A practical treatise on the diseases of children / by J. Forsyth Meigs and William Pepper.

  • Meigs, J. Forsyth (John Forsyth), 1818-1882.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children / by J. Forsyth Meigs and William Pepper. 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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    from whispering to hoarseness or to clearness of the voice; looseness of the cough ; moderation of the fever; improvement of the temper and moral state; and amelioration of the general condition. The case should not, however, be abandoned as hopeless until life is actually extinct. An instance has been elsewhere put on record by one of us {see paper by Dr. J. F. Meigs, loc. cit.) of the recovery of a child after momentary suspension of animation from asphyxia on two occasions, though these attacks were followed by a dreadful illness of two days. Treatment.—We are desirous, at the beginningof our remarks upon the treatment of this disease, to express the opinion, that none is likely to succeed, unless it be applied early in the case, and by this we mean, in the course of the first, or at the latest, second daj'. And not only should it be commenced early, but the most active remedies ought to be applied at this period, in their full force. The very moment there is good reason to suppose that a case will prove to be one of membranous croup, the most energetic means ought to be brought to bear upon it, and if this be done from the first, or even second day, we cannot but hope that a considerably larger proportion of recoveries may take place than lias heretofore been thought possible. In the study of the treatment, it will be necessary to rely chiefly upon the works that have been published since the distinction between the two forms of croup has been correctly drawn, for it is impossible to place much dependence on the assertions of previous writers, inasmuch as their opinions in regard to the effects of treatment must have been formed from indiscriminate experience in two very opposite maladies. It is only necessary to recollect the enormous difference in the mor- tality of the two affections, as shown by our own experience and the statistics quoted from Guersent, to be convinced that the success of any jjlan of treatment in the one, is no fair argument for its probable suc- cess in the other. The most imj)ortant objects to be held in view in the treatment, are the following: to prevent, if this be at all possible, the formation of false membrane; after its jDroduction, to cause its dis- solution, or render it less adherent; to provoke its expectoration; to prevent its reproduction after it is once expelled; to subdue the inflam- matory diatbesis which exists;' to allay the painful symptoms; and in every way to support the system. Bloodletting.—Some authors still award to bloodletting a high place in importance amongst the medical means in our possession, and it was formerly regarded by many in tins country as an indispensable agent in the cure. Moreover, there are not a few who believe that, when promptly and boldly resorted to, it will seldom fail in arresting the disease. The more careful and extended study which this question has received during the past few j-ears, however, has led many observers to doubt the efficacy of venesection in arresting the course of this inflammation, or Ijreventing the formation of membranous exudation. In those cases where croup supervenes in the course of epidemic