FALSE CROUP. 17 



i>e supposed to be due to disease of the brain, but such is very rarely the 



The tti/i/ijttunis of laryngisinus stridulus are a sudden suspension of respiration. 

 The child wakes suddenly from its sleep, starts up and struggles for breath, then 

 ut'ten becomes unconscious, and lastly, as the spasm of the windpipe relaxes, it draws 

 in its breath with a loud crowing noise, which is highly characteristic. The suspen- 

 sion of respiration may endure so long as to cause the child's face to become pale and 

 livid, but directly the breath has been drawn, this symptom disappears, and the child 

 becomes well again. The attacks are generally renewed again and again at uncertain 

 intervals. During the attacks there are usually observable curious contractions of 

 the fingers and toes which are technically known as the carpo-pedal contractions, and 

 which are almost absolutely characteristic of this disease. The toes are bent down 

 and are rigid, and the thumbs are tightly bent across the hands. The disease may 

 be looked upon as indicative of an impaired constitutional state rather than as 

 dangerous in itself, but it must also be borne in mind that children do occasionally, 

 though happily very rarely, die during a spasm. This is an accident which, in point 

 of fact, is liable to occur whenever the upper part of the windpipe is diseased, and 

 especially when the patient is of tender years. Recovery, however, is the rule, and 

 death is the exception. 



This disease has to be distinguished from the catarrhal false croup and true croup, 

 and the distinction is generally not difficult, for not only are we guided very often 

 to a right conclusion by the spasms of the hands and feet, but the fact that the child 

 is absolutely well between the attacks of crowing is sufficient to prevent any mistake. 

 In catarrhal croup, the voice is hoarse, even between the attacks of spasm, and in 

 true croup the voice is either hoarse or reduced to a whisper, and the noise of the 

 respiration is high-pitched and hissing. 



The treatment of spasmodic false croup must be directed to the prevention of 

 the spasm, and the curing of the constitutional condition which is the cause of it. 

 The spasm is liable to be brought on by any excitement, any quick movement 

 of the child, or anything which may be likely to rouse its emotions or passions. 

 Children, therefore, who are liable to this disorder must be kept very quiet, and 

 should be separated from any of their little companions who are likely to be too noisy 

 or rough. 



The diet must be most strictly attended to, and a careful surveillance must be 

 kept lest the child get hold of any of the edible trash which is such a potent 

 cause of sickness in children. Until a child has cut its first teeth it ought to be 

 kept like a baby, and ought not to be allowed to be nursed at meals with the rest 

 of the family, and be fed upon a variety of things which its young stomach is 

 not able to digest. As soon as a child is weaned, its diet should consist almost 

 entirely of milk and meat broths, and the less starchy matter it has the better. 

 There is no greater mistake than to cram a child with patent foods, which are so 

 much in vogue at present. If the child vomits curdled milk or passes white curdy 

 matter from the bowels, a little lime water should be mixed with the milk to 

 counteract the undue acidity of the intestinal secretions. About three table- 

 Bpoonftda of lime water to every pint of milk is generally sufficient. If the bowels 

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