CHAPTER V
RESPIRATORY SYSTEM
CHAPTER V
RESPIRATORY SYSTEM
Children and infants are subject to the same general class of dis-eases as are adults and there are no dis-eases which are particularly peculiar to childhood. The incoördinations are not peculiar but rather the children as patients are peculiar. The incoördinations of the child’s respiratory system are practically the same as those affecting the respiratory system of the adult but there are certain peculiarities of the patient that should be considered. Our work will be principally the consideration of these peculiarities rather than the incoördinations themselves. It is not our thought to produce a work on symptomatology.
ACUTE NASAL CATARRH
This is also called coryza, cold in the head and acute rhinopharyngitis. It is a very common condition in infants and small children and one that is readily recognized and easily handled chiropractically. It is very essential that we be able to distinguish between a simple acute nasal catarrh and the coryza which accompanies such conditions as measles, influenza, and nasal diphtheria. If in these conditions there is profuse discharge tinged with blood for two or three weeks, nasal diphtheria should be suspected, even though there are no other very serious symptoms. With a very young infant a persistent acute nasal catarrh may indicate syphilis. In such a case, a careful watch should be kept for more positive symptoms.
Symptoms
The onset may be more or less sudden with sneezing and a slight fever. There is a profuse discharge from the nose in severe cases which at first is seromucous and later becomes mucopurulent. The mucous membrane is red and swollen. The equation for the mucous membrane is calorific plus and N.C.R. for the mucopurulent discharge. In severe cases there may be a temperature of 103° F. to 105° F. with marked constitutional disturbances. In the mild cases the symptoms will be less severe and many times very transient.
Results are obtained very quickly with acute nasal catarrh or coryza and when the adjustment is given at the beginning of the symptoms there will be no complications. However, if the condition is allowed to run until it has gained momentum, longer time will be required for results and there may be distressing complications. If the condition is not corrected at once the throat may become involved and even the bronchi, which may develop into bronchopneumonia. Retropharyngeal abscesses may also develop. Nasal catarrh may continue until it becomes chronic.
Equation
Primarily the equation in nasal catarrh is M-. In the capillaries of the mucous membrane lining the nasal passages this results in hyperemia of the blood vessels and exudation. This results in C+ in the mucous membrane. The exudation which at first is a colorless fluid soon becomes mucopurulent from the C+ so the equation for the exudation becomes N.C.R.
Family
The family for the C+ condition in the mucous membrane is fever family, while the N.C.R. condition is in the degenerations family. The products of the degeneration may produce symptoms in the poison family.
Adjustment
The major adjustment for acute nasal catarrh is M.C.P. and K.P.
Conditions of this kind are sometimes aggravated by the care which the child receives at the hands of a careless mother. She may keep the child too warm or not warm enough. Often a child is dressed so warmly that the least exertion will cause profuse perspiration. Then the child “takes cold” because of the inability of Innate Intelligence to bring about an intellectual adaptation in so short a time. An infant may be and should be kept very warm, but as the child grows older he should be allowed sufficient freedom, especially in the summer time, to permit of exercise and yet not become too warm.
The hygienic measures to be used are attention to the sleeping rooms, which should be properly ventilated, always having plenty of air at night, and the house temperature during the day. This should be from 65°F to 68°F.
FOREIGN BODIES LODGED IN THE NOSE
Children often in their play will place such foreign bodies as peas, beans, buttons, beads and other small objects in their noses. These set up a mechanical irritation and produce swelling of the mucous membrane and often pain. If the object remains for any length of time there is likely to be a profuse discharge of a mucopurulent character. If there is such a discharge from only one, nostril special attention should be given to determine the presence of any foreign body and if there be one the child should be taken to a surgeon at once. If the discharge continues following the removal it will be due to a subluxation at M.C.P., which is interfering with the transmission of mental impulses preventing normal adaptation and reparation taking place. This should be adjusted. However, if there are no subluxations the injury which was done by the mechanical obstruction will be repaired in a short time.
