Tracheotomy in croup / by George W. Gay.

  • Gay, George Washington, 1842-1931.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Tracheotomy in croup / by George W. Gay. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    times in the practice of Dr. Ware and his contem- poraries, without presenting some of its constitu- tional symptoms. Fatal cases of diphtheria in which the larynx is not affected are common. Idiopathic croup, on thecon- trary, is invariably a laryngeal disease, is confined to the air-passages, and causes death by suffocation. In short, membranous croup is simply that, and nothing else ; while diphtheria, though occasionally attended with croup, is always something more. Although I am aware of the fact that a majority of the cases of croup of late years are diphtheritic, and that in exceptional cases it may be difficult to make a differential diagnosis, yet I submit the fol- lowing statements as the result of my experience and study of the subject: First. There is an acute, non-contagious disease of the larynx, characterized by the presence of false membrane, which causes the principal symptom, dyspnoea; and often destroys life. This is mem- branous, or idiopathic croup, and is of rare occur- rence. Second. There is an acute, contagious affection presenting a similar exudation in the larynx and other localities, accompanied by symptoms of blood- poisoning, such as enlarged glands, nasal discharge, albuminuria, debility, and coma. This is diphtheritic or secondary croup. For twenty years it has been the prevailing type in the United States, and it is very fatal. Third. There are occasionally fatal cases of acute laryngeal stenosis, in which no membrane is seen during life or at the autopsy. As thickening and oedema of the mucous membrane are present in these cases, they are probably of the same nature, and require the same treatment, as the membranous form.