Acute Inflammation of the Epiglottis
This is the disease by which our country lost its most loved and distinguished citizen, George Washington. This complaint was not understood at the time of his death, the intelligent physicians who attended him supposing it to be inflammation of the windpipe. From their very clear description of the symptoms, we now know it to have been an acute inflammation of the epiglottis and glottis.
From the rapid inflammation of the epiglottis, water is effused into this cartilage, so as to puff it up, and prevent it from shutting clown in the act of swallowing. The lips of the glottis are swollen from the same cause, and brought so near to each other that air passes through to the lungs with great difficulty, and unless relief is soon obtained, the patient is strangled.
Symptoms. The disease begins with a severe chill, accompanied with some pain, and a sense of stricture or tightness in the upper and fore part of the throat There is cough, with difficult and sometimes painful swallowing. These symptoms are soon followed by quick and laborious breathing. Speaking aloud is from the first difficult, and soon becomes impossible. As the complaint runs its rapid course, the breathing grows more difficult, and death soon results from complete strangulation.
Treatment. The steam inhaler should be used 'at once to loosen up the exudation and soothe the membranes. A good solution to use would be No. 111 leaving out the honey; or compound tincture of benzoin one half ounce to the inhaler full of hot water.
While this local treatment is being employed, liberal doses, from five to twenty drops, of tincture of veratrum viride should be given every hour, watching the effect, and discontinuing when the pulse sinks too low.
Hot fomentations applied externally, and filling the room with steam, as recommended in cases of croup, would be useful.
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