False Croup. [Volume: 2, Issue: 3, December, 1895, pp. 166-168]

FALSE CROUP.

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fact that this is popularly known as
"false croup," and the additional
fact that a certain form of that deadly
disease diphtheria is also called croup,
is sufficient to give the name some of
its terrors. It does not, however, require any borrowed features to make
an attack of so-called croup alarming
to witness, and it is to the violence of
these symptoms during the paroxysm
that the fear-inspiring nature of the
disease is, no doubt, largely to be
traced.
False croup is always due to spasms
of the muscles of the larynx. The
larynx, as my readers know, is the
special organ of the voice, situated at
the upper part of the windpipe, consisting of a cartilaginous box across
which are stretched folds of mucous
membrane, the vocal chords, which,
by their vibration, due to the passage
of air from the lungs, produce sound.
The attacks occur in infants from a
few months old to the third year, and
not infrequently a year or two later.
It is said that boys are more subject
to it than girls. Reflex irritation
from the teeth is a common cause,
occurring most frequently during the
first dentition, but quite common during the second. Irritation from the
stomach and bowels is not infrequently concerned in the causation. In
some families it is hereditary. Enlarged tonsils are frequently present.
The exciting cause is usually an irritation of the mucous membrane of
the larynx due to catching cold, but
the nervous element is the main factor
in the attack.
The characteristic feature of the disease is a spasm of the muscles of the
larynx. The invasion is sudden, the
child usually goes to bed with a slight

cold; is probably feverish, and a little
hoarseness is present. Sometimes
the attack is preceded by a mild sore
throat, or cough; more rarely there is
no disturbance of the general health.
At midnight or later the child
awakens with a choking sensation,
there is a peculiar whistling or crowing breathing. The lipsbecome blue,
the eyes prominent and the body is
bathed in perspiration; it seems as if
death by suffocation were imminent.
There is much hoarseness, and a
harsh cough which resembles barking. In a few minutes the violence
of the paroxysm passes off, and the
child who has been badly frightened,
becomes easier; the breathing is more
regular, the cough softer, and in an
hour or two the exhausted little sufferer falls asleep. A second attack
may occur the same night, but it is
usually not repeated till the following
one, while during the day the child
seems quite well. The second seizure
is generally lighter than the first, and
is sometimes followed by a third,
which usually ends the trouble for the
time.
It will be seen from the above that
such an attack as described has nothing to do with laryngitis, whether of
the inflammatory or of the diphtheritic type. True croup is attended by
high fever, great prostration, and does
not occur in attacks which rapidly
pass away and leave the child in good
health. It does not run into diphtheria, and no false membrane is present, or formed. False croup is a
purely spasmodic affection, and notwithstanding the apparent severity of
the symptoms it never terminates
fatally. The symptoms are so characteristic that there is no difficulty in