Year: 1853
Type: article
Abstract: The question now presents itself, what are the grounds for believing that the two forms of the disease which I have distinguished as membranous and inflammatory, are not the same in different degrees or in different stages ?and may not pass one into the other ?The grounds are-1.The very great preponderance of fatal results in the membranous croup, and a similar preponderance of re coveries in the inflammatory, and the evidence which exists that in the few cases of recovery from the former, the membrane has been formed, and in the few cases on record of death from the latter, that a membrane has not been formed-afford strong reason for believing that the diseases are essentially different.* *No fatal cases having'occurred of inflammatory croup under my own notice, 1 am happy to be able to avail myself, in support of the views above taken, of an account of four such cases, contained in thefirst volume of the New England Journal of Medicine and Surgery, by James Jackson, M. D., formerly Professor of Theory and Practice of Physic in Harvard University.The symptoms in all these cases were unquestionably those of croup.In one of them bronchotomy was performed.In the first case, "the mucous membrane of the larynx was much inflamed, and smeared over with a quantity of loose mucus, but without any false mem brane.The inflammation extended into the trachea as far as could be exam ined wuthout opening the chest."In the second case, "the appearances of the larynx were the same.The lungs were fuller of blood than usual."In the third case, "there was not any coagulable lymph, the mucous mem brane was highly inflamed and swollen, and the rima glotidis was very much narrowed.The membrane was smeared over with a thick mucus."The fourth case I give at length in the words of the author: "I was called to this on Sunday, July 5, 1812, at 3 o'clock, P. M. The dis ease had commenced 20 hours before, and was very strongly marked.The symptoms were considerably mitigated after vomiting.I tried in vain to take blood; the child was very fat, and the veins were all hidden, even the external, jugular.The respiration grew bad again before morning, but the patient lived till the next morning, the 7th, so that the disease continued two days and a half, or sixty hours.18 hours after death, Dr. Bigelow examined the body, and the following is his report of the appearances: "The trachea with the larynx was removed.The whole tube was pervious as usual, excepting the presence of alarge quantity of mucus of the ordinary consistence.On dividing the larynx and trachea at the posterior side, and exposing the internal surface, the mucus being removed, a number of distinct red spots were discovered, of considerable-size, on the lining membrane.One of these was immediately below the glottis-
Source: PubMed Central
Author: John Ware
Institution: Harvard University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4390792413