CHRONIC NASAL CATARRH
Chronic nasal catarrh, also called chronic rhinitis, is a chronic inflammation of the mucous membrane lining the nasal passages and pharynx. There may be structural changes take place resulting in injury to the organs of smell, taste, hearing, speech and respiration.
Symptoms
The mucous membrane becomes congested and swollen. There is a constant mucous or mucopurulent discharge from the nose. The air passages may be partially or completely closed. If the child is old enough the nose may be easily freed from this discharge by blowing. If the child is not old enough to do this great inconvenience and discomfort will be experienced. The upper lip may become irritated, swollen and permanently enlarged and prominent from the constant blowing and wiping the nose. The excretion produces a constant irritation. There is a marked tendency on the part of the child to constantly pick at the nose; this tends to increase the irritation both of the nose and the upper lip. Usually there are adenoid growths, which will produce mouth breathing and may interfere with the function of hearing. A very marked characteristic is the inclination for the child to continually snuffle.
If the condition is allowed to remain for a long time without adjustments, ulcerations may occur on the mucous membrane; the discharge from this will be very offensive. In the atrophic form ozena is very common. Ozena is a very fetid discharge from the nasal cavity associated with ulcerations which may involve the bones of the nose.
Equation
The equation is the same as the acute form with the exception that the N.C.R. condition becomes more prominent.
Family
Same as the acute form except that the degenerations family takes precedence over the other families involved.
Major Adjustment
The adjustment is the acute condition—M.C.P. and K.P. A greater length of time will be required, however, than in the acute stage, but the prognosis is always good. In caring for a child in this condition the parents and attendants should exercise care that there is no unnecessary irritation of the nose and local parts. The nose should be kept clean and as soft a handkerchief as possible used in wiping the nose. During the process of retracing discharge from the nose will pass through practically the same stages as during the progress from the acute stage. The process is just reversed. The scabs that form in the nose now begin to soften and the discharge continues to change until it becomes as it was in the beginning of the acute stage in a thin watery discharge. Finally the discharge ceases entirely and the child is well.
EPISTAXIS
Nose bleed does not often occur in infants but is quite common during childhood. It is the result of interference with the transmission of motor mental impulses to the muscular walls of the capillaries of the nose. Epistaxis may result from a fall or blow on the nose. It occurs as an early symptom of different incoördinations such as typhoid fever and measles; as a matter of fact, it occurs in the hemorrhagic form of all eruptive fevers, in some cases of diphtheria, and in dis-eases of the heart and blood vessels.
Epistaxis is often considered of little consequence, but it may be a very serious condition and even result in death. It is especially serious when occurring in infants.
Equation
The equation for epistaxis is M. There is a relaxation of the muscular walls of the capillaries resulting in the hemorrhage.
Family
Epistaxis is in the prolapsis family due to the relaxation of the muscular fibers in the walls of the capillaries.
Adjustment
The adjustment for epistaxis is M.C.P., and in most cases this is fourth cervical. In some cases the results come instantly. The prognosis is always good when the proper adjustment is given.
INCOÖRDINATIONS OF THE LARYNX
CROUP
Croup is an inflammation of the larynx characterized by a more or less severe spasm of the laryngeal muscles. This spasmodic contraction distinguishes it from similar affections in adults. The spasm produced is very often more marked and results in more severe symptoms than does the inflammation. This incoördination is also called spasmodic laryngitis and catarrhal croup.
Symptoms
In spasmodic laryngitis or croup there is a slight catarrhal inflammation of the mucous membrane lining the larynx and a marked spasm of the larynx. There may be a slight discharge from the nose and slight hoarseness. The attacks usually come on at night with a hollow, metallic cough. About this time there is difficult breathing and the cough becomes more severe and of a teasing nature, the child making every possible effort to keep from coughing. The voice becomes husky but is seldom lost. There is rapid pulse and a slight temperature seldom over 101° F. The attack lasts three or four hours, after which the child will fall asleep. The dyspnea is aggravated and the spasm increased by excitement. During the day the child will appear well except for the slight cough and hoarseness, but the second night the attack will return with about the same degree of severity as that of the first night. Usually the attack may not return the third night or if it does it will be less severe.
