hatever it is
it must be found by a careful physical examination or a number of
careful physical examinations, because these cases are as a rule obscure
and difficult to diagnose, and even the most expert examiner
cannot always tell where the trouble is without seeing the child a
number of times. The parents must therefore have patience and confidence
in the physician and must aid him all they can by watching and reporting
all the symptoms, etc., to him. (See article on Adenoids).

SUMMARY:--

Coughs that resist careful treatment are not "ordinary coughs."

Coughs of this type require special medical care.

The usual cough medicines are not only useless in these coughs, but
dangerous. Don't give them.

ACUTE CATARRHAL LARYNGITIS: SPASMODIC CROUP: FALSE CROUP

Croup is one of the common diseases of childhood. It usually follows a
catarrhal "cold in the head" with a cough. Croup is most frequently
associated with large tonsils and adenoids. It may come on gradually or
it may occur suddenly. There is always fever with croup. One of the
first symptoms is a hard, dry, croupy, barking cough, which gets worse
toward night. If it occurs suddenly, the child will wake about midnight
with the characteristic croupy cough. The disease may go no further than
this and under the proper treatment is well in a few days. In other
cases, however, there develops marked interference with breathing. Every
inspiration is accompanied by a loud hissing or "crowing" sound. This
feature of the disease is one that frightens the parents, though it
seldom means anything serious. The child sits up in bed, frightened, and
struggles for breath. It may clutch its throat with its hands as if
something was tied round its neck. The lips may become slightly blue and
the perspiration appears upon the child's brow. After some time,--it may
be two or three hours,--the attack wears away and the child goes to
sleep. Next morning it wakes up apparently well except for the croupy
cough. The attack may repeat itself the next night and mildly on the
third night.

Treatment.--The object of treatment during an acute attack, when
the child is struggling for breath, is to relax quickly the spasm of the
larynx which interferes with the breathing. The simplest way is to give
the child a teaspoonful of the fresh syrup of ipecac. If the child does
not vomit in fifteen minutes, give another teaspoonful and keep on
giving it every fifteen minutes till the child vom