

ADDITIONS TO THE REVISED EDITION OF 1880. 59 



4. P. 23. 



Bartels sees a further explanation of the asphyxia in the ana- 

 tomico-pathological conditions above described, where the air is 

 found almost exclusively in the front of the lungs and the blood 

 at their back part. Sometimes pneumonia or hot fever contributes 

 to the fatal result. When the patient recovers, the catarrhal symp- 

 toms and the disorders within the lungs continue for weeks, and 

 more rarely for a much longer period. 



5. P. 25. 



Recovery from genuine croup is rare. When tracheotomy is 

 performed, the percentage of deaths is somewhat better than when 

 other treatment alone has been relied upon. But the statistics of 

 tracheotomy disagree seriously, varying from the loss of nearly all 

 cases to the very unusual success of 50 per cent. (JBoeckel, of jStrass- 

 burg). Of cases operated upon, Bartels has seen seventeen out of 

 sixty-two recover ; of forty-one treated otherwise, but five got 

 well. Sporadic croup seems to be less fatal than epidemic croup. 

 In the first two years of life even an operation gives very slender 

 hope of recovery. Of course, in a given case, the degree and per- 

 sistence or remission of the fever, the state of the lungs and bronchi, 

 and above all the stage of the disease, must be considered. When 

 carbonic-acid poisoning has set in, when the face is pale or livid, 

 the child drowsy, the senses benumbed, when an emetic ceases to 

 act, an operation alone affords one last chance of recovery. 



6. P. 39. 



At the bottom of these sores, in the midst of the connective tis- 

 sue still intact, Rindfleisch has found rounded cell-masses as large as 

 a gland acinus, which he is inclined to regard as miliary tubercles. 



7._p. 44. 



According to Gferhardt, the state of the voice is characteristic 

 when the polypus is seated upon the edges of the vocal chords, as is 

 so common with adenomata and papillomata. When the patient 

 after drawing a deep breath is made to open the mouth widely and 

 to utter a simple note, and when we listen attentively close to the 

 mouth, the note so uttered may be divided into three parts : first, a 

 tolerably natural but perhaps somewhat hoarse sound (here the 

 tumor still hangs beneath the chord in the lower recess of the lar- 

 ynx) ; second, a very hoarse, perhaps piping, cracked sound (the 



