LARYNGISMUS STRIDULUS.
The primary cause—rickets, infantile convulsions, status lymphaticus, tetany, &c.—should be treated between the intermittent attacks of spasm of the glottis.
The best thing to do is to dash a little cold water against the face and chest, or to apply a hot fomentation to the neck and draw the chin for wards, and afterwards plunge the patient into a warm bath if seen during the attack, which is seldom, as the onset is alarmingly sudden and its duration exceedingly brief. A whiff of chloroform may be administered. Faradisation of the recurrent laryngeal or the forcible pulling forwards of the tongue may be resorted to if the physician should happen to be present at an attack which does not yield to a dash of cold water. Am monia or Amyl Nitrite to the nostrils may also be tried. There is generally no time for the action of an emetic, unless in those cases where successions of attacks follow each other. Artificial respiration should be tried and persevered with in every case which does not yield to the above agents. Seldom is tracheotomy indicated.
Chloral, Bromides, Musk, Morphia, Emetics, Nitroglycerin, Succus Conii, and Belladonna internally have been recommended in recurring cases. The writer has obtained the best results from full doses of the Bromide of Ammonium, of which 2 or 3 grs. may be given every 3 hours or oftener to a child r year old, with gr. Chloral Hydrate. Henoch speaks highly of Morphia, pushed to the extent of causing drowsiness, but this treatment cannot be free from serious dangers, especially as the disease rarely, if ever:occurs except between the fourth and twenty-fourth month. Lancing of the gums may he tried, but there is little benefit to be expected. Antipyrine in small doses (i gr. every hour for a child i year old) has been reported as successful in preventing the return of the paroxysms; Watkins administers 1 drop of weak Tincture of Iodine every hour at first, and then every 2, or 3 hours, but as a rule treatment directed to the rachitic condition meets all requirements.