portance.... Purgatives should be continued through the whole course of the disease; . . . a blister should be applied of sufficient size to embrace the whole breast"! ("Family Medical Library," pages 174, 183).
Croup is an obstruction of the upper air-tubes, induced by the lethargic influence of overfeeding and warm, impure air. How an overloaded stomach reacts on the functions of the respiratory organs, many adults have an opportunity to experience in the strangling sensations of a "nightmare," though the respiratory stimulus of the cool night-air generally helps to overcome such affections, especially if the sufferer can ease his lungs by a contraction of his arms or by turning over on his side. But infants are not only more grossly overfed than the most gluttonous adults, while the phlegm-producing quality of their food increases the danger of respiratory obstructions, but that danger is still aggravated by feeding their lungs on the sickening air of an overheated and ill-ventilated bedroom, and still further aggravated by swaddling and bandaging them in a way to prevent every motion that might help to ease their distress. Spasmodic croup generally occurs after the establishment of a plethoric diathesis—after persistent overfeeding has turned a baby into a mass of fat and fretful sickliness. Some night, usually after a heavy surfeit, the child is awakened by a feeling of suffocation and gasps for breath till the obstruction is removed by a violent fit of coughing. "Croup-sirup" (treacle and laudanum) subdues the symptoms by lethargizing the irritability for a little while, for soon a second and more violent fit has to complete the work of the first paroxysm by expelling the accumulated phlegm.
But a far more dangerous form of the disease is developed when the predisposing causes are aggravated by an inflammation of the larynx. Inflammatory croup, or exudative laryngitis,[1] does not occur unawares, but is preceded by a very peculiar cough, a hoarse, cough-like bark, mingled with strange wheezing and metallic sounds. The windpipe is congested, and in that note of warning appeals for relief from impure air and deliverance from the influence of a crapulent diet. Nine times out of ten the effect of its appeal is a dose of narcotic cough-medicine, more tightly-closed windows and a hotter stove. The process of surfeit in the mean while continues; the windpipe, already abnormally contracted by its inflamed condition, becomes less and less able to resist the obstructing influence of the accumulated phlegm; at night, when the exclusion of every breath of fresh air[2] has
- ↑ Called also "true croup," or "pseudo-membranous laryngitis," "plastic laryngitis."
- ↑ "I lately attended an infant, whom I found muffled up over head and ears in many folds of flannel, though it was in the middle of June. I begged for a little free air to the poor creature; but, though this indulgence was granted during my stay, I found it always on my return in the same situation. Death, as might have been expected, soon freed the infant from all its miseries; but it was not in my power to free the minds of its parents from those prejudices which proved fatal to their child" (Dr. G. G. Norwood, "Management of Children," p. 619).
