PARATHYROID GLANDS 695 



essary. The drug, if administered by mouth, should be given in much 

 smaller doses (Ibrahim). If laryngospasm threaten life, chloral should 

 certainly be used. Chloroform inhalations can usually be dispensed 

 with. 



It is said that a lumbar puncture will sometimes stop rapidly recur- 

 ring convulsive attacks in children. A little sodium bromide three times 

 a day, given for two or three days, may lessen the tendency to laryngo- 

 spasm. 



Children subject to laryngospasm or to eclampsia should be kept per- 

 fectly quiet. Excitement or fright may precipitate an attack. Horsehair 

 pillows, instead of feather pillows, have been advised, or the head may be 

 kept on a head ring. Injections of camphorated oil may be given, if a 

 quick stimulant should be required. 



When a severe attack of laryngospasm occurs, the parent and nurse 

 should first wait quietly. If the child does not soon begin to breathe, it 

 may be sprinkled with a little cold water ; and if the attack continue, the 

 base of the tongue may be pressed down with the finger. Should this not 

 prove sufficient, an injection of camphorated oil should be given, after 

 which attempts to aid by artificial respiration may be necessary. The 

 resistance to respiration may be insuperable, the pathologically closed 

 glottis allowing no air to go either in or out. The moment the child in- 

 spires, making the characteristic sound that accompanies this, it is best 

 to stop all further measures, so as to avoid bringing on a new spasm. 

 Only when the breathing does not become regular does one continue arti- 

 ficial respiration. Intubation or tracheotomy comes nearly always too late, 

 for death occurs from failure of the heart rather than from asphyxia. 

 Some pediatrists have suggested continuous intubation of threatened chil- 

 dren during days of greatest danger. Death is, fortunately, relatively rare 

 from laryngospasm, though it does occasionally occur. 



Brown and Fletcher, of Toronto, lay great stress upon the danger 

 of the use, by children predisposed to tetany, of foods that have been 

 superheated and that contain a high percentage of carbohydrates (espe- 

 cially proprietary foods). They believe that such a diet upsets the 

 balance of the body salts, causing retention of sodium and potassium 

 (the irritating salts) and loss of calcium and magnesium (the sedative 

 salts). Mild diuresis, mild purgation, and correction of the diet will, 

 they think, quickly bring about improvement. 



10. Surgical Therapy other than Organ Trans- 

 plantation in Tetany 



When the special symptomatology and the prognosis of tetany asso- 

 ciated with disease of the gastro-intestinal tract was discussed (vide supra), 



