The disease, though similar to croup in some of its symptoms, is essentially distinct in the circumstance that it is purely nervous, and altogether independent of vascular irritation or inflammation of the larynx. The complaint is usually characterised by a shrill sound in drawing in the breath, somewhat like the crowing of a cock, which has given origin to the name of crowing disease. The complaint is confined to infancy and very early childhood, occurring at any time from a few days after birth to the end of the third year, but most frequently during teething.

The attack is sudden, and may occur at any time, though it most frequently comes on during sleep, from which, the child awakes suddenly with a start. The first symptoms are a struggle for breath, with the head thrown back, the breast elevated, the nostrils expanded, the mouth open; the veins of the neck and head are distended; the countenance flushed, swollen and purplish, or else of a pale cadaverous hue with an expression of anxiety and distress. At length, but occasionally not until symptoms of suflo-cation appear, the spasm of the glottis somewhat relaxes, and the air rushes in with a shrill whooping sound. The child then usually begins to cry, and, after a short period of hurried breathing, returns to his previous health. Not unfrequently along with the difficulty of inspiration, there is a spasmodic contraction of the fingers and toes, and the paroxysm is sometimes followed by general convulsions. When the attack is over, the child is free from all symptoms of disease of the throat. Occasionally, only a single paroxysm occurs at first, and the disease does not return for weeks. But the interval is often much shorter; and, in bad cases, the attacks take place several times a day, increasing in duration and frequency.

The complaint is usually unattended with cough, fever, or bronchial disease, and thus it may be easily distinguished from Croup.

Though often a trifling disease, it is sometimes very serious. In a few cases the child perishes with suffocation from the severity of the spasm, but in general, the complaint, when alarming, is so, merely as a sign of serious disorder elsewhere. It is often rather a symptom than itself a disease.

The disease appears sometimes to depend upon a general morbid excitability of the nervous system, which is affected by slight causes, such as the sudden contact of cold air, any quick unexpected movement, or mental emotion, especially fright. Hence infants are sometimes attacked with it, when tossed playfully in the air. The act of swallowing occasionally brings on an attack. This state of nervous irritability is most frequently owing to teething; but it may also be produced by other causes which deteriorate the general health, such as impure and confined air and unwholesome food. Attacks may be brought on by sources of irritation in the intestines, including undigested food, acidity, acrid secretions and worms. It is very apt to attack children brought up by hand. In some instances the disease is dependent on affections of the brain, and hence it has been considered one of the earliest signs of water on the brain.


It is sometimes highly important to relax the spasm of the glottis at the commencement of the paroxysm, so as to prevent suffocation. This may generally be accomplished by dashing cold water upon the face or shoulders, gently slapping the back, blowing into the face, or exposure to a current of cool air at an open window. One of the best means of preventing a return of the fit is to put the child up to the chin in a warm bath two or three times a day. Inhalation of the vapour of Ether was successful in curing a very bad case, recorded by Mr. Image, of the Suffolk Hospital, England. It was applied by means of a sponge held to the mouth and nostrils, at the commencement of the paroxysm, which was instantly checked; and at length the attacks ceased entirely. The bowels should be carefully attended to, and should be regulated by small doses of Rhubarb and Magnesia, and occasionally, if the motions are of an unhealthy colour, small doses of Mercury and Chalk (Hydrarq: cum Creta); for an infant under a year old one grain doses may be given. The child should be warmly clothed, and, if not weaned, and the mother's milk is not sufficient, or the mother is not in good health, it should be fed on good cow's milk, thickened with arrow root, ground rice, prepared barley, or corn starch; good bread soaked in chicken, veal or mutton broth will also be good.