Spasmodic laryngitis should not be confused with laryngismus stridulus, membraneous croup or with acute catarrhal laryngitis. According to Holt and Howland laryngismus stridulus occurs only in infants, and there is not only stridulous breathing, but also periods of complete arrest of respiration.
Major Adjustment
Lower cervical and S.P. is the combination major to use in this incoördination. Under adjustments results are often obtained immediately with no recurrence of the attack the following night.
In chronic cases enlarged tonsils and adenoid growths may be found. This, however, will not change the adjustment or the combination, but will increase the amount of time required to completely correct the condition so far as the chronicity is concerned. It will not interfere with the relief from acute attacks.
LARYNGISMUS STRIDULUS
This incoördination, according to Holt and Howland, occurs only in infancy. It is characterized by muscular spasms in the larynx with marked dyspnea.
Symptoms
There may be complete arrest of respiration for short periods, during which there will also be a marked lack of oxygenation of the blood. There may be recurrence of these attacks several times a day, and unless adjustments are given may last for weeks. There may be general convulsions and carpopedal spasms which are spasmodic contractions of the joints of the hands and feet. During the periods of arrested breathing the face becomes cyanosed. This terminates with a slight cough or a high-pitched crowing sound produced by the sudden inspiration of air. Because of this it is sometimes called “child crowing.” It is also known as thymic asthma and spasms of the glottis.
Major Adjustment
The combination major is lower cervical and stomach place. Under adjustments results are obtained in a very short time, in many cases almost instantly.
ACUTE CATARRHAL LARYNGITIS
This incoördination is found in children from one to five years of age. It may be severe and even cause death. It may be a secondary condition following measles, scarlet fever, influenza and other like incoördinations; however, it may result directly and not be associated with any other condition. It is often aggravated by inhaling steam, gases or irritating dusts.
There is congestion and inflammation of the mucous membrane lining the larynx; there is swelling and dryness of the membrane followed by an exudate which may become profuse. If the swelling is exaggerated there will be stenosis of the larynx. The vocal cords become swollen and produce aphonia.
Symptoms
The symptoms are hoarseness, dry metallic cough, which may become very severe and teasing. The onset is sudden with a marked tendency to cough, especially during the night. The voice often is entirely lost and the larynx becomes sore and painful. There is dyspnea and the respirations are short and shallow.
In some cases which develop more slowly there will be coryza for a day or two preceding the severe attack, or the laryngeal symptoms may precede the acute symptoms. The onset, however, may be very rapid and the most severe symptoms be present within a very few hours after the manifestation of the first symptom. In the well developed, case the cough is dry, metallic, barking and stridulus. The inspiration is labored. The dyspnea is severe, occurring in paroxysms during the night. There is temperature, rapid pulse and increased respiration. If the inflammation extends down into the bronchi it will result in bronchopneumonia. Laryngeal obstruction may occur often and prove very severe.
It is sometimes very difficult and in some cases impossible to distinguish acute catarrhal laryngitis from membranous laryngitis or laryngeal diphtheria. This is not so important to the chiropractor, for if adjustments are given soon enough results will be obtained before positive diagnostic symptoms have time to develop. However, it is well to be thoroughly informed on the difference in the symptoms since the chiropractor is sometimes not called in until the condition is well under way. At the onset the two conditions are very much alike, which is very reasonable to the chiropractor, since the only difference is in degree of severity, due to a different combination, and a difference in degree of the functions involved resulting from the same combination o£ subluxations. In the catarrhal condition the temperature is usually greater than in the membranous form. The dyspnea in catarrhal laryngitis is usually paroxysmal; it is less exaggerated during the day but worse at night, while the membranous type is constant and rapidly becomes more exaggerated. The dyspnea occurs on both inspiration and expiration, while in the catarrhal form it occurs only on inspiration. If the culture shows Klebs-Loeffler bacilli it is considered laryngeal diphtheria.
