Volume 1

Lectures on the principles and practice of physic : delivered at King's College, London / by Sir Thomas Watson.

  • Sir Thomas Watson, 1st Baronet
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the principles and practice of physic : delivered at King's College, London / by Sir Thomas Watson. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    923/936 (page 903)
    .XL.] LARYNGISMUS STRIDULUS. seem to me fair and satisfactory arguments. As to contagion, evidence of that property miglit probably have been found with respect to croup, had it been suspected and looked for. The very tirst two cases in which Dr. Home discovered the false membrane occurred in cluldren of the same family, a boy aged 7, and a girl aged 5, she having sickened four days after her brother's death. For many years diphtheria was almost un- known in Great Britain except in its sporadic form; a form to which children may probably be more obnoxious than adults. Dr. Hillier asserts, from his own experience, that in severe cases of simple laryngitis, albumen may be found in the urine. With regard to the ahsence of symptoms of disordered innervation, these are not constant even after unequivocal diphtheria; and coming late, after the disease seemed at an end, they might easily be overlooked, especially when unexpected. It is re- markable that they were not noticed by Bretonneau in the epi- demic which he has so minutely described. You will understand that I give in my adhesion to the opinion that croup, accompanied by false membranes in the larynx and trachea, is always diphtheria—whether in the child or in the adult; and that simple laryngitis is never associated with the exudation of false membrane. I have next to invite your attention to that laryngeal affection which is now commonly called Larynr/ismus stridulus. It is a disorder of infancy, and it has received a variety of names, which shows that it has been recognised as a distinct malady by various observers. In some sort it resembles, and has not seldom been confounded with, what Englishmen have been accustomed to call the croup. And it is spoken of sometimes as bastard croup, spurious croup, spasmodic croup. It is tlie thymic asthma of the Germans. The somewhat pedantic and cacophonous title of Laryngismus Stridulus was bestowed upon it by Dr. Mason Good. For my part I much prefer the home- spun term child-crowing, first used, I believe, by my late friend Dr. Gooch, The disease consists in spasmodic narrowing, or even per- fect closure of the glottis. The child is seized all of a sudden, roused perhaps from its sleep, or checked during the act of suck- ing, by a catch or interruption of its breathing, more or less complete. It strives and struggles to expire, but is apparently unable to do so; at length, the effort is successful, and the