The third type is membranous or diphtheric croup found in association with real diphtheria. From a close examination of the childs throat the diphtheric membranes can be found and its treatment should be the same as of diphtheria.
auxiliary MEASURES: Relief can be rendered by hot fomentation on the throat with a piece of flannel wrung out of hot water. Taking some common salt in a piece of cloth it can be warmed and applied over the throat.
MEDICAL TREATMENT: Dr. Farrington found the following medicines useful in the treatment of croup: DD Acon., Ant-t., Ars., Bromide., Calc-fl., Calc-s., Hep-s., Iod., Kali-bi., Kaolin, Lach., Lyco., Merc-cy., Phos., Sang. Spon.
THERAPEUTIC HINTS: Aconite, Spongia and Hepar-sulph. will be sufficient in most of these cases of croup. Dr.Boenninghausen won the laurel for homoeopathy by introducing them in an epidemic of croup in Germany and thus they are known as Dr. Boenninghausens Croup Powders”. Since then, the efficacy
of these three remedies has been testified in croup times without number, in many hands and in many countries.
Aconite is the first medicine repeated often to bring down the high fever of croup. Spongia follows next repeated similarly, to ease the spasm further and when the cough becomes loose enough a dose of Hepar-sulph. in high potency will complete the cure. Phosphorus has been recommended by some high authorities as a preventive against relapse.
LEADING INDICATIONS: Aconite: When the trouble is originated from an exposure to dry cold; the complaint develops not only suddenly but also soon after the exposure. If the child takes cold in the evening he would get the attack in the first sleep, perhaps at 9 or 10 p.m. Its croup has always a high temperature accompanied by restlessness and an anguish cry. In very small babies its characteristic thirst may not be noticeable but the elderly ones will express relief and satisfaction when cold water is offered to drink. The child starts up from sleep gasping for breath. It has a dry heat and a dry barking cough.
Bromine: The child is aroused with great difficulty in inspiration. Constriction of the vocal chord is the principal characteristic of the remedy. Spasmodic cough with much rattling; relief from cold drinks. It follows well after Iod. and Hep-s.
Chamomilla: When its irritative mood and peevishness are present this remedy will be sufficient in catarrhal croup. The child wants to be carried all the time; green diarrhoea.
Hepar sulph: Rickety children who catch cold very easily. Its attacks come after midnight. The cough is usually loose with much rattling of mucous but the child cannot expectorate any phlegm. He cannot bear to be uncovered as it excites his cough. All its troubles are aggravated from uncovering the body or the limbs; from cold air, cold drinks and after midnight. Hoarseness during cough and choking fits are also its accompanying features. Unhealthy skin.
Iodium: It is suitable in membranous croup of fleshy children. Dry, hoarse, barking cough: wheezing and sawing respiration (Spong). Face pale and cold; voice husky. The child grasps the throat often as he must be feeling pain and soreness in the larynx.
Kali-bi: This is another remedy suitable for membranous croup of fleshy and heavy children. Its guiding symptoms are a tenacious, stringy mucous with violent wheezing in the wind pipe which can be heard at a distance. Hoarse cough of metallic sound. Its breathing difficulty is better on lying down (a peculiar symptom indeed) and the cough is worse towards the morning, between 3 and 5 a.m.
Lachesis: The snake poisons are notorious for sleep aggravation and hence when this remedy is indicated it will be noticed that the sleep causes difficulty in breathing and brings suffocation arousing the child up with great dyspnoea and gasping for breath (compare Acon.). The throat is very painful, and sensitive to touch and the little sufferer cannot bear the least pressure over it as that causes suffocation. It follows Kali-bi well when the inflammatory condition shows much improvement but the spasms in the glottis still persists.
Phosphorus: This medicine is used as a preventive against relapses. It is also useful to remove the persistent hoarseness of croup after cure has been wrought with other medicines. The larynx is sore and painful preventing the child to talk or cry sufficiently aloud. One of its peculiar symptom is that when the child coughs his whole body trembles. All its troubles are worse towards evening and only lying on left side. Do not forget this medicine when the condition recurs every night.
Spongia: It has already been mentioned that when Aconite brings down the high temperature but the spasmodic, barking, ringing cough persists Spongia will remove the spasm. Like Acon. its attacks also come before midnight, but not so soon after the exposure, it is always little later, say at 10 or 11 p.m. It has a harsh, sawing breathing and the cough has a metallic sound, little or no expectoration; the cough becomes tighter and tighter every minute. Some advises to alternate this remedy with Aconite.
BIOCHEMIC MEDICINES: In Biochemistry Kali-mur. is the principal remedy for all the three varieties of croup and white coating over the tongue is its guiding symptom. They advise it in alternation with Ferrum-phos. as long as the fever continues, and with Cal-flour. to control the spasm of the larynx. The spasmodic cough of Calc.fl. is worse from cold drinks and on lying down, and better from warm drinks. Ferrum-phos. has inflamed and red tonsil, the fauces also is red and inflamed. Hard dry cough with hoarseness.
REMEMBER: Arsenic when croup is resulted from a retrocession of urticaria or when it occurs in place of usual urticaria.
Aconite has more inflammation: Spongia, more spasms of larynx; Hepar, more rattling of mucous without any expectoration and Phosphorus more recurring tendency.
