SPASMODIC CROUP
It is believed that children with enlarged tonsils and adenoids are much more subject to croup than others. Although very sudden in its onset and very alarming, spasmodic croup, fortunately, is seldom dangerous. A little child goes to bed in apparently normal condition and wakes up suddenly with a coarse metallic cough, difficult breathing, and with a distressed expression on the face.
Alternate hot and cold compresses should be applied to the throat—first the hot cloths (wrung from very hot water) being applied over the throat, which should be covered with a single thickness of dry flannel. Then after three minutes of the hot cloths a very cold cloth is applied to the skin itself for one half minute; then more of the hot compress, followed again by the short cold, until five such changes have been made. A bronchitis tent should be quickly improvised so that the child can be "steamed."
Vomiting must be produced by kerosene (three or four drops on sugar), alum and molasses, or ipecac (ten drops every fifteen minutes). Some remedy must be administered continuously until free vomiting occurs. A good dose of castor oil should be given after the spasm. Suitable treatment should be administered through the day to prevent a recurrence of the attack the next night.
The general vital resistance should be raised by outdoor life, improved circulation, good food; adenoids if present, should be removed.
Medical advice should be sought in every case of severe croup, for membraneous croup usually is indicative of diphtheria, and the diagnosis is important, as on it hangs the determination of the administration of antitoxin.