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.