SUMMARY:-- Coughs that resist careful treatment are not "ordinary coughs." Coughs of this type require special medical care. The usual cough medicines are not only useless in these coughs, but dangerous. Don't give them. ACUTE CATARRHAL LARYNGITIS: SPASMODIC CROUP: FALSE CROUP Croup is one of the common diseases of childhood. It usually follows a catarrhal "cold in the head" with a cough. Croup is most frequently associated with large tonsils and adenoids. It may come on gradually or it may occur suddenly. There is always fever with croup. One of the first symptoms is a hard, dry, croupy, barking cough, which gets worse toward night. If it occurs suddenly, the child will wake about midnight with the characteristic croupy cough. The disease may go no further than this and under the proper treatment is well in a few days. In other cases, however, there develops marked interference with breathing. Every inspiration is accompanied by a loud hissing or "crowing" sound. This feature of the disease is one that frightens the parents, though it seldom means anything serious. The child sits up in bed, frightened, and struggles for breath. It may clutch its throat with its hands as if something was tied round its neck. The lips may become slightly blue and the perspiration appears upon the child's brow. After some time,--it may be two or three hours,--the attack wears away and the child goes to sleep. Next morning it wakes up apparently well except for the croupy cough. The attack may repeat itself the next night and mildly on the third night. Treatment.--The object of treatment during an acute attack, when the child is struggling for breath, is to relax quickly the spasm of the larynx which interferes with the breathing. The simplest way is to give the child a teaspoonful of the fresh syrup of ipecac. If the child does not vomit in fifteen minutes, give another teaspoonful and keep on giving it every fifteen minutes till the child vomits. One or two doses is usually enough, but it must be given till the child vomits. If the attack comes suddenly during the night and there is no syrup of ipecac in the house, the physician should be sent for at once and informed that the child probably has croup, so he may know what to take with him. While waiting for the physician the mother should apply over the front of the neck (in the region of Adam's apple), hot applications. These are best made of flannel wrung out of quite hot water every two or three minutes: also a hot mustard foot bath. When the physician takes charge of the case he will also direct the treatment for the following day in order that the attack of the next night may be a very mild one, if it should came at all. Children who have a tendency to frequent attacks of croup should receive the same attention as the children do who are subject to attacks of tonsilitis and acute catarrhal rhinitis. SUMMARY:-- 1st. Spasmodic Croup always requires prompt and efficient treatment.