(_g_) Croup is a term derived from the German Kropf the crop or craw
of the bird; this disease is known by a great many different names,
but on account of its shortness, _croup_ has received the preference.
The disease has to do with an affection of the organ of the voice, the
_larynx_, which is the upper part of the air passage, and situated
between the trachea and base of the tongue at the upper and front
part of the neck where it forms a projection in the middle line which
is prominent above and called the pomum Adami or Adam’s apple. The
larynx contains the vocal cords, running from before backwards on both
sides; these form the narrow fissure or chink, the _rima glottidis_,
through which we breathe. Like all other air passages this too is
lined with mucous membrane. The symptoms that foreshadow croup are not
particularly significant, for they simply indicate that the child has
a cold. The children have a cough, they sneeze, and their appetite is
capricious for a few days; they are not as lively as usual and are more
or less feverish. In a certain proportion of cases there is nothing
noticeable before the croup develops, for the children may go to bed
perfectly well and sleep calmly the first few hours of the night,
when suddenly they are awakened with a barking cough, which greatly
frightens young children and they begin to cry. The cough may repeat
itself at short intervals, the voice become hoarse and husky and lower
and lower, so that in the morning a well marked croup is developed. The
voice finally disappears so completely that it is not heard above a
whisper, and the greatest pain and harassing symptoms of suffocation
do not enable the child to utter a loud sound. The respiration becomes
labored in proportion to the swelling of the vocal cords and other
obstructions to the passage of air through the larynx. Croup has
vagaries that cannot be foretold. One child may have symptoms of so
threatening a nature that one believes it will suffocate at any moment,
yet, with a few simple remedies, the symptoms will gradually lessen and
it recovers in a few days, while another may be suffering comparatively
little and from appearances one would imagine that there is little or
no danger, but at once it will change and grow worse so rapidly that
it will die in a few hours. For this simple reason no case of croup
should be carelessly or lightly considered. When a child has croup it
should be put at once into a warm room; a big fire should be kept up,
and the child given hot drinks or a cupful of hot tea so as to make it
sweat. The front part of the neck should be rubbed with equal parts of
turpentine and sweet oil until it feels warm and the skin reddens. If
the child has eaten a good supper, a teaspoonful of syrup of ipecac
should be given every half hour until it vomits; otherwise vomiting
should be omitted. The following mixture always gives relief and with
other precautions is all that is usually required.