Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

The lungs consist of four types of tissue: connective tissue, blood vessels, air sacs and tubes called bronchi. When a baby is being formed the bronchi grow downward from above and the air sacs grow upward from below. The bronchi can therefore have an infection without involving the air sacs. If the air sacs get infected the disease is called pneumonia.

Acute bronchitis is always associated with a cough and often with wheezing. Fever frequently accompanies acute bronchitis. Chronic bronchitis usually produces a chronic cough with no fever, although there may be a slight evening temperature elevation with or without a night sweat. Most upper respiratory tract infections including colds will have a phase of acute bronchitis beginning a day or two after the onset of cough followed by wheezing and coughing when a deep breath is taken. The cough may be dry and tickling, or may produce a mucus secretion. There may be noisy respiration because of the secretions which are produced deep within the bronchi. A mild fever and a slight increase in white blood cells may last for 7-10 days.

The treatment of bronchitis is quite simple. First, the extremities should be kept quite warm. Even a short walk across the floor barefooted can sometimes cause a cough to be prolonged another day or so. Most people are unprepared to appreciate the degree of warmth that the extremities require in order to be entirely healthy. Any reduction in the ability of the body to circulate blood perfectly into the skin of the extremities increases the susceptibility to viral diseases. There are "soldier" white blood cells stationed permanently in the skin which are capable of removing substances from the blood and imparting beneficial and protective proteins to the blood. These proteins act as antibodies or enhancements to the immune mechanism.

A hot foot bath can increase the circulating white blood cells and make them more active in fighting infections, can quiet the coughing, can redistribute the circulation to the extremities, and produce helpful relaxation of the patient. A hot half bath will act similarly. A child with a cough should be treated with a hot half bath lasting one minute for each year of his age after the age of 3, and from birth to age 3 the length of time for the hot bath is 3 minutes. As the child gets older the temperature of the bath water can be increased. Use bath water temperatures from 104 to 110 or 112° F. A normal adult can easily tolerate 112° or more for 15 to 20 minutes.

A heating compress should be applied to the chest each night. Briefly, the method is to put a thin wet cotton piece of fabric against the skin, cover it well on all sides with a piece of plastic cut from a bread bag or similar material, and secure the compress in place with a long strip of bed sheet, a snug-fitting sweat shirt which is pinned securely to take up all slack, or a snug-fitting vest. Then the chest should be warmly covered and the compress worn all night. It should be remembered that the wet cotton cloth is squeezed from cold water, not warm water.

Hot steam fomentations over the chest are most useful in severe or stubborn cases.

Water should be drunk freely. I always tell my patients that every time they cough they should drink a small glass of water. If they cough again in the next five minutes, drink another glass of water, another cough, another glass of water. In this way the secretions will finally become loose enough that they can be expectorated freely, or the bronchial surfaces will become lubricated nicely to reduce the tickling.

Catnip tea can be used for mild sedation to quiet a cough. One should never use cough syrups containing codeine, as they suppress the cough reflex which may lead to the retention of secretions in the lungs as they contain antihistamines, sugar, and other potentially injurious agents. Sugar inhibits phagocytosis by white blood cells, making the body's defenses less active. For this reason one should take a diet in which there is no free sugar. Oils also inhibit the immune mechanism and the oxygenation of tissues, and should be prohibited during a cough. This means that one should not use heavy or rich foods, hard-to-digest food items, margarine, mayonnaise, fried foods, cooking oil, or other rich foods. Meat, milk, eggs and cheese should be used either sparingly or not at all. Two meals daily are preferable, or else three small meals.

The clothing should be abundant on the extremities and over the chest, but not so heavy or thick as to promote sweating which tends to lead to chilling. Multiple layers of clothing on the extremities are better than a few thick ones. A vaporizer or humidifier may be used to great advantage to keep the secretions thin and avoid drying and irritation of sensitive mucous membranes.

Exposure to sunlight and moderate exercise out-of-doors are most useful for both acute and chronic bronchitis.