cumbent to a sitting posture. I have, on several
occasions, known the neglect of these precautions followed immediately
by what cannot but be regarded as the needless death of the patient.

During the illness, there is little for the mother to do, except to try
to carry out the doctor's directions, and to give the child constantly
little bits of ice to suck, which lessen the swelling of the throat, and
relieve the pain and inflammation. If the child knows how to gargle, it
should be induced to do so constantly, and finding the relief which this
affords, will do so very readily. This is not the time, however, when
the lesson 'how to gargle' can be learnt. A thoughtful mother teaches it
while the child is well, and if the gargle is composed of raspberry
vinegar and water, the lesson is learnt without tears. There comes a
time, however, if the disease is at all severe, when gargling is no
longer possible, for the muscles of the back of the throat lose their
power; but now some medicated solution, employed by means of the
spray-producer, may most efficiently take its place.

When croupal symptoms have gone on growing worse and worse, and the
child is in the agonies of suffocation, the doctor may propose to open
the windpipe, in the hope of giving the child another chance of
recovery, and even though the operation fail, of at least lessening its
sufferings.

The operation is sometimes objected to by the parents, on the ground of
the uncertainty of the result, and the torture of the operation to the
child. Now the anguish of a child dying of croup is due to two causes;
first, the actual mechanical impediment to the entrance of air produced
by the deposit in the windpipe, and secondly, to the spasm of the
muscles in the upper part of the windpipe which that deposit produces.
How large an amount of distress the latter may produce, anyone can judge
for himself, to whom it has ever happened to swallow the wrong way, as
it is called. The opening made below the seat of the muscles which close
the windpipe, leaves them in perfect rest, and does away with all the
suffering produced by spasm, while there is always a fair prospect if
the operation is not put off too long, of the deposit being limited to
the part above the artificial opening, and of the good being permanent.

It is true that we have no certain means of knowing the extent of the
deposit beforehand; it is true also that the operation is not in itself
a cure of the dise