Diseases of the larynx / by Dr. J. Gottstein ... trans. and added to by P. M'Bride.

  • Jacob Gottstein
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the larynx / by Dr. J. Gottstein ... trans. and added to by P. M'Bride. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    should be placed near the patient's bed ;* usually the administration of warm drinks (milk and seltzer, or sugar and water) is sufficient. As the attacks of cough and difficulty of breathing occur principally at night during sleep, the child should be wakened from time to time, especi- ally when the breathing becomes noisy, and a warm drink administered. We can hardly consider it as a senseless proceeding that many mothers prevent their children, when suffering from pseudo-croup, from going to sleep again, under the impression that sleep is dangerous. Internally small doses of ipecacuanha and alkalies, and, in the case of older children, tartar- ated antimony may be given. We have seldom found benefit from spray inhalations, and it is difficult to get children to use them. Abstraction of blood and blistering can be dispensed with, the former being usually directly injurious ; on the other hand, mustard poultices, or, better, warm sponges laid upon the throat should be tried. Narcotics should be avoided as much as possible in children. If the cough be very trouble- some, Rauchfuss recommends codeia as one of the surest and most easily regulated remedies, 003 to '01 per diem (1 gramme = 15*43 grs.). For a long time emetics played an important part in the treatment of pseudo-croup, and this is to some extent still the case. Riihle believes that, in the early stages of inflammations of the pharynx and larynx, they may almost abort the disease. It is difficult to explain in what way they are supposed to act. Unbiassed observation, however, proves that many cases end—one might say—abortively, that is to say, the children startle those around them with attacks of croupy cough for one or two nights and soon recover, whether emetics be used or not. In other cases the catarrh runs a more severe course in spite of emetics. We believe, therefore, with Rauchfuss, that emetics may be dispensed with in the treatment of pseudo-croup, although they ma}' be used when symptoms of stenosis are due to the collection of mucus in the larynx. As to the local treatment of acute laryngeal catarrh, the views of authors are widely divergent. While some have seen local inflammation disappear after the application of a solution of nitrate of silver [2 to 30 (Gibb) or even 5 to 10 (Stoerk)], others disapprove of every local appli- cation ; we agree with the latter, but make two exceptions. In the first place, laryngitis sicca requires local treatment. It is here necessary to remove the dried-up secretion which causes, not only aphonia, but also spasmodic cough and dyspnoea, and to restore the mucous membrane to its normal state of secretion. This object is attained by the inhala- tion of steam which liquefies the secretion, or, better still, the application of a 4 per cent, solution of chlorate of potassium, to be followed by painting with a solution of nitrate of silver 4-6 per cent, (approx. 20-30 grs. ad ^i). We have not only found this medication useful but * In this country bronchitis kettles and croup tents find more favour (Translator).