induced by cold damp air.
Hepar. The child seems croupy, decidedly so, and the phlegm is loose and choking.
Ipecacuanha. Much nausea and vomiting of mucus; the cough is strangling and suffocating, so much mucus seems to be accumulated in the bronchial tubes.
Lycopodium. There is much oppression of the chest; and the alae nasi are seen to dilate or spread out wide, like the large end of a trumpet, and then to contract alternatively.
Nux v. The child is always worse after four o’clock in the morning.
Phosphorus. Severe and exhausting cough, which the child dreads and avoids as long as possible. The case becomes worse in the evening; and continues so during the night. The fever is often very high; and the pulse very rapid.
Pulsatilla. The cough is very loose, and with all the fever there is but little or no thirst. The child gets worse towards evening; and it has more difficulty of breathing when it lies on its side.
Silicea. in children who have large bellies; perspiration about the head; of a scrofulous constitution.
Sulphur. The child has papular eruptions upon its skin; rather inclined to excoriation; much rattling of mucus in the chest; sleeps in very short naps, frequently awaking.
Tartar e. Much thirst; wishes to drink little and often. When the child coughs there appears to be a large collection of mucus in the bronchial tubes; and it seems as if much would be expectorated, but nothing comes up.
PNEUMONIA.
As an idiopathic disease, inflammation of the lungs is comparatively rare in infants, never occurring, it may be affirmed, except in those who have a decided constitutional predisposition to such affections. Such predisposition may be traced in little children whose parents, one or both, have suffered with pulmonary phthisis. Infants born from such parents, one of whom may have recently died with consumption, when but a few months old, have been observed to fall victims to pneumonia developed in a very rapid manner, and under the influence of scarcely noticeable external causes.
It is not always easy to determine, at the first, and with any degree of positiveness whether an infant is suffering with pneumonia, or with bronchitis; nor in fact is it absolutely necessary for the Homoeopathic treatment. Since we carefully select the remedy which is the exact simile of the existing symptoms and conditions; nor will the prescription be properly influenced by our pathological interpretation of these symptoms. And indeed in many cases both forms of inflammation, that of the parenchyma of the lungs and that of the mucous lining membrane of the air-passages, run into each other; and the pneumonia of infants is as apt to be associated with bronchitis, as that of adults to be complicated with pleurisy. The sputa, alike characteristic in bronchitis and in pneumonia, afford no aid where the patient is either an infant or a very young child, since these little folks never expectorate. The existence of the mucous rale distinctly confined to one lobe of the lung, and a circumscribed redness in the cheek of the same side, would afford strong presumption of pneumonia. In this latter disease, also, the cough is less violent, though frequent and short, and it is not so much attended with rattling of mucus; there is often a circumscribed redness of the cheek of the same side with that of the inflamed lung; and the child evidently prefers lying on the affected side. Where the pneumonia invades both lobes of the lungs, which, however, may be a successive development, there will be still more evidence of congestion; flushing of the face and hurried and short respiration, and rapidly increasing exhaustion. The history of the case, and its relation to whooping cough, to influenza, or to measles, either of which may remarkably tend to develop such phenomena, will greatly aid in the diagnosis; and the same is true of the previous history of the patient and of his hereditary proclivities.
in pneumonia, at its onset, as in bronchitis, the fever comes first, with dry cough; then the fever abates somewhat, as the cough becomes more loose and catarrhal. But in no stage of the disease does the cough assume the paroxysmal and almost spasmodic form so often seen in bronchitis, and which results from the tenacious nature of much of the secretion in this latter disease and the consequent difficulty of starting it from the bronchia. The first stage of pneumonia is characterized by nervousness, fretfulness, and restlessness; constipation of the bowels and sometimes vomiting; redness of the tip of the tongue, the latter coated white in the middle; the child breathes through the open mouth, instead of through the nose; he sucks by starts, because he cannot breathe as usual through the nose while nursing; he “seizes the breast eagerly, sucks for a moment with greediness, then suddenly drops the nipple, and in many instances begins to cry.
In the second stage the little becomes languid, sometimes drowsy; the respiration is more evidently hurried, the alae nasi are dilated with each inspiration, the abdominal muscles are brought into play to assist in its performance, and any change of posture renders the breathing more labored and more hurried. The cough becomes much more frequent; it is still hard, sometimes evidently painful, so that the child cries at each cough; at other times it is an almost constant, short hack. As the disease still advances the bright flush of the face and the florid tint of the lips subside; the body remains very hot, while the extremities may become cool; the face may appear the pale and the lips assume a livid hue where the pneumonia is very extensive. The babe becomes still weaker, vomits the food, which it takes greedily from the severe thirst; and finally, through the hurried nature of the respiration, becomes incapable of nursing at all.
In the third stage, the respiration becomes more labored and irregular, though less frequent. The little sufferer loses its voice; or becomes very hoarse and almost entirely incapable of coughing. The face is sunken, the extremities cold; the pulse extremely small, and so frequent as to be almost impossible to count. The child is restless at intervals, or lies ion a stage of half-consciousness; and suffers very much from dyspnoea on being moved. The face and nails exhibit a livid hue, if the disease advances unchecked; and coma and convulsions close the sad scene.
During dentition, under the attack of measles, and the prevalence of influenza, infants are especially liable to become subject to pneumonia; at such times, therefore, the physician will most carefully scrutinize every symptom which might indicate the onset of a disease that is alike insidious and fatal in the aged in the very young. The only other form of disease for which infantile pneumonia might be mistaken is incipient hydrocephalus; to this error, the vomiting, the fever, restlessness and constipation, which are alike common to both diseases, might easily lead those not on their guard. And this the more especially, since according to Dr. West, to whose work we are much indebted in the above description, the cough in some cases of pneumonia is at first so slight as scarcely to be noticed; and even where it is more strongly marked, it might easily be mistaken for the sympathetic cough which is sometimes present in the early stages of hydrocephalus.
