This is a disease which is alarming from the suddenness of its attack and the rapidity with which it runs its fatal course if unchecked; but, on the other hand, in the majority of cases, it is easily checked if the treatment begins immediately it occurs.

Symptoms

The following is generally the course of the disease: - A child is put to bed in its ordinary health, apparently, or it may have a slight cold, and a cough a trifle rough, but not enough to excite attention to it. After a variable time the child wakes up with a hoarse, ringing, rasping cough and difficulty in breathing, and countenance expressive of its trouble; each inspiration and expiration being attended with a rough metallic tubular sound, and the voice masked or obliterated by a harsh, hoarse croaking vocalization. The cough is dry, harassing, and unattended with expectoration in the outset, but after a while some portions of membranelike mucus may be coughed up. The pulse becomes rapid, the skin hot, the countenance more and more distressed, and if relief be not afforded, the patient becomes drowsy, the complexion becomes blue, and the little patient may die from suffocation within forty-eight hours. Happily, however, this is not the most common course of the disease, if the treat?nent be prompt and active.

The first thing to be done is to give a teaspoonml of ipecacuanha wine every ten minutes until vomiting occurs. Ipecacuanha wine is preferable to antimonial wine, as the latter is too depressing.

[N.B. - Where children are subject to croup, ipecacuanha wine should always be at hand].

Meanwhile, a hot bath should be prepared, and used as quickly as possible; and while in the hot bath a wet sponge, sprinkled with mustard, should be held on the upper part of the chest and front of the neck.

After the vomiting has subsided, small doses of the ipecacuanha wine (from five to fifteen drops, according to the age of the child) should be continued every three hours, until the hoarseness in the breathing and voice ceases and the cough becomes loose.

The atmosphere of the bedroom should be kept warm and moist by steam from a pipe or spout of a kettle. The temperature should not be allowed to fall below 6o°, if possible.

The Diet Light And Simple

If, however, within twelve hours there be not a decided improvement, small doses of calomel should be given also, and the front of the neck should be painted with blistering liquid.

As a last resource, supposing these remedies are not at hand or obtainable, and the disease be making rapid strides, life may be saved by applying scalding water to the neck, holding it there on a sponge or flannel for a minute at least. This is a most extreme and violent means, but it is one by which the writer has seen a life saved.