16 DISEASES OF CHILDREN. 



The cold, instead of settling in the nose or the head, " flies to the throat," as it is 

 termed, and a trifling catarrh, i.e., the slightest possible inflammation, is liable to 

 affect the upper part of the windpipe. To this symptom not unfrequently is super- 

 added spasm of the glottis (the opening of the windpipe), and the child wakes in 

 the night with a loud crowing inspiration and also with a difficulty of breathing. 

 This crowing sound as a rule subsides after a little time, and the sound 

 of the respiration, although it may be slightly loud and hissing, has not the 

 clanging crow which only supervenes during the attacks of spasm. This cold in 

 the windpipe lasts about as long as a cold in the nose a variable period from 

 forty-eight hours to a week and then subsides, and with it subside all the 

 alarming croupy symptoms. This condition of things is very liable to recur, and 

 when we hear of a child being liable to croup, we know that this mild catarrhal form 

 is meant, and not the severe kind, which is characterised by the growth of false 

 membrane, and which (if the child escape unscathed from its attack) we believe never 

 returns. The treatment of catarrhal false croup is simple. The state of the bowels 

 should be attended to, and, if necessary, a mild purgative should be given. A 

 powder composed of rhubarb and carbonate of soda, to which a very small quantity 

 of grey powder is added, will be found of service. To the outside of the throat a 

 mustard plaster, or even a blister, should be apolied, and the child should be made to 

 inhale the steam of hot water either from a common jug or from one of the patent 

 inhalers which form part of the stock-in-trade of every druggist. Many parents whose 

 children are liable to this form of croup are accustomed to carry always with them a 

 bottle of emetic (generally ipecacuanha wine), which they administer directly the 

 familiar symptoms make their appearance. This does good very often by emptying 

 tlif stomach ; and since the determining cause of these attacks is frequently some 

 error in digestion, the emetic is often sufficient of itself to effect a cure. 



Spasmodic False Croup. Child crowing, or Laryngisinus xtridulus, as it is 

 technically called, is a totally different disease, and although resembling true croup 

 and catarrhal false croup in its prominent symptom, it is on no account to be con- 

 founded with either. It occurs generally during infancy, while the child is cutting 

 its first teeth. The children who suffer are of delicate constitution, never robust, 

 ami the constitution which seems most liable to this disease' is the rickety (see 

 Hii'ki'tii). The period of first dentition is always a time during which the nervous 

 system manifests an undue activity, and while some children suffer from attacks of 

 Ufiicral convulsions (see Convulsions), others show a tendency more to a convulsion 

 or spasm of the windpipe. There is Amorally some irritation present which is recog- 

 nisable as the cause of the spasm. This may be found in the stomach in the form of 

 indigestible or improper food, or in the intestines in the form of worms, and often. 

 no doubt, the irritation of teething is sufficient to produce it. These patients are 

 generally backward with their teeth, but one must not on that account rush to the 

 conclusion that the backwardness or difficulty of cutting the teeth is the cause of 

 the spasm, but we must remember that the spasm of the glottis or windpipe and 

 the delayed dentition arc generally dependent on the same cause, viz., the rickety 

 constitution. These children have often the big head of rickets, and the trouble 



