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membranous, croup, child, throat, cough and breathing

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CRAMP.--A painful muscular contraction occurring chiefly in the lugs, especially of swimmers and wheelmen. The best remedy for cramp is to rub briskly the part affected. Bromide of potassium, io grains, taken internallv, is recommended as a remedy that gives relief and checks recurrence ot the spasm. If the cramp is in the lower extremities (growing pains), rub the leg well with witch-hazel ; adduction of the toes to the leg will immediately stop the pain if in the calf of the leg. People suffering from such cramps should never stretch their legs with adducted toes. For cramps in stomach or abdomen, see ABDONIINAL PAINS or Couc.

CROUP.—An inflammatory disease of the throat in which the formation of a false membrane obstructs the respiration. Called true, or membranous, croup as distinguished from false croup, which is a catarrhal inflammation of the larynx, without membranous formation or exudation.

In true, or membranous, croup, since the air that passes to the lungs must enter through the larynx, or organ of the voice, and the channel through it is so narrow in one place (rima glottidis) as to be little more than a mere slit, it stands to reason that when the membranous lining of this slit becomes inflamed and swells, the swelling, together with the obstruction caused by the formation of the false membrane above referred to, is sufficient, or nearly sufficient, to close the slit and cause the suffocation of the patient. This is the chief source of danger in membranous croup.

The modern medical view of acute membranous croup is that it is diphtheria spreading from the throat or of independent occurrence in the larynx instead of its most frequent site, the pharynx, or windpipe. This form, therefore, has but one cause—infection, as by taking in the germ from some patient already suffering from diphtheria, or from vitiated atmosphere. Children suffer from croup most often up to their fourth year, and particularly in their second, third, and fourth years, after that period it occurs less frequently, until the age of ten is reached, when they seem no longer liable to it. C,irls are believed

to be less liable to it than boys.

The symptoms vary widely. The preliminary signs are slight fever, hoarseness accompanied by a hard cough, running nose, and thirst. Occa sionally the child, as if to point to the seat of suffering, grasps at its throat or rubs it as if to ease the pain. This condition may last from twenty-four to thirty-six hours, when a marked change takes place. ANN-aking suddenly usually at night, the child is greatly alarmed by a feeling of suffocation, and draws its breath with great difficulty and in hurried gasps. The cough now recurs continually, and has a harsh, brassy sound. The face is flushed and the look anxious. The child becomes restless, refuses to lie down, and struggles to get out of bed. Then follows marked difficulty in breathing ; every breath is drawn with a hissing, croupy sound characteristic of the disease. Throughout the remainder of the night, the hard, brassy cough and the croupy breathing continue in sudden spells until, when morning dawns, the child is almost worn out, but otherwise a trifle better, and falls into a brief sleep. Unhappily, the improvement is not permanent. The temperature rises as the day progresses, the pulse beats hard and fast ; fever increases, and is accompanied by a tormenting thirst ; the tongue is coated, and the voice almost gone. Breathing becomes still more difficult and the cough harsher, and, unless the child is relieved by coughing, or by bringing up some membranous shreds and glairy mucus, its respiration becomes much more difficult, and it grows correspondingly restless, tosses about wildly, throws off its bedclothes, and clutches at its throat, as if in an effort to remove the obstacle to its breathing. Often it throws its head back as far as it can in an effort to open the passage for the air. The patient loses all appetite, but craves for drink.

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