The Good old days: Plastic bronchitis

Plastic bronchitis is a rare variant of bronchitis, being quite distinct from the catarrhal form of the disease.

It is not the spreading of croupous inflammation from the larynx into the bronchi, but a distinct affectation of the middle-sized tubes, resulting in the formation of casts of their walls, which are from time to time coughed up.  

Some of these casts are tubular, some are solid plugs. Usually only a small part of the bronchial system is involved. The whole history of the disease is obscure, and has not been fully studied.  

However, plastic bronchitis seems often to attack those of fine breeding who apparently seem robust. Such unfortunate subjects are what it is customary to call of ‘soft fibre’. That is to say, they readily fall ill and take much nursing to become well. Persons such as these may come from apparently good aristocratic stock, but in-breeding may have weakened them. It may also be the case that excessive parental protection in childhood produces this weak affect.  

The plastic bronchitic condition is also reported to sometimes occur in the more common man, particularly those who labour in industry. The probable cause of the affliction in such folk is probably attributable to certain irritants, such as coal dust and stone-cuttings. Iron in a fine state of division may also act as a precipitant of the disease in those exposed to their influence by reason of occupation.  

Men — for it is indeed usually the male of the species — who succumb to this particular form of bronchitis, may shake off the effects of the malady with the aid of the inhalation of steam and the application of strong mustard poultices to their back and chest.  

But there are those who seem unable to mount an effective defence, and these poor souls begin to fall ill with the coughing of blood and foul sputum. Such signs are of grievous portent, and many soon succumb from these events. If the cough is very troublesome, 40 drops of laudanum may be given. Bronchitis kettles should be employed to add moisture to the air of the room and a warm bath may be occasionally employed.  

Adapted from Practical Medicine, by Alexander Silver MA MD, published in 1874 by Henry Renshaw of London

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