Major Adjustment
As has been stated, the chiropractor gives the same adjustment whether it is membranous or catarrhal. The major combination is L.C. and S.P. with K.P. Excellent results are obtained from adjustments in these cases. When the first symptoms are manifest adjustments should be given immediately in order to get the best results. The usual difficulty in such cases is that the parents consider the condition only a cold and of little importance. Therefore, they neglect taking the child to a chiropractor until great momentum has developed. Such cases necessitate a greater amount of time before results are obtained.
CHRONIC LARYNGITIS
This form is simply a prolongation of the acute form, but may be associated with adenoid growths of the pharynx, with tuberculosis of the larynx, with syphilis or with new growths in the larynx.
Symptoms
The symptoms are similar to those in the acute stage except they are not so severe.
It is not uncommon to find adenoid growths in the pharynx of the very young infant. There is a superficial inflammation of the mucous membrane producing a local calorific plus. This is the result of interference with transmission of mental impulses to these tissues and when this interference is removed Innate Intelligence will function normally and the growths will disappear.
Major Adjustment
The adjustment is the same as in the case of acute laryngitis. The results will be slower in the chronic case than in the acute case, but in the course of time the child will be entirely relieved of the condition without the aid of surgery. If the proper adjustment is given during the acute attack the condition will never reach the chronic state.
A chronic laryngitis is often accompanied by papillomatous growths which occur very early in life, in most cases during the first year. This condition occurs more often in boys than in girls. The size and location of the growths determine the severity of the symptoms. There is paroxysmal cough, dyspnea, loss of voice, and hoarseness. The symptoms usually develop so slowly that they do not attract attention until the growth has attained quite a size. Holt states that the prognosis is usually serious from a surgical standpoint because there is danger of bronchopneumonia following the operation. It is also stated that operations have been largely given up because of the tendency of the papilloma to return in increasing numbers. These tumors are the result of the interference with transmission of mental impulses to the tissues, preventing the normal personification of Innate Intelligence in the production of function. Under adjustments which results in the restoration of the normal transmission excellent results are obtained. In the course of time under adjustments the growths will disappear and with them all the symptoms of the chronic laryngitis. Adjustments should be given just as soon as the growths are suspected and kept up until the symptoms have disappeared.
TUBERCULAR LARYNGITIS
Tubercular laryngitis is seldom found in infants and is rare even in later childhood. Usually pulmonary tuberculosis develops later; by some it is considered to be always associated with it. There is cough and hoarseness with aphonia, expectoration of mucopurulent or in some instances bloody character. Microscopic examination of the sputum reveals the tubercle bacilli. Results are obtained under adjustments, providing a sufficient amount of time is allowed to permit Innate to overcome the momentum and rebuild the structures that have been destroyed.
FOREIGN BODIES IN LARYNX AND BRONCHI
Children are likely to acquire the habit of putting small objects, such as buttons, small playthings, and even pins, into their mouths. If the child becomes frightened, tries to cough, laugh or cry that which is held in the mouth at the time is likely to be drawn into the larynx and may lodge there, especially if it is sharp or has rough edges. If, however, it is a smooth object, such as a button or bean, it is more likely to pass into the bronchi, usually the right one.
When the foreign body enters the larynx there will be violent coughing which may result in the expulsion of the object. If it is not immediately expelled but becomes impacted in the larynx there will be marked dyspnea and even death from suffocation.
