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. He becomes cyanosed, and seems moribund. 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. 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 vomiting induced by ipecacuanha wine, or other means. Rickets, enlarged tonsils or adenoids if present should be treated.