Case of fatal croup in the adult : with remarks / [J. Warburton Begbie].

  • James Warburton Begbie
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Case of fatal croup in the adult : with remarks / [J. Warburton Begbie]. Source: Wellcome Collection.

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    thirty-two years, although exhausted by misery and imperfect nourishment, had not suffered from any other malady. In the remaining six cases of Louis, croup was a complication of typhoid fever in two; in other two, of an inflammatory affec- tion of the gastro-intestinal' mucous membrane; in one it occurred in the last stage of phthisis; while in another, it supervened on an attack of chronic pleurisy. In a case com- municated by Dr. Hollo to Dr. Cheyne, and the particulars of which are given by the latter in his work,1 the patient had, previous to the attack of croup, suffered from a severe catarrh; in his youth, too, he had been more than once ill with croup. This was a gunner in the Royal Artillery. A preparation from the case is preserved in the Museum of the Royal College of Surgeons (Catalogue 1293, xxvi B). The case recorded by Dr. Gillespie, already referred to, and the one published in the ‘Lancet’ for 1838, are two well-marked examples of primary croup in the adult. It is worthy of remark that in both subjects pregnancy was far advanced. With one exception (the seventh observation), the existence of a distinct false membrane in Louis’ cases was not limited to the air-passages properly so called—larynx, trachea, and bronchi—as in the case of Hamilton; but the uvula, the tonsils, and pharynx—in some the oesophagus and posterior nares, were likwise involved. To the absence of false membrane over the mucous surface of the pharynx in the exceptional instance, special attention is directed by Louis; and he remarks, that, having in the six cases previously detailed, observed that the membranous concretions are propagated from above downwards, the question suggests itself, whether the malady in this instance may possibly have had a differeift course; or, supposing it to have originated, as in the others, by implication first of all of the pharynx, -whether the false membrane formed there may not have been detached, so as to permit its subsequent only very incomplete re-formation. M. Louis himself does not answer this question; it would therefore be presumptuous in me to do so. In 1818—that is, some years before the publica- tion of M. Louis’ cases—M. Bretonneau had read to the Irench Academy his original observations on “ Diphtherite;” and in 1826 his remarkable treatise on that subject, as well as 1 Loco citato, p. 115.
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