Volume 1
A text-book of practical medicine : with particular reference to physiology and pathological anatomy / by Felix von Niemeyer ; translated from the eighth German edition, by special permission of the author, by George H. Humphreys and Charles E. Hackley.
- Date:
- 1880
Licence: Public Domain Mark
Credit: A text-book of practical medicine : with particular reference to physiology and pathological anatomy / by Felix von Niemeyer ; translated from the eighth German edition, by special permission of the author, by George H. Humphreys and Charles E. Hackley. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
35/792 page 15
![CHAPTER II. CEOFP.—AKGITSTA MEMBEA]SACEA. LAETNGITIS CEUrOSA.—MEM- BKANOFS CKOUP. Etiology.—Croupous inflammations are inflammatory disorders in which a fibrinous exudation which rapidly coagulates is thrown out upon the free surface of a mucous membrane, but which involves the epitheUum only. If the croup-membrane thus formed be detached, the epithelium is quickly reproduced. No loss of substance occurs in the mucous membrane itself, and no scar remains. The diphtheritic process is also characterized by the production of a fibrinous rapidly-coagnlable exudation, but differs from croup, the exudation forming, not merely upon the surface of the mucous membrane, but also witliin its sub- stance. The pressure upon the blood-vessels exerted by this mterstitial exudation, as well as by the swollen elements of the tissue, results in sloughing of a portion of the inflamed mucous membrane, and in the foi-mation of a so-called diphtheritic eschar, which, upon separating, oc- casions a loss of substance and consequent cicatrix. Of these two forms of inflammation (the essential duahty of which has of late been much in dispute), it is almost exclusively the croupous form which ap- pears in the mucous membranes of the respiratory passages; and it is only in rare and sohtary instances of secondary croup, when that malady forms part of some general acute infectious disorder, as measles, small- pox, typhus, scarlatina, or epidemic diphtheria, that a transition from croupous to diphtheritic inflammation is observable. Even here, too, though the pharjTix maybe the seat of a most exquisite diphtheria, it is far more common, and it is, in fact, the rule, for the lar^mgeal inflamma- tion to retain the characteristics of true croup. (See chap. Diphtheria.) Croup is of far rarer occurrence upon other mucous membranes than upon those of the air-passages, and, during childhood, is almost ex- clusively a disease of the trachea and larynx, rarely affecting the alveoli of the lungs. On the other hand, croupous pneumonia, a true croup of the air-cells, is one of the most common diseases of adults, in whom primary croup of the trachea and larynx scarcely ever occurs. Although pecuharly a disease of chHdhood, stiU the disposition to it IS less during the period of suckHng. After the second dentition, too, the disease is more rare; so that the period of greatest predisposition for croup Hes between the second and the seventh year of hfe. Boys are more subject to it than giris ; but it is an error to suppose that vig- orous, fuU-blooded, blooming chUdren are especially hable. . On the contrary, tender, dehcate, ill-nourished offspring of tul^erculous parent- age, with pale skin and conspicuous vems (an ominous sign even for the](https://iiif.wellcomecollection.org/image/b21981772_0001_0035.jp2/full/800%2C/0/default.jpg)
