CROUP. 29 



3 i S. 3 i. 2 h.). (Cupri. sulp. gr. i ; aqua?, 3 i ; s. 3 i. 2 h.) Sulptmret 

 of potassium (IJ potas. sulp. 3ss. 3j; aquae; syrup simplic. aa i 

 fl], s. 3 i. every 2 hours), in spite of the warm eulogium of distinguished 

 authorities, such as Rilliet and Barthez, has never come much into use, 

 and now is almost obsolete. The proposal of bicarbonate of soda in 

 large doses is obviously based rather upon theoretical grounds than 

 upon actual experience ; hence deserves little reliance. The drug has 

 been administered in the hope of loosening the false membrane, and 

 preventing further coagulation of the exudation, or else of improving 

 the state of the blood. 



Chlorate of potash, which is a favorite remedy in treatment of diph- 

 theria of the fauces, and of the secondary croup of the larynx, which 

 accompanies it, is also recommended in true primary croup, by those 

 who make no distinction between the latter and the pseudo-membranous 

 laryngitis of acute infectious disorders. I have no personal experience 

 of the action of this article in treating primary laryngeal croup. 



When called to the bedside of a child, recently attacked, the physi- 

 cian should not be misled by the idea that, without his immediate and 

 active interference, the child must soon die. Leeches should never be 

 applied, save under the exceptional conditions above stated, and the 

 after-bleeding from the bites should be kept within bounds. It is bet- 

 ter, in most cases, to confine one's self to the use of cold, and do not 

 hesitate to put on the first compresses with your own hand, until the 

 parents perceive the relief which they afford. Besides this, if the 

 bowels be confined, administer a clyster, so that the diaphragm may 

 have free room to act. The best is a cold one, of three parts water, and 

 one of vinegar. If the dyspnoea increase, if the respiration be impeded, 

 give an active emetic, without suspending the cold applications. The 

 emetic is to be repeated, under the conditions stated above ; if, however 

 under this treatment, there be no remission, apply a solution of nitrate 

 of silver, at intervals of several hours, to the entrance of the glottis. 

 Do not forget, during the night, that, with the early morning hours, 

 there often comes a remission, nor during the next day, that, in spite of 

 the improvement, the coming night may again bring with it the greatest 

 danger. However well the child may seem to be, it must not quit itp 

 bed. The temperature of the room must be kept uniform, and the air 

 rendered moist by means of open vessels of water. Give half a grain 

 of calomel every two hours ; aud now change the compresses less often, 

 and cover them with a woollen cloth. Continue meanwhile, but at longer 

 intervals, to use the solution of nitrate of silver. The next night, if the 

 croup grow worse, the same measures are required. 



Should this treatment remain without effect, should there be no 

 improvement in the course of ten or twelve hours, do not lose time 



