Laryngismus Stridulus

In children who are subject to spasmodic croup the attacks are often precipitated by dyspepsia caused by overfeeding and nursing, by improper food, or by constipation. The diet must therefore be regulated according to the rules laid down under the heading Infant Feeding. The habit of night feeding especially should be much restricted after the first month of life. This can usually be done after two or three trials. If the infant awakens crying at night it must be offered a little cool water, and it may presently drop asleep. Up to the fourth month six meals a day, three hours apart, are all that are allowed, and from that time on until the second year five meals must suffice.

Between the attacks the milk should be lessened in amount, and so modified as to insure more perfect digestion. Children over six months of age should be given from one to three tablespoonfuls of pressed beef juice in a day.

Older children had better be kept upon a fluid diet of meat broths, milk, and egg albumin, solid food being withheld until the seizures abate. Cod-liver oil should be given in most cases.

Tubercular Laryngitis

In tubercular laryngitis intense pain is excited by the act of deglutition. Nutritious but non-irritating food is therefore required. Thick soups and gruels, purees, cream, beaten raw eggs, scraped rare beef, raw oysters, junket, can all be swallowed more readily than very fluid or solid food. Strong condiments, vinegar, and salt must be avoided, for they increase the pain.

The difficulty experienced in deglutition is considerably relieved by the method proposed by Wolfenden, which is to have the patient lie prone on a lounge, and with his face protruding over the lower edge he is to suck through a glass tube semifluid food from a tumbler on the floor. Sajous advises the patient to lean over forward when eating, which, he says, "causes the food to pass down along the pyriform sinuses, thus avoiding the upper portion of the larynx, contact with which causes the severe pain experienced by advanced cases during the act of deglutition".