CROUP

croup, a name formerly given to diseases characterized by distress in breathing accompanied by a metallic cough and some hoarseness of speech. it is now known that these symptoms are often associated with diphtheria (q.v.), spasmodic laryngitis (q.v.), and a third disease, spasmodic croup, to which the term is now alone applied. this occurs most frequently in children above two years of age; the child goes to bed quite well, and a few hours later suddenly awakes with great difficulty in inspiration, the chest wall becomes markedly retracted, and there is a metallic cough. the child becomes cyanosed, and, to the inexperienced nurse, seems in an almost moribund condition. in the course of four or five minutes, normal respiration starts again, and the attack is over for the time being; but it may recur several times a day. the seizure may be accompanied by convulsions, and death has occurred from dyspnoea. the best treatment is to plunge the child into a warm bath, and sponge the back and chest with cold water. subsequently this can be done two or three times a day. should the cyanosis become very severe, respiration can be restarted by making the child sick, either with a dose of ipecacuanha wine, or by forcing one's finger down the throat. generally the bowels should be attended to; and the throat carefully examined for enlarged tonsils or adenoids, which if present should be treated.