GLOTTIS, SPASM OF.—A spasmodic condition of the diaphragm and of those muscles which move the vocal cords. It occurs chiefly in patients suffering from a pronounced or hidden attack of rickets, and principally during the months of January, February, and March. It is a very dangerous disease, as it attacks young children of three months to two years of age, sometimes affecting all the children of a family. The attack comes on without warning, and is usually caused by sudden excitement or great fright. The child at first makes eager attempts to breathe, then stops breathing altogether, and stands with the mouth wide open and with the head thrown backward. The face turns purple, the veins of the head swell and protrude, and the eyes stare vacantly into space or roll heavily from side to side. In some cases there are spasmodic movements of the arms and legs, clenching of the hands, and distortion of the face, followed at times by involuntary passing of urine and faeces. After being breathless for about half a minute the child makes several whistling inhalations, whereupon it revives unless another seizure sets in. If the spasm ceases, the child recovers quickly, is able to breathe as before, and the colour of the skin becomes normal. Some children are cross and sleepy after an attack, others are as cheerful as usual. At times the tongue rolls back during an attack, closes up the passage of the glottis, and causes death by suffocation.
If some children of a family have had these attacks, it is wise to try and ward them off in the younger children by letting them have plenty of pure air to breathe and the food best suited to their ages mother's milk is preferable. Every disturbance of digestion is to be carefully warded off or controlled. During an attack, the child's clothing should be loosened, a hot sponge applied to the larynx, and cold water sprinkled over its face. Pressure of the finger on the roof of the tongue or on the epiglottis will often stimulate the breathing. A child who has a spasm of the vocal cords must be treated by a physician, and needs the greatest care and attention. One of the most useful modes of treatment calculated to increase the resistance of these children is the daily sponge bath. In the severe cases the patients should be given a warm bath two or three times a day ; and at the close of the bath the chest, neck, head, and spine should be sponged off with cold water. Cod-liver oil is useful in these cases. Particular care must be taken by the mother that the dangerous true croup, or laryngeal diphtheria, is not confused with this comparatively mild affection.