CROUP

An inflammation of the larynx and trachea, accompanied by difficulty of breathing and cough, and by a peculiar shrillne of voice and wheezing; there is also generally more or le expectoration of purulent and filmy matter, which is thrown out upon the affected part and continually threatens suffocation. This disease is most common in infants, and in children from three to nine years old; it is of rare occurrence, in its acute form at least, after twelve years of age. In the succe ful treatment of this distre ing and dangerous disease, every thing depends upon promptitude in the application of remedies calculated to subdue the local inflammatory action. This is to be done either by leeches to the region of the trachea, by cupping, or by bleeding m the jugular vein; by the cautious application of external irritants of rapid action, such as a piece of lint dipped in strong acetic acid, which, however painful, is sometimes of service; by blisters, and by the exhibition of large doses of calomel: there is a difference of opinion as to the employment of emetics. The inhalation of steam is useful where it can be resorted to, but in young children it is impracticable. In spasmodic croup the wheezing and sense of suffocation appear to depend upon spasmodic action of the larynx or epiglottis: like the former it attacks infants and children, but comes on and goes off very suddenly, returning at intervals, during which the patient is comparatively easy. In weakly and irritable children it sometimes appears a consequence of teething. An emetic, calomel purges, warm bath, diaphoretics, and a blister, are the leading remedies; bleeding should be avoided. There is a kind of croup which sometimes attacks children of weakly constitutions, and which appears symptomatic of irritation in the stomach and bowels, for it is relieved by purging, and disappears as the constitution improves. Another form of this disease is called chronic croup. It is attended by cough and the expectoration of tough mucus, sometimes apparently membranous or tubular, occasioning difficulty of breathing and suffocation. This disordered state of the trachea and bronchial membranes may occur at all periods of life: it is relieved, and often cured, by using the inhaler with warm water, by expectorants with Bmdl doses of sedatives and mercurials, and by occasional surging. 304 [s. 318]