26 AFFECTIONS OF THE LARYNX. 



fact that the croup is the result of " taking cold." With true fanaticism, 

 the moment that a child becomes hoarse, an incredible quantity of hot 

 sweet milk (which is here preferred to elder-tea) is poured down his 

 throat. Not until the child begins to sweat do they believe him safe, 

 and the foe (often an imaginary one) driven from the field. The 

 teachers of the hydropathic school claim similar results from envelopment 

 of the body in wet cloths, by means of which, " in a great number of 

 cases, they attain the most brill ! ant success," by thus restoring the re- 

 pressed action of the skin. 



Granting, however, that n my cases of croup arise from chilling of 

 the surface, the disease is nol so simple a one, the nutritive disorder of 

 the mucous membrane is of iar too grave a nature to admit of restora- 

 tion by the mere production of diaphoresis. In catarrh it may be other- 

 wise. Where hyperaemia alone has sufficed to swell the mucous 

 membrane, active solicitation of the blood to the surface may produce a 

 depletion from the same and cure the complaint 



As, however, it is almost impossible for the laity to distinguish be- 

 tween the two maladies, and as even the physician is often obliged to 

 reserve his decision when first called to see a child suffering from 

 hoarseness, a barking cough, and sudden nocturnal dyspnoea, it is well, 

 hi such emergencies, while awaiting the doctor, to give the child hot 

 drinks, to cover him warmly, and to apply a succession of hot, moist 

 sponges to the throat. It has been stated that in many instances, espe- 

 cially of epidemic croup, the inflammation seems to be propagated from 

 the pharyngeal surface into the larynx. If, then, croupous patches be 

 visible upon the fauces, the utmost energy is demanded on the part of 

 the physician. He must not content himself with the application of a 

 few leeches over the throat, as such practice is of very doubtful efficacy. 

 Let him rather remove the false membrane from the tonsils, and 

 thoroughly cauterize the affected part. This treatment is much more to 

 be relied on, and (perhaps from the astringent action of the caustic) is 

 one of the surest of antiphlogistics. 



With regard to the management of the disease itself, many phy- 

 sicians, especially country ones, are in the habit of calling for leeches 

 and emetics, and of forthwith applying one or both articles, if the 

 smallest trace of pseudo-membrane be discoverable. The leeches are 

 to moderate the inflammation ; the emetic to remove the exudation. 

 Hardly any one has ever had the courage to treat croup expectantly, 

 and to wait until special incidents in the disease shall call for special 

 measures. It is chiefly to the homoeopaths that we owe the discovery, 

 that even a child with the croup may get well without leeches or 

 emetics. Leeches (of which we apply one or two upon the manubrium 

 Bierni or throat of a child under a year old, increasing them in number 