When the foreign body passes the larynx it will lodge, usually, in one of the bronchi or at the bifurcation of the trachea. If this occurs there will be localized pain over the region of the foreign body. There is a cough and may be spitting of blood. The irritation will result in a local inflammation; this may result in the formation of an abscess which may prove serious. In some cases following such conditions there is prolonged illness resembling pulmonary tuberculosis during which there may be sufficient relaxation in the muscular walls of the bronchi to permit the foreign body being expelled during a paroxysm of coughing. This has occurred in many cases. Following the expulsion of the foreign body the patient recovers very rapidly. In some cases there are repeated attacks of pneumonia. The health of the child becomes greatly impaired and thus he becomes easily susceptible to the acute attacks which may prove too much for the adaptability of the body.
Symptoms
The symptoms of a foreign body in the larynx are characteristic and consists in the very sudden appearance of the attacks and also in the severity of the symptoms. There will be a history of something having been in the child’s mouth, or the possibility of the child having placed some object in his mouth. A metallic body can always be located by means of the X-ray.
Ordinarily these cases do not come within the scope of Chiropractic. There might be a subluxation which would prevent adaptation from taking place, and if so, an adjustment might result in a relaxation of the muscles to such an extent that the foreign body could be expelled by coughing. These cases are traumatic and should be taken to a competent surgeon at once.
EDEMA OF THE GLOTTIS
This is a dropsical condition of the glottis and is very rare in infancy or early childhood. Usually there will be other symptoms indicating abnormality of the kidneys.
Symptoms
If the edema is great enough there will be attacks of suffocation because of the interference with inspiration. There is very little if any interference with expiration. There may be hoarseness, painful and difficult swallowing and a cough. The symptoms may come on suddenly and develop very rapidly and soon result fatally.
Equation and Major Adjustment
The equation for the local condition is secretion plus (T+). If the condition is involved with nephritis the equation for the nephritis is calorific plus (C+) in the kidneys with N.C.R. in suppurative nephritis, which results in excretion minus (E-). The major adjustment is K.P. with S.P. and local L.C.
INCOÖRDINATIONS OF THE LUNGS
GENERAL CONSIDERATIONS
The thorax of the infant is shaped somewhat different from that of the adult, being more cylindrical, the antero-posterior being nearly the same as the transverse diameter. The transverse diameter begins to increase about the third year and this continues until puberty when the typical conical or dome-shaped thorax is attained.
In the infant and young child the walls of the thorax are exceedingly yielding and elastic. This is because the greater portion is made up of cartilaginous tissue before the completed ossification of the bony structures has taken place.
The thoracic muscles are imperfectly developed. This makes the thoracic walls very thin. In well nourished infants the walls are made thicker by the abundance of fat which is found deposited on them. The diaphragm is very high in the infant and this greatly decreases the capacity of the thorax as well as does the frequent distention of the stomach and intestinal tract because of the accumulation of gas. The trachea and bronchi of the infant are comparatively larger than in the adult, the air cells are much smaller, and for this reason a slight acute congestion will interfere almost as much with their function as will hepatization. This necessitates immediate action in all conditions which involve the respiratory tract, and especially those which affect the lungs or bronchi. In all such cases results are obtained very quickly under adjustments. In the child there is a greater tendency for the inflammation to spread in the lung tissue than in an adult.
ACUTE CATARRHAL BRONCHITIS
There is probably no one acute incoördination affecting infants and children that is so common as acute catarrhal bronchitis, commonly called cold in the chest. During the cold months, and especially in the late winter and early spring, there are a great many cases. The chiropractor who is careful in handling these incoördinations will find no class of cases that will give more satisfactory results. The analyzing must be done very carefully and the vertebrae must be moved from the very beginning because if results are not obtained quickly the inflammation will spread to the air vesicles very rapidly. When this occurs there is danger of serious complications.
Symptoms
In the more mild form of bronchitis the symptoms develop rather gradually and the first noticed may be a coryza or nasal catarrh. As the bronchi become involved there will be a slight rise in the temperature, noticeably increased respiration, and a slight cough. There may be restlessness, anorexia and vomiting, usually caused by swallowing the mucous that is coughed up.
