CROUP. 



CROWN. 



appearance of hoarseness, which in vrry young children does not 

 luiully attend common catarrh, and consequently, when observed in 

 child living in a district which generate* croup, this symptom U always 

 much more deserving of attention, especially if accompanied with a 

 rough cough, than it would be after puberty, thu excellent phyiicUn 

 ays, 



' In the approach of an attack of croup, which almost always take* 

 place in the evening probably of a day during which the child has been 

 exposed to the weather, and often after catarrhal symptoms have ex- 

 isted for several days, he may be observed to be excited ; in variable 

 spirit*; more ready than usual to laugh or to cry; a little fluahed, 

 occasionally coughing; the sound of the cough being rough, like that 

 which attends the catarrhal stage of the measles. More generally 

 however the patient baa been for some time in bed and asleep before 

 the nature of the disease with which he in threatened is apparent; 

 then, perhaps without awaking, he gives a very unusual cough, well 

 known to any one who has witnessed an attack of the croup ; it rings 

 as if the child had coughed through a brazen trumpet ; it is truly a 

 t tut 1 1 damjota ; it penetrates the walls and floor of the apartment, and 

 startles the experienced mother ' Oh, I am afraid our child is taking 

 the croup ! ' She runs to the nursery, finds her child sleeping softly, 

 and hopes she may be mistaken. But remaining to tend him, before 

 long the ringing cough, a single cough, is repeated again and again : 

 the patient is roused, and then a new symptom is remarked ; the sound 

 of his voice is changed ; puling, and as if the throat were swelled, it 

 corresponds with the cough : the cough is succeeded by a sonorous 

 inspiration, not unlike the kink in pertussis a crowing noise, not so 

 shrill, but similar to the sound emitted by a chicken in the pip (which 

 in some parU of Scotland is called the roiip, hence probably the word 

 croup) ; the breathing, hitherto inaudible and natural, now becomes 

 audible, and a little slower than common, as if the breath were forced 

 through a narrow tube ; and this is more remarkable as the disease 

 advances. A blush of inflammation may sometimes be detected on 

 the fauces, and in some rare instances a slight degree of swelling round 

 the larnyx, and the child complains of uneasiness in his throat, and 

 says he is choking. The ringing cough, followed by crowing inspira- 

 tion, the breathing as if the air were drawn into the lungs by a piston, 

 the flushed face, the tearful and blood-shot eye; quick, hard, and 

 incompressible pulse ; hot dry skin ; thirst, and high-coloured urine 

 form a combination of symptoms which indicate the complete esta- 

 blishment of the disease. Sometimes the symptoms enumerated sub- 

 side about midnight, even in the absence of medical treatment ; perhaps 

 to return in the course of the following evening. From seven or eight 

 o'clock till midnight this complaint is always at its height; but in 

 general, unless the patient be treated with promptitude and judgment, 

 the disease may be expected to terminate fatally; a new order of 

 symptoms, the second stage of croup, as it is called, taking place in 

 the course of the next day." 



If ihe diet of the child be changed from its ordinary food to that of 

 the simplest and blandest kind, as gruel or arrow-root, the moment 

 the hoarse cough and rough voice are perceived ; if it be immediately 

 placed and kept in bed in an equable and moderately warm tempera- 

 ture, and one grain or two grains of the powder of ipecacuanha be 

 given every hour, or every alternate hour, all the symptoms may 

 subside without any further remedies, and the threatened attack be 

 effectually prevented ; but if with this hoarse cough and rough voice 

 the child be allowed its ordinary diet, and be exposed as usual to the 

 open air, the attack will hasten on in the mode described until the disease 

 is fully established ; and then any treatment that may be employed, 

 to be of the least avail, must be most energetic. The prompt employ- 

 ment of the most powerful remedies is indispensable ; yet they must 

 be administered with cautious and judicious boldness. It is a disease 

 in which the inflammation, which it is the great object of medical 

 treatment to subdue, is not so much of a violent as of a peculiar 

 character, and this renders it necessary that the practitioner should be 

 guarded in the administration of some of the more powerful remedies 

 to which he must resort, and especially in the employment of blood- 

 letting. When the fever is intense, the skin hot, the pulse full and 

 hard, and the patient plethoric, bleeding must indeed be employed, 

 and carried as far as the strength will admit; but experience has 

 amply shown that in this disease the strength will not admit of its 

 being carried as far as is safe and even necessary in diseases purely 

 inflammatory. Bleeding, either by the lancet or by leeches, which 

 latter should never be applied to the throat itself, but to its immediate 

 neighbourhood, is a most powerful auxiliary ; but it is not the remedy 

 to be relied on. That is mercury, which should be given instantly 

 and efficiently, that is, in doses of from one to three grains of calomel 

 every hour, or every two hours, until the mouth be affected, the breath 

 foetid, or the patient relieved. If the calomel irritate the bowels, the 

 Ayrfror; yruw mm rrtta may be substituted, or a free inunction of the 

 mercurial ointment, which latter may be conjoined with the calomel, 

 or the mercury and chalk powder. Many practitioners prefer the full 

 employment of tartar emetic to the mercurial plan of treatment All 

 agree that blisters are useful auxiliaries, applied at the bottom of the 

 sternum, or between the shoulders, but never at the throat. The 

 vomiting produced by the tartar emetic sometimes powerfully pro- 

 motes the expulsion of the adventitious membrane. There are other 

 remedies of minor importance, the judicious employment of whicB 



may assist in putting a stop to the progress of this most formidable 

 malady. The use or abuse of these cannot be discussed bore ; l>ut 

 what has been stated may excite the attention of the mother, and 

 guide her to the choice of efficient remedies in the first hour or two 

 of the attack, during which it may not be always possible to obtain 

 medical aid. 



