=Symptoms.=--Hoarseness is the first symptom noticed, and perhaps
slight chilliness, together with a prickling or tickling sensation in
the throat. There is a hacking cough and expectoration of a small
amount of thick secretion. There may be slight difficulty in breathing
and some pain in swallowing. The patient feels generally pretty well,
and is troubled chiefly by impairment of the voice, which is either
husky, reduced to a mere whisper, or entirely lost. This condition
lasts for some days or, rarely, even weeks. There may be a mild degree
of fever at the outset (100 deg. to 101 deg. F.). Very uncommonly the
breathing becomes hurried and embarrassed, and swallowing painful,
owing to excessive swelling and inflammation of the throat, so much so
that a surgeon's services become imperative to intube the throat or to
open the windpipe, in order to avoid suffocation. This serious form of
laryngitis may follow colds, but more often is brought about by
swallowing very hot or irritating liquids, or through exposure to fire
or steam. In children, after slight hoarseness for a day or two, if
the breathing becomes difficult and is accompanied by a crowing or
whistling sound, with blueness of the lips and signs of impending
suffocation, the condition is very suggestive of membranous croup (a
form of diphtheria), which certainly is the case if any white,
membranous deposit can be either seen in the throat or is coughed up.
Whenever there is difficulty of breathing and continuous hoarseness,
in children or adults, the services of a competent physician are
urgently demanded.
=Treatment.=--The use of cold is of advantage. Cracked ice may be held
in the mouth, ice cream can be employed as part of the diet, and an
ice bag may be applied to the outside of the throat. The application
of a linen or flannel cloth to the throat wrung out of cold water and
covered with oil silk or waterproof material, is also beneficial, and
often more convenient than an ice bag. The patient must absolutely
stop talking and smoking. If the attack is at all severe, he should
remain in bed. If not so, he must stay indoors. At the beginning of
the disorder a teaspoonful of paregoric and twenty grains of sodium
bromide are to be taken in water every three hours, by an adult, until
three doses are swallowed.
Inhalation of steam from a pitcher containing boiling water is to be
recommended. Fifteen drops of compound tincture of benzoin poured on
the surface of a cup of boiling water increases the efficacy of the
steam inhalation. The head is held above the pitcher, a towel covering
both the head and pitcher to retain the vapor.
The employment, every two hours, of a spray containing menthol and
camphor (of each, ten grains) dissolved in alboline (two ounces)
should be continued throughout the disease. If the hoarseness persists
and tends to become chronic, it is most advisable for the patient to
consult a physician skilled in such diseases for local examination and
special treatment.
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