Rales are heard over the entire chest. These appear very early and may remain for some little time after all other symptoms have disappeared. It is very common to hear coarse rales with a very slight cold in the young infant.
If the condition is permitted to go for some little time without adjustments the symptoms become more severe. The cough becomes more serious, there is dyspnea, increased fever and a moderate degree of prostration which increases as time goes on. During inspiration the nostrils will be noticeably dilated. In most cases there is great difficulty in nursing. In the later stages there is usually great prostration. The cry becomes feeble and the cough weak, there is rapid superficial respiration and feeble pulse. The facial expression is dull and there may be stupor and apathy. The attacks may come on very suddenly and terminate fatally in a very short time. Therefore it is necessary for action from the adjustments to be obtained as quickly as possible.
Equation and Family
The subluxation at lower cervical or upper dorsal region interferes with the transmission of mental impulses to the bronchi. The function primarily involved is motor which results in a relaxation of the muscular walls of the capillaries. This produces hyperemia and congestion from which there is an exudate of mucous. At first it is clear, but with normal heat applied to this exudate it soon becomes mucopurulent. This gives calorific plus, therefore the equation for the mucous membrane lining the bronchi is calorific plus (C+) with N.C.R. for the mucopurulent discharge. The equation for the general fever is C+. The family is fever and degenerations.
The major adjustment for acute catarrhal bronchitis is L.C. or Up.D. with K.P. In some cases CP. will be included in the combination.
CHRONIC BRONCHITIS
It can readily be seen that chronic bronchitis would not often be found with the very young infant. In early childhood it is more often found and frequently follows the acute attack or is the sequel of measles, influenza or whooping-cough. Unhygienic surroundings may tend to influence and exaggerate the condition.
Symptoms
There is little or no fever, although the cough is bad; there is very little if any dyspnea. The condition becomes worse during cold weather, and the patient is usually subject to attacks of acute bronchitis. There may be no constitutional symptoms and the general health of the patient may not be greatly affected.
If there is a light rise in the bodily temperature regularly in the evening, with loss of weight and slight anemia, pulmonary tuberculosis should be suspected.
Major Adjustment
The adjustment for chronic bronchitis is the same as that for acute bronchitis, Up.D. and K.P. If the child receives adjustments during the acute attack the chronic condition will not develop.
A child suffering with chronic bronchitis should be given adjustments immediately and the results will be most satisfactory, complete recovery resulting in a very short time.
BRONCHIAL CROUP (Fibrinous Bronchitis)
This incoördination is relatively rare in small children, except in diphtheria, when it appears as a contamination into the bronchi from the larynx and trachea. It may be acute or chronic and affects all ages from infancy to puberty. The characteristics are severe dyspnea and the coughing up of fibrinous casts from the large bronchi after which there is a marked improvement. As the exudate collects again the symptoms reappear. In the chronic form there is dyspnea and expectoration of fibrinous casts.
Major Adjustment
The adjustment for fibrinous bronchitis is the same as that for other forms of bronchitis. The prognosis is excellent, providing adjustments are given in time to enable Innate to overcome the momentum. Results are obtained in a very short time.
PNEUMONIA
Aside from digestive disturbances, the most common incoördinations affecting infants are those involving the lungs, and especially as a sequel following the so-called infectious dis-eases. The different types of pneumonia are named according to the area of the lungs involved and the nature of the changes affecting them. The two general divisions are bronchopneumonia and lobar pneumonia. These two principal groups are divided into several subdivisions according to the particular pathology and stage of development. It is not of vital importance to the chiropractor to know just what part of the lungs or bronchi is involved or the nature of the pathology. He must, however, be sufficiently familiar with symptoms to correctly determine the zone in which the incoördination is located. In bronchopneumonia the entire bronchial wall of the small bronchi is affected, while in lobar pneumonia the bronchitis is usually very superficial and the terminal bronchi and alveoli are filled with a fibrant exudate. An entire lobe may be involved or the inflammation may involve only part of a lobe. Very often the two varieties, bronchopneumonia and lobar pneumonia will be present in the same case, one variety affecting one part of the lung, while the other variety will affect another part of the lung. In children by far the larger percentage of cases of pneumonia is of the bronchopneumonia type; however, as has been stated, the type of pneumonia is of little importance, but the location of the zone or zones is of vital importance.