(Dr. Cheyne on Croup ; Dr. T. Pavies OH At Dunua of At L<tat 

 and Heart, in loco. ; Oojlis, Tratt. <U RUt Oognotmda tt Sananda 

 Angina Manbraxarra ; Copland,. Dial, of Prat*. Mid.; and Cydop. 

 Pratt. Ittd. m lac.) 



CROWN, the ornament of the head which denotes imperial or royal 

 dignity, from the Latin corona. The radiated appears to be the 

 earliest form of the royal crown with which we are acquainted. It 

 appears upon the heads of the figures which are represented upon the 

 Persian dines: radiated crowns also occur on the coins of Antiochus 

 IV. of Syria, and of his successors; on many of those of the Greek 

 cities ; and on those of Augustus and other emperors down to the very 

 destruction of the Roman empire. The fillet, and the laurel wreath, 

 were also used as crowns in very remote times : the fillet was the most 

 universal of all. In Constantino's time the fillet of pearls came into 

 use; which the latter Byzantine emperors turned into a kiixl of 

 coronet. Focas, as he is called upon his coins (not Phocas), has a plain 

 low crown. Later emperors varied its form according to their fancy. 

 Manuel Patoologus, who was crowned in 1363, is represented wearing 

 a close crown studded with pearls. (See Du Cange, ' Hist Byunt,' 

 p. 242.) The trefoil upon the crown is thought to be of Gothic intro- 

 duction. We find it on the crowns of Clovis and his sons, which has 

 induced antiquaries to call it the fleur-de-lis (Montfaucon, ' Monum. de 

 la Mon. Fr.,' p. xxviii. Diss. prelim.), but the truth is, these trefoils 

 were used on Constantinopolitan crowns before the time of the Franks 

 (Ibid., p. xxxii.), and afterwards on those of German princes no way 

 allied to Charlemagne. (See Montf. i., xxxiii.) 



Crowns were placed on the statues and images of the heathen gods, 

 as well as worn by the priests in sacrificing. Some antiquaries nave 

 even thought that the crown was originally rather a religious than a 

 civil ornament ; and that it only became common to kings, inasmuch 

 as the ancient kings were priests u well as princes. 



In regard to the crown as used in our own country, a fillet diadem 

 of pearls appears on several of the Saxon sceattse ; upon one or two 

 others a radiated diadem occurs. (See finding's ' Annals of the Coin- 

 age of Britain,' pL 6, 7.) Similar diadems or fillets adorn the heads of 

 many of the Heptarchic kings, and continue as the most common 

 crown upon our coins through the whole of the Saxon series. The 

 circle surmounted by three small projections first occurs upon the 

 coins of Athelstan ; on some of Edred's coins the projections end in 

 pearls. A radiated cap appears first on a coin of Ethelrcd II., and the 

 trefoil ornament upon the crown upon a few of the coins of Canute. 

 Several varieties .of arched cap and crown appear upon the coins of 

 Edward the Confessor. (See Ruding's plates, 15-23.) The close or 

 arched crown, which appears on some of Edward the Confessor's 

 coins, U used on all the types of Harold, and was adopted by the 

 earlier Norman kings. On Edward the Confessor's and the Con- 

 queror's coins, we see labels appended at each ear ; these, as we 

 learn from an anecdote related by William of Malmsbury, in wearing 

 the actual crown, were fastened by a clasp or button beneath the chin. 

 On the coins of Stephen and Henry II., the open crown with fleurs- 

 de-lis appears. Henry III. wears on his seals a crown fleury, pointed 

 or rayed, the points raised, but not high, between the flowers ; in his 

 second seal the points are wanting, as on that on his tomb ; but in 

 Matthew Paris we read he was first crowned with a circle of gold. 

 Edward I. has a similar crown on his coins and seals to that of 

 Henry III. as well as his queen upon her tomb ; so have his successors 

 Edward III., Richard II., Henry IV. and V. Evelyn ('Numism.,' 

 p. 34) says the monarchs of England were the first who pretended to 

 the arched crown : that is, as it appears in modern times. Sclden 

 (' Titles of Honour,' edit 1762, b. i. chap. 8) says he had read that 

 Henry V. was the first of them that had a crown of the kind. In a 

 window of Ockholt House in Berkshire, built by John Norreys, Esq., 

 in 1 465, there certainly remained, till within a very few years, the 

 arms of Henry VI. and his queen Margaret of Anjou, in separate 

 coate, both surmounted by the arch barred crown ; from Henry VII. 

 downward, this arched crown, with the globe and cross, has been 

 continued. 



Two of the most celebrated medi.-cval crowns arc that of Charle- 

 magne, preserved hi the Imperial treasury, Vienna, and the iron crown 

 of the Lombards, used at the coronation of the kings of Italy, and 

 which is kept in the cathedral of Monza. The crown of Charlemagne ' 

 " is composed of eight plates of gold, four large and four small, con- 

 nected by hinges. The large ones, studded with precious stones, form 

 the front (the central one being surmounted with a cross), the back, 

 and the intermediate points of the crown ; the small ones placed 

 alternately with these, are ornamented with enamels, representing 

 Solomon ; David; King Hezekiah seated on his throne, having before 

 him the prophet Isaiah; and Christ seated between two flaming sera- 

 phim, such as the Greeks usually represent them. The costume of the 

 figures resembles that of the emperors of the lower empire, and 

 although the inscriptions which accompany the figures are in 

 the whole bears the impress of Greek workmanship. The ground of 



