LECTURES

Armstrong
1825 The Lancet  
HAVING, in the preceding lecture, explained the symptoms, morbid appearances, and treatment of inflammation, seated in different portions of the mucous membranes of the air passages, I shall speak, in this lecture, of that affection which, existing lower down, has been by most recent authors called Bronchitis. This inflammation, however, has been designated by different names; by the old writers it was called Peripnewnonia notha, when acute, and when chronic in old persons the Catarrhus
more » ... , or Humeral Asthma. Yet whatever changes may be rung upon such words, there is an intimate connexion between the acute and chronic forms, which very frequently pass or repass to each other. It frequently happens that an acute inflammation supervenes on a long standing chronic one of the bronchial lining. For example, an old man may go about coughing through the summer and autumn nearly all the day long, and expectorating freely; but when the winter comes he is seized with an inflammation of a more acute kind, and if not attentively watched might sink under its influence. Jn the investigation of such cases you should ascertain the following points, 1. The circumstances connected with the origin of the disorder; 2. The circumstances connected with the progress; and 3. The present state of that disorder. It is a great mistake to suppose with some of the old writers that this disorder is confined to adults in a great measure. The truth is, that children are very liable to its attack. I before mentioned that the skin and mucous membranes of infants and children are remarkably delicate and predisposed to inflammation. This predisposition is frequently strengthened by an here. ditary tendency, for the children of some families are more predisposed than those of others. The predisposition is sometimes such as I have before described under the title of tvtal. Sometimes the predisposition is sexual; the organs of voice undergoing a remarkable change about the period of puberty, occasionally become predisposed at that period. Lastly, this tendency to inflammation of the mucous membranes of the air passages is acquired, through the influence of habits, operating from infancy, through the middie period of life, up to old age. In adults it often happens that irritation set up in the alimentary canal, with disordered functions of the skin, frequent--ly predisposes to inflammation of this mucous membrane. Thereis remarkable sympathy between the skin and internal mucous membranes. Debility is also a powerfully predisposing cause. .Exciting causes of Bronchitis. With respect to the exciting causes of bronchitis, the principal one is a low or variable temperature of atmosphere. It prevails most in low damp weather. Sometimes the cause is epidemic, a certain state of atmosphere extending over a certain district; or it may be endemic, confining its influence to a particular spot, or even to a particular house. Wherever you find the general or local taints of atmosphere, the mucous membranes are the parts which i become affected when fever arises. The same applies to contagion generated in the human body, which being given off from one is very liable to affect another in the same manner, chiefly operating on the internal mu. cous membranes. There is greater prostration of strength geuerally attendant on bronchitis arising from an epidemic state of the atmosphere than when it arises from a low and variable temperature of the atmosphere, or in other words a common cause. Symptoms of Common Bronchitis. I would premise that you must distinguish this inflammation from inflammation of the substance of the lung and pleura, for the treatment, in some respects, is remarkably different. Structure modifies very much the pathology of diseases, and consequently their treatment.
doi:10.1016/s0140-6736(02)92607-3 fatcat:jmunbalrmjbulk4j4mzkt3bv4i