A chronic catarrh sometimes follows the acute process. In some cases, particularly in false croup, the mucus becomes dry and thick, causing the dyspncea, which ceases as soon as the crusts are expelled.
The diagnosis of the mild form of catarrhal laryngitis is easily made, but in cases of pseudocroup, true croup naust be thought of. In pseudocroup, the membranes on the gums, tonsils, pharynx and larynx are absent, and the sudden onset at night, with the decided relief in a few hours is characteristic.
Prognosis.—The prognosis of simple catarrhal laryngitis is favor able. False croup is more serious because of the possibility of suffo cation, and complications like bronchitis and pneumonia. These com plications are more apt to develop when influenza or measles have caused the laryngitis.
Treatment.—The child should be kept in a warm moist tempera ture, the air of the room being saturated with steam, Drugs are un necessary in mild cases, and no attention need be paid to the temperature.
For the dryness of the throat, warm drinks (warm lemonade, tea or milk), may be given to favor free perspiration. When this begins, the laryngeal secretion will also start. Warm, moist compresses to the neck are also useful. After the first flay, the feeling of dryness in the throat can be relieved by inhalations of water or saline solution. When the cough is severe, with little expectoration, heroin, four. 0,02 Cm.: 100 c.c. (1 gr. to 31 oz.), small teaspoonful every 2 or 3 hours, or morph, mur. in the same doses, may he given, or apomorph. mur. 0.03 Gm.
(1 gr.), acid mur. dil. 0.3 Gin. (ay 7), sq. dest. 150.0 c.c. (5 oz.), tea .spoonful every 3 hours). As soon as there is free secretion, expectorants like ipecac should be used.
In severe forms, when the symptoms depend upon excessive secre tion of mucus, emetics should be given, the best being tartar emetic, one dessertspoonful of a 0.2 per cent. solution, which may be repeated in fifteen minutes. In cases of pseudocroup, foot baths, with ice in the mouth and cold compresses to the neck, with steam inhalations and expectorants are useful. Tincture of aconite and belladonna, two or three drops every two hours will sometimes do good. When the difficulty in breathing beeomes alarming, either intubatiou or tracheotomy must be resorted to. If an intubation tube can be left in long enough this method is often successful. If not tracheotomy must be performed.
is the duty of the physician to prevent recur rences if possible. To accomplish this, the powers of resistance of the individual should be increased. :'4usceptible children should not be per mitted to go out in bad weather and extreme temperature changes should be avoided. The child may be made less susceptible by proper atten tion to clothing, gymnastic exercise, fresh air, and ventilation of rooms. Most important of all is a cold sponge bath at least once a day. Swim ming is very good. When possible a change of climate is often effective.