A spasmodic affection of the larynx (spasm of vocal cords) and windpipe of children, in the milder form unaccompanied by inflammation, and consisting of sudden attacks of suffocating cough, usually waking the child from sleep. This is called “Millar’s asthma,” or Laryngismus stridulus. Another form, usually arising from cold, and especially from exposure to cold east wind, begins with a slight cough and hoarseness, the suffocative attacks occurring suddenly in the night. This kind arises from catarrhal inflammation of the larynx and windpipe, occasioning spasm of the vocal cords. In the worst form of all there is, in addition to inflammation, the formation of a thick membrane. This is almost always associated with diphtheria in the throat.
All forms of the disease are dangerous, and require prompt treatment. A medical man will, of course, always be consulted when possible, but there is much to be done before he can be obtained, as the attacks come on suddenly and find everybody unprepared.
Symptoms.-Whether preceded or not by slight cough, the attack, which comes on suddenly and almost always in the night, partakes of the same general characters. A choking cough wakes the child from sleep. The cough has a shrieking, sharp sound like the first attempt at crowing of a young cock. There is great difficulty in inhaling, and the breath is expelled in jerks. After the attack has passed off the child remains hoarse and cross. There may be a return the same night. Often the child is apparently quite well the next day, but has a return of all the alarming symptoms in the night.
General Treatment.-During the attack apply a sponge wrung out of hot water, as hot as can be borne, to the larynx (“adam’s apple”) and let both the arms be immersed in the water itself. If the patient grows cold and struggles with suffocation, pour very cold water on the head, nape of the neck, and throat. The room must be kept warm, and during the day the child must be carefully guarded from colds. Flannel must be put round the neck, and he must not be allowed to eat fruit of any kind.
Medicines.-(To be given every ten or twenty minutes during an, attack, according to the urgency of the symptoms. Every three or four hours during the interval.)
The slight premonitory cough, as soon as cold is observed; at the beginning of the attack, choking, dulness, anxiety, fright.
For the premonitory cough when hollow and wheezing. For the hoarseness remaining in the morning after an attack in the night. If the attacks come on after midnight or grow worse then, Hepar is better than Spongia. Rattling with the cough.
Voice rough, cough hollow, breathing, sawing, piping; can be heard at a long distance, the attack comes on before midnight; absence of rattling.
Carbo veg. 6.- Face blue, extremities cold, breath cold, voice almost extinct.