CROUP  , a name formerly given to diseases characterized by

distress in breathing accompanied by a metallic cough and some hoarseness of speech . It is now known that these symptoms are often associated with diphtheria (q.v.), spasmodic laryngitis (q.v.), and a third disease, spasmodic croup, to which the term is now alone applied . This occurs most frequently in children above two years of age; the child goes to bed quite well, and a few hours later suddenly awakes with great difficulty in inspiration, the chest wall becomes markedly retracted, and there is a metallic cough . The child becomes cyanosed, and, to the inexperienced nurse, seems in an almost moribund condition . In the course of four or five minutes, normal respiration starts again, and the attack is over for the time being; but it may recur several times a day . The seizure may be accompanied by convulsions, and death has occurred from dyspnoea . The best treatment is to plunge the child into a warm bath, and sponge the back and chest with cold water . Subsequently this can be done two or three times a day . Should the cyanosis become very severe, respiration can be restarted by making the child sick, either with a dose of ipecacuanha wine, or by forcing one's finger down the throat . Generally the bowels should be attended to; and the throat carefully examined for enlarged tonsils or adenoids, which if present should be treated .