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.