



CROUPOUS INFLAMMATION- -PHARYNGEAL CROUP. 469 



D the disease, but in the cases that I have seen, this improvement has 

 only been apparent, or, at least, only temporary. Solutions of corro- 

 sive sublimate or sulphuret of lime have not proved more beneficial. 

 Recently, as recommended by Lewin, I have, in some cases, tried a 

 LugoVs solution ($ iodin. gr. vj; potass, iodid. gr. xij; aquas ?vj), 

 for painting the pharyngeal mucous membrane, and, although I have 

 not used it in a great many cases, it seems preferable to other remedies 

 in dry catarrh of the pharynx, with or without granulations. In this 

 form of chronic pharyngeal catarrh the alkaline muriatic mineral waters 

 have the best reputation, particularly those of Ems and the sulphur 

 springs, especially those of Weilbach, and some Pyrenean springs. 



OHAPTEK II. 



CROUPOUS INFLAMMATION OP THE PHARYNGEAL MUCOUS MEMBRANE 

 PHARYNGEAL CROUP. 



ETIOLOGY. In the croupous inflammation of the pharyngeal mu- 

 cous membrane, the croup membrane often adheres so firmly to the 

 inflamed mucous membrane that, on detaching it, a bloody, superficial 

 loss of substance remains. Then the affection shows a change from 

 croupous to diphtheritic inflammation. 



1. Pharyngeal croup occurs as an independent disease, from the 

 same causes as pharyngeal catarrh, and it almost seems as if it were 

 occasionally only a more intense form of catarrh. 2. The croupous 

 deposits on the tonsils, so often seen in parenchymatous angina, are 

 explained by the intense participation of the mucous membrane in the 

 inflammation of the subjacent tissues. 3. Pharyngeal croup, which 

 appears as a symptom of a sporadic, or, more frequently, epidemic 

 croupous inflammation, affecting the mucous membrane of the palate, 

 pharynx, larynx, and trachea, is very important. In this form the croup 

 sometimes seems to spread from the larynx to the pharynx (croup as- 

 cendant), sometimes the reverse (croup descendant). 4. Lastly, pha- 

 ryngeal croup occurs with croupous and diphtheritic inflammations of 

 other mucous membranes in the later stages of typhus, in septicaemia, 

 and similar diseases, a form which we shall not consider further at 

 present. 



ANATOMICAL APPEARANCES. We see white or grayish- white mem- 

 branous masses on the reddened mucous membrane of the soft palate, 

 tonsils, and pharynx. They usually form small, irregular, roundish 

 islands ; more rarely extensive membranes. Under these there is no 

 iOss of substance. 



SYMPTOMS AND COURSE. Idiopathic, uncomplicated croupous an- 



