Croup

Croup, a term derived from an Anglo-Saxon word, signifying to cry out. The word croup was apparently employed for many centuries in Scotland to a certain kind of cough associated with disease of the larynx in children. Thus, the term croup originally referred to a symptom of disease. About the middle of the last century an attempt was made to associate the word not with a symptom, but with an actual form of disease. The croupy cough was found in some instances to be caused by the presence of membranous exudation in the larynx, and it was considered desirable to designate such a condition of things by a specific term, viz. croup. Meanwhile the pathology of diphtheria was worked out by a French physician, Bretonneau, and it became obvious that many cases of membranous laryngitis were of diphtheritic origin. The question arose - were the terms diphtheritic laryngitis as employed by Bretonneau, and croup as understood by the Scottish physicians, co-extensive, or were they to be considered as descriptive of entirely distinct forms of disease? For many years it was the fashion to distinguish between croupous and diphtheritic inflammation, and much controversy and much confusion resulted. The question cannot yet be held to be finally settled, but the tendency at present seems to be to restore to the term croup its original signification, and to consider it to denote a set of symptoms and not a species of disease. The character of the croupy cough can only be grasped by actual experience; no amount of description will do justice to it. Mothers are apt to apply the term croupy in a very indiscriminate manner. True croup is a symptom of grave significance; it is only produced by involvement of the larynx; and laryngeal disease in young children is no trifling matter. Croup particularly affects children between two and five years of age; it is said to occur with special frequency in cold and damp situations; it not unfrequently accompanies the onset of measles, and certainly in many instances it is caused by the specific poison of diphtheria. Unfortunately in many patients the history is one of rapid progress from bad to worse, of increasing difficulty in breathing, and finally of death by suffocation. Hence the advisability of procuring professional advice from the outset. In some of the gravest cases tracheotomy (q.v.) has proved the means of saving the patient's life. Spasmodic croup, false croup, or laryngismus stridulus, is a distinct affection met with in young babies from six months to two years old. The subjects of this disease are almost always boys, and they usually present symptoms of rickets. The seizures only last a few seconds, but they are apt to recur, and may prove fatal. Laryngismus stridulus is allied to epilepsy, and is usually associated with carpopedal contractions.