CROUP. 11 



urine will suffice to determine this question. Chemical and microscopical observa- 

 tions will not fail to give evidence, should any disease be present. 



The treatment of fits is generally very simple. During the fit we must loosen the 

 child's dress, and see that it has a plentiful supply of air. We must also take care 

 that while the convulsions are in progress it takes no harm, and it is advisable to 

 stand by it, and exercise some slight control over the movements of its limbs. If 

 the cause can be detected, every effort must be used to remove it. The bowels 

 must be emptied by a purgative, or the stomach relieved by an emetic, or, if there 

 l>e real necessity, the gums may be lanced. A hot bath is often of great service, and 

 the application of mustard plasters to the calves of the legs is a method of treatment 

 of such respectable antiquity that we cannot but believe in its utility. 



It is important not to employ too strong measures. Fits are no indication 

 of inflammatory action, and it is not necessary to apply leeches, nor to use strong 

 purgatives, nor apply blisters. These weaken the child, and increase its danger. 



Fits prove fatal by the exhaustion that they cause, and it is therefore highly 

 necessary to keep up the child's strength. In the intervals between the fits it must 

 have some nourishing food milk, beef tea, or meat jelly ; and if the fits are of long 

 continuance, we may add a small quantity of wine, or even brandy. If it is. found 

 impossible to feed the child by the mouth, owing to the close setting of the jaws, it 

 may be necessary to give nutritive injections by the bowels, but such strong measures 

 are only admissible by and with the advice of a medical man. 



Next to feeding, the most important indication in treatment is to calm the excita- 

 bility of the nervous system, and if possible get the child to sleep. The bromide of 

 potassium or ammonium, in doses of five grains every three or four hours, may be 

 given either dissolved in water or in food, and this will generally be found to 

 have the desired effect of producing calmness, if not sleep. If the convulsions 

 are very frequent indeed, the medical man may think it necessary to administer 

 a little chloroform, but we need hardly say that the friends will not think of 

 dealing with this potent medicine on their own authority. The greatest caution, 

 too, is necessary in dealing with the stronger narcotic medicines, as opium 

 or chloral. 



Consumption. (See Tuberculosis. ) 

 Coiv Pox. (See Vaccination, p. 63.) 



Croup. This disease, which is one of the most terrible and fatal to which 

 children are liable, is characterised by inflammation of the upper part of the wind- 

 pipe (larynx), accompanied by the growth of membrane. The membrane which 

 grows in the windpipe makes it narrower, and consequently the ingress and egress 

 of air from the lungs is very greatly impeded. In addition to this mechanical 

 obstruction, however, there is superadded a spasm, caused by the irritation of the 

 inflammatory action, for during the continuance of croup there is always more or 

 less difliculty of breathing, and this permanent difficulty, aggravated by spasm, 

 renders respiration at times an absolute impossibility, and if this impossibility lasts 

 for more than a few minutes, the child is necessarily killed by suffocation." The 



