صور الصفحة
PDF
النشر الإلكتروني

he possessed and departed for the West. His neighbors looked at him and shuddered as they passed; and the two little children, who escaped their intended doom, and the graves of the murdered brother and his wife, and the kind old bachelor, were too near him; the vacant face of the idiot boy, too, would now and then flit before him; all were too near him; but there was something still nearer: even he was uncomfortable. The young lawyer also removed. Men talked about him; he was not acceptable in the social circle; his first great lesson might be too suggestive of the next step in life, and what might that not be?

Reader, beware of money! It is not the chief good: the love of God and man is better.

ON CROUP.

WHAT IS CROUP? ITS SYMPTOMS AND TREATMENT.

FEW subjects present greater interest to the American mother, than that sudden and violent inflammation of the delicate lining membrane of the wind-pipe in children, termed Croup. The extraordinary vicissitudes of our climate, with the known frequency of its occurrence near the ocean, and the surprising carelessness, and universal ignorance on the subject of dress, together with the prevalence of that deplorable method of heating our city houses with furnaces, and thus destroyingthe constitution, gives no hope of the decrease of this terrible disease. Nevertheless, although far too common for the comfort of the parent's mind, it is by no means as frequent as those miserable parasites, the numerous quacks, both allopathic, homeopathic, and hydropathic, would have them. believe. Many a slight catarrh, that a little warmth and care would remove, is made the subject of a domestic alarm and self-glorification by one of these harpies; and the poor infant is drenched with emetics and slops, and parboiled with a warm bath, till exhausted nature comes to its relief, and it falls asleep from sheer exhaustion, and thus escapes its tormentor for a short time. But, alas! the poor little creature is now pronounced "subject to croup," and it must be carefully watched; it would never do to let it go with one medical bout. The mother keeps a bright look-out for a "bark or a crow," and is constantly summoning the doctor.

We are very far from wishing to foster carelessness-heaven knows that the American city mother is often careless enough-but it sickens us to see the daily misery endured by the poor, timid, young creature, who is victimized by some of these harpies.

The first point to which we would direct the reader's attention, is the fact, that croup, properly so called, belongs exclusively to the wind-pipe, or that portion of it that lies between the top of that projecting bone, or rather cartilage, that is so plainly visible in men in the middle of the neck, and all that part of the wind-pipe below it down to the breast-bone. It is a sudden inflammation of the delicate lining membrane of the wind-pipe, produced by exposing the child to cold and damp air when perspiring more or less sensibly, or when going from a warm room into the cold air. The blood is driven from the skin by the cold air, and rushes to that lining membrane, and clogs up all its little bloodvessels; thus closing up the wind-pipe, and producing spasmodic inspiration, and a sudden and harsh cough, like the hoarse crowing of a young cock. Generally speaking, this inflammation begins high up near the apparatus of the voice, or what we call the larynx, or the part that incloses the vocal chords; it then travels downwards below the windpipe, where it is single and in the neck, and often runs on till it gets into the two branches that go off like the tines of a pitchfork, one to each lung, called the Bronchia.

In bad cases, i. e., where the child is pre-disposed from peculiarity of constitution, or in those which are badly. treated or neglected, a false membrane is formed around the inner part of the wind-pipe, partially stopping it up, and looking, when coughed up, or taken out of the dead body, very much like a boiled stick of macaroni. As we shall have frequent occasion to speak of the formation of membranes and would avoid leading our readers astray, we take occasion to remark that the membrane formed in croup,

never becomes regularly organized by blood-vessels, &c., as in some other diseases of longer continuance, where newly organized parts are necessary to form a wall round an abscess, and thus to stop the issue of the matter into parts where it would cause inflammation and death, as in the belly, for instance; or when nature forms a little sack around a splinter of glass, or a leaden ball, that will remain for many years in the body. This croup membrane is not organized; it does not grow from and fast to the natural lining membrane that belongs to the wind-pipe, but it is rather a mere mould, formed by the exudation of lymph from the small blood-vessels of the natural membrane, and merely sticks to it; so that if the child could live long enough without its presence causing suffocation, it might gradually decay, and be coughed up piecemeal. There is a predominance of the white or albuminous tissues in children. This is albuminous, but not organized.

For these desperate cases, the operation of opening the wind-pipe has been proposed, so as to let the air enter below the obstruction, and thus preserve life till nature and medicine might have a longer chance. Although it has been successful, and may be resorted to in desperate cases with propriety, it does not depend upon any fixed principle, and is therefore unphilosophical; because we can never ascertain the extent of this false membrane. It may exist far below the opening, which can only be made at the lowest in an infant a little below the middle of the neck, and it may therefore be found quite useless. We have ourselves been thus mortified, the case proving fatal after the operation. It was performed on the fifth day as a desperate remedy, in a case very much mismanaged by a quack, and at the request of the late Dr. Churchill, of this city, who was called in at that late period. We have given it this prominent mention, because it is frequently talked of by the young surgeon as a reliable resort, and may therefore hin

der the adoption of those powerful medical means which are not only justifiable, but imperative, in a desperate

case.

There is an inflammatory affection of the larynx, as we call it, i. e, the highest part of the wind-pipe, in which the apparatus of the voice exists, originating also mostly from atmospheric causes; though sometimes from inhaling acrid fumes, and from that dreadful disease, syphilis. This is, for obvious reasons, far more frequent amongst grown persons, In its distinct form, it is almost unknown among children; and yet the croup, we think, far oftener begins high up in the wind-pipe than low down; still, as it goes almost always rapidly downwards, and spends its chief force there, it would seem to prefer, as it were, the wind-pipe proper. Why these two diseases should differ so widely in the selection of such different ages, and each one evince such an evident predilection for its little space of the same continuous lining membrane of the wind-pipe, is indeed remarkable. This predilection is probably the result of changes in the organization, necessary to the proper performance of the functions of the wind-pipe at the respective periods, as yet unknown

to us.

Dr. Watson, of London, remarks-"The interval that lies between the periods of weaning and puberty, is the time during which croup is chiefly to be apprehended. Comparatively few cases of it occur during the first year of infantile life. There are more in the second year than any other. This is, in all probability, connected with the change that ensues with regard to diet, upon the child being weaned. Dr. Cheyne, whose experience of croup was very extensive, says, the younger children are when weaned, the more liable they usually are to this malady. From the second year onward, the number of children affected with croup gradually decreases. Of ninety-one cases reported by Irwin, only one was after the tenth year." General Washington is said to

« السابقةمتابعة »