Bronchopneumonia occurs most often during the winter months, being more prevalent in late winter or early spring. One or both lungs may be involved, but the most common seat of the inflammation is the lower left lobe, or if in front only, the right apex. The local subluxation producing this condition will be found to be the second or third dorsal vertebra, which is producing the pressure upon the nerves and interfering with the transmission of mental impulses. As a result there is a relaxation of the muscular fibers of the blood vessels which results in a distention of these vessels in the affected area. The seat of the catarrhal inflammation is in the mucous membrane of the large and small bronchi.
Symptoms
The most frequent type of bronchopneumonia among infants is the acute congestive type. Its duration may be only one or two days. The symptoms develop very rapidly and produce a great shock to the nervous system because of the suddenness and severity of the attack. There is a sudden rise of temperature and prostration is very great from the beginning. There is cyanosis and rapid respiration. There may be no cough. There may be little or no pain felt in the chest. During respiration the expansion of the affected side will be less than that of the unaffected side. However, this must not be confused with the natural tendency found in extremely young infants; when a child is placed in certain positions the expansion of one lung will be greater than that of the other. In the severe cases there is profound stupor and other cerebral symptoms, such as dullness, apathy and there may be convulsions. The progress of the incoördination is very rapid, due to the sudden engorgement of the lungs, which in the infant produces symptoms almost the same as those of consolidation in older children or in adults. This is due to the air vesicles being extremely small. These cases should be adjusted as soon as there is a manifestation of symptoms, otherwise the momentum of the dis-ease may, because of its rapid progress, become so great that it will be impossible for Innate to overcome. When the medium and small sized bronchi only are affected, it is known as capillary bronchitis. The symptoms will be very much the same as in the type just mentioned, with the exception that in this type there is always a more or less severe cough. Prostration is not so great and the symptoms do not develop so rapidly. There is very rapid respiration with dyspnea and rales over the entire chest. There are symptoms which will indicate consolidation. While bronchopneumonia may come on very abruptly, yet it is not uncommon for the symptoms of bronchitis to merge gradually into those of pneumonia. From a chiropractic standpoint it would make little difference to the chiropractor whether the condition was called bronchitis or bronchopneumonia, for if adjustments are given at the beginning results will be obtained before a diagnostician would be able to make a positive diagnosis.
Children with pneumonia should not be permitted to lie in one position for any length of time. A constant change in the position is essential to prevent the accumulation of the exudate in a localized area. The child may be more easily cared for and made more comfortable by being held in the arms of an adult. This will permit frequent changing of the child’s position with very little disturbance to the child. In all cases of pneumonia plenty of fresh air is essential, but if there is any bronchitis, care must be exercised that the air is not too cold. In cases involving hepatization there is no danger of having the air too cold.
Symptoms of Lobar Pneumonia
Lobar pneumonia is not so frequent in infants as is bronchopneumonia although it does occur occasionally in early infancy. The previous health of the child seems to make little difference, since it often occurs in the strong and robust children. As a matter of fact, the strong child is more likely to contract this form of pneumonia.
There are three stages in lobar pneumonia. There is: first, the congestion; second, the red hepatization, in which the lung becomes filled with a fibrant exudate containing red blood corpuscles; the third stage, that of gray hepatization, wherein the exudate undergoes a decomposition. These stages are of little importance to the chiropractor, except to indicate the degree of momentum attained by the incoördination. The first symptoms usually consist in loss of appetite, general weakness and headache. There is restlessness, excessive thirst, dry skin and a high temperature. There is rapid pulse and the respirations are from forty to fifty per minute. During the night the child is restless and slightly delirious. Occasionally there are convulsions, but this is very rare.
