The Birmingham age-herald., 1914-10-11
Cunningham Uses Bunch of Grapes to Illustrate Eff
 feet on the Lungs
ESPECIALLY FATAL
 TO YOUNG CHILDREN
Prevention Not So Much Sanitary Problem as One of Personal Hygiene-Mortality.
 Prevention

City Health Officer R. NJ. Cunningham today in his weekly bulletin No. 20 dis cusses "Broncho- pneumonia" as follows;
 "Broncho-pneumonia is an Inflammation of the smallest bronchial tubes and the air cells. A bunch of grapes is good illustration The main stem would repre- sent the bronchial tubes, the terminal twigs the smallest tubes. and the grapes the air cells. Imagine that all these are hollow. The whole bunch would repre- sent lobe, and each terminal twig and a grape would represent lobule This last is the seat of broncho pneumonia As a rule, scattered lobules are involved and not the whole lobe. The character of this inflammation is catarrhal-that is, the products are mucous and pus, usually in the form of muco-pus. There Is also some coagulating material, and red and white blood cells. and epithelium scales There are present various germs-the pneumo- coccus. pus. catarrhal, influenza. etc.
 There Is no particular germ for this disease. The effects of this Inflammation 1 is to occlude more or less the terminal bronchial tubes. and the air cells, so that | out. particularly to pass h. There are little local areas of consolidation, partial or complete. corresponding to the lohules Sometimes the air in the air cells Is forced out leading to collapse of the cells, so that they are airless. Squeeze the pulp out of few of the grapes. and these col lapsed air cells are illustrated. It rarely I happens that all the lobules are affected. When 1t does the whole lobe is collapsed or soidified. being much smaller than the normal lobe. Broncho- pneumonia is prae- tically always on both sides, particularly on the back and base of the lungs l Varieties:
 l 1. Primary.
 2. Secondary.
 g. Deglutition.
 1 The primary type Is rare. It so closely resembles lobar pneumonia in its onset, symptoms. signs and effects as to be prac- tically indistinguishable. The third or deglutition type is caused by the in- halation of food and other solid particles. It generally results in abscess, and is usually fatal. The secondary type is the most common. and is the one discussed in this paper. It is disease of the extremes of life-infancy and old age. All acute diseases that have a bronchial catarrh as a part of their effects are liable to be fol- | fowed by ho-pneumonia.
 "Whooping cough. measles, scarlet | fever, diphtheria, typhoid fever and small pox are conspicuous examples. particu- larly the first three. Common colds (bronchitis) may also result in broncho- pneumonia The inflammation in the large and medium sized tubes extends down into the terminal tubes and air cells and when thus extended broncho-pneu- monia results. It follows, therefore, that this disease is largely disease of chill dren. In old age it is not an uncommon disease brought about by the senlt
 changes in the lungs, and by the chronic : bronchitis and other chronic diseases ot that period of life. It may, however, oc- cur at any age.
 Mortality
 ''This is very fatal disease in both old , and in children. Next to infantile dar
 rhoea. it ranks a cause of death. II Birmingham during nthe years 1912 and 1913 there were l26r deaths in childrer . under years of age. Of these 23s oi
 1887 per cent. died from broncho-pneu
 nonia In this disease the failure O respiration or want of breath is the chic  . right heart The toxins play a secondar,
 part. whereas in lobar pneumonia the. play the most important part
 Prevention
 This is not much a sanitary prob
 lem as one of personal hygiene. Bad san itary conditions. however, contribute her
 as elsewhere to the predisposing factors
 Broneho- pneumonia usually develops dur ing the last stages or at the beginning o convalescence of the diseases above men tioned. The chief preventive measure , are ample fresh air and keeping the bod
 warm. and not exposed to drafts. Jnde
 no circumstances keep out the air. Tn ] child should be kept warm by appropri ate clothing and bedding. A frequent ter , imitation of broncho-pneumona is tuber culoss This should be especially gSarde Y against by observing the proper hygien and avoiding crowds and other dangers c
 tubercular infection. The physicians ad
 vice on all these matters should b
 sought and given.
 'R. M. CUNNINGHAM. M. D..