Pierre weekly free press. (Pierre, S.D.) 1889-19??, 1916-06-01
COUGH AND CONSUMPTION.

One of the very earliest and also one
OF the most constant systems OF con-
sumption is cough. Cough is the effort
made by the muscles Of respiration to
relieve the nerves of the air passages
of something which is irritating them.
First, there Is an irritation of the
nerve. Usually this irritation is in a
bronchial tube. 1t nay he in the ear,
the palate, h pleura, or somewhere
more or less removed from the bron-
chial tubes.
If you will press with a toothpick on
the floor Of the outer ear canal you will
cough. When the irritation Of the nerve
sends an alarm to the nerve center for
coughing the muscles of respiration
contract violently and force a column
of air from the lungs through the
vocal cords. If the cords are held
tense a loud barking sound esults If
they are relaxed the sound is slight.
Theoretically; the object Of the cough
is to free the nerves of that which ir-
r1tates them. Practically the act is not
very we'll adapted to the work for
which it was intended and consequent
ly coughing is often ineffective.
In tuberculosis the cough begins as
soon as the growth of tubercles and the
secretion of the bacilli irritate the
; nerves of the lungs. At the beginning
it is a dry, irritating, nonproducing
cough. There is no sputum because
there is no secretion for the lungs to
bring up. Remember this: It Is not
safe to say tuberculosis is absent be-
u the cough is dry and nonpro-
ductive. A hacking cough lasting for
several weeks or months is quite sug-
gestive Of consumption.
After a while the cough begins to
bring up a little mucus. This mucus
means nothing more than a limited
bronchitis. Such a bronchitis may be
the result of coughing. 1t may mean
that tubercular nodules are growing in
the walls of the bronchial tubes. Some
times he microscope will show an
abundance of tubercle baci.li in this
clear mucous. In some cases of tuber-
culosis no bacilli a be found in this
mucous. Later the cough becomes more
productive, brings up more sputum.
When this stage is reached the cough
becomes less troublesome. There is
not the constant tendency to hack
found earlier in the disease.
AS the sputum increases In quantity
1t changes to a white, Their q yellow
n later grayish color. There is
nothing about the color which is q sign
by which diagnosis can be made. AS
the disease progresses and cavities are
formed the amount Of sputum coughed
up In a day measures more than a pint.
Some patients cough more in the morn
ing. They cough until they have
cleaned out their lungs. Others cough
more when they first lie down. The
prone position stimulates cough in
them.
When a stranger visits a tuberculosis
sanatorium he Is struck by the fact
that he hears nobody coughing. One Of
the most useful points in personal hy-
gtene taught consumptives in sanitaria
Is how to cough. In the first place.
trey are taught that coughing which
fails to bring up anything i%rritates the
c cords. harms h lungs, tires the
muscles, uses up vitality, and does no
good. They are taught to discrimin-
ate between the irritation which means
that there Is something to be brought
up and that which means a dry hack.
Next they are taught that loud. vio-
lent. noisy coughing Is worse than USE
lasc