Southern Medical and Surgical Journal - Georgia Regents University

:488 Guillon on Croup. [MarchBecause, cynanche trachealis being a local disease whenit begins, this local medication, with a suitableregimen,ought to be preferred to emetics, purgatives, etc., prescribedby some physicians to destroy what they call thespecific morbid element.It must also be used in preference to the substitutivemedication, recommended by Dr. Trideau, which doesnot prevent diphtheritis from extending from the pharynxto the trachea, and from constituting a croup which soonbecomes fatal. Hear what he says (page 11 of his book)" The croup which follows cynanche trachealis, we mustadmit, will almost invariably resist all sorts of treatment."I must here observe that, had this treatment been moregeneral, we should not have seenso often those cases ofparalysis brought on by diphtheritic poisoning, whichhappen in the course of that disease — paralysis of theoesophagus, which compels the use of stomach tubes forthe introduction of food, as also those cases of suddendeath resulting from paralysis of the respiratory organs.As the insufflations are performed in two or three seconds,and the pain produced by the nitrate of silver isonly felt later, if the patient presented any symptoms ofincipient croup, the first insufflations should be madewhen he takes a deep inspiration, so that the powder mayreach the larynx and stop the croup in its beginning,before the pain is developed.As the diphtheritic membranes aresometimes formedagain, I use astringent gargles, and should these fail, Ihave recourse to a new insufflation of nitrateof silver.In 1858, Mr. B. and his son were both attacked withcynanche trachealis. The insufflation in Mr. B.'s mouthwas performed in presence of Mr. Bretonneau ; that onthe son, in presence of Mr. Blache.Two insufflations ineach case were sufficient to insure complete success.Another cure was obtained on a patient of Dr. Delpech,