Equation and Family
The chiropractor is concerned chiefly in the location of the incoördination and the family involved. In order to determine the family it is first necessary to know the functions that are abnormally involved. From the symptoms given we observe readily that all cases of pneumonia, of whatever type, will be in the fever family, but it is quite obvious that this is not the only family involved. From the symptoms manifest we recognize that there is hyperemia and exudate, that this exudate undergoes degeneration and thus becomes of a toxic nature. The fever, or C+ condition, is exaggerated by the presence of this poison being retained in the body. This gives us an overlapping of the poison and the fever families.
Major Adjustment
The major for the poison family is K.P.; for the fever family C.P., the local being Lu.P.; therefore, the combination major is lung place, center place, and kidney place. In making an analysis of the infant with pneumonia it is of the utmost importance to select the specific vertebra in these different regions. Although the patient will have quite a temperature, in many cases a hot box may be detected in the spine. In endeavoring to find a hot box in the spine of an infant the back of the patient should be exposed for sufficient length of time to eliminate the possibility of the temperature being greater at one point than at another because of clothing that may have been heavier at one point than at another.
The vertebra causing the impingement at lung place may be either second or third dorsal. This should be determined by very careful palpation and by the presence of the hot box. We cannot emphasize too greatly the necessity for very careful palpation, since in the child nerve tracing can very seldom be used. In severe cases it may be necessary to adjust as often as once every six hours. With careful conscientious work on the part of the chiropractor, there should be very little danger in losing a patient, even in the most severe cases, and if the adjustments are given in the early stages of the dis-ease, the more marked symptoms will not develop, results will be shown in a very few hours and the child will recover in a short time.
ASTHMA
The type of asthma found among adults very seldom affects infants. The most common form is associated with mild attacks of bronchitis and is of a catarrhal nature. The attacks are very likely to accompany or be associated with different incoördinations involving the bronchi. In some cases the attacks seem to be exaggerated by certain kinds of food which the child eats. It is thought by some that attacks are brought on by the indigestion of some foreign protein. These proteins are very numerous and it is very difficult to determine the particular food in which the offending protein is found. In some patients an attack of asthma may be brought on by the eating of eggs. From a chiropractic standpoint we do not consider that the cause of asthma is in the food which the child eats, although there might be an interference with transmission which would impede the normal processes of digestion, this would result in the production of a poison which might produce certain symptoms. This, however, does not change the fact that when the subluxations are properly adjusted the incoördinations will disappear, regardless of the kind of food that the patient eats.
Symptoms
The acute attack of asthma is accompanied with slight fever and acute catarrhal symptoms. Later the typical asthmatic symptoms appear in which there is a constriction of the bronchi due to spasms of the unstriped muscular fibers. There is hyperemia in the mucous membrane and a slight exudate. Usually the tonsils are enlarged and there are adenoid growths. There is more or less severe dyspnea, moderate cyanosis and, in severe cases, prostration. The peculiarity in respiration consists in a short inhalation with slow, labored exhalation. Dyspnea may be so severe that it is impossible for the child to breathe lying down. There is an almost constant dry teasing cough. Many infants suffering from asthma are inclined to be rachitic.
Equation
The functions involved are motor and calorific; C+ for the heat in the mucous membrane lining the bronchi and M+ for the contraction, muscular contraction in the bronchi, with T+ for the accumulation of the mucin.
Family
This condition involves two families, the fever and spasms family.
Major Adjustment
Asthma is caused by a subluxation in the lower cervical or the upper dorsal region, producing pressure upon the nerves which transmit mental impulses to the pharynx and bronchi, interfering primarily with the motor function. The major adjustment is lower cervical or upper dorsal in combination with kidney place.