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This alarming suffocative attack occurs in young children of two to four years of age. It is rare under six months. It usually happens at night, the child waking into a paroxysm of breathlessness characterised by crowing inspiration, barking, metallic cough, husky voice, violent struggles for breath and clutching at throat. Both child and parents are usually terrified; this tends to aggravate the spasm. The attack lasts half to three hours and then suddenly eases and the child settles off to sleep. Attacks are apt to recur for two or three nights. The child is usually already suffering from a teasing cough before the onset of the attacks.
Three remedies have been found of special value in this condition: ACONITUM, HEPAR SULPHURIS, and SPONGIA (q.v. preceding section on Cough). The most applicable one should be given every 2 hours or so (30 or 6, till relief is obtained, or at longer intervals to prevent recurrence of the attack).
Suffocative breathing which does not quickly pass off with relaxation of spasm must be investigated without delay as the cause may be diphtheria, the presence of a foreign body in the air-passages, or other pathological condition resulting in pressure in or on the wind-pipe. Sometimes sudden (Edematous swelling of the larynx may threaten to choke the patient, and urgent tracheotomy may be
called for. In this condition there is also usually obvious and severe swelling of the epiglottis at the back of the tongue; the remedy to give with the least possible delay would be APIS (200 for one or two doses, or 30 for several doses, at half to one hour intervals) while summoning expert aid.
Small children sometimes are seized by a sudden spasm of the larynx with cessation of breathing, rigidity of body, blueness of surface, and the worst seems about to happen. However the seizure terminates with a long crowing inspiration and the attack is over for the occasion. To expedite matters it is advised to sit the child up, slap its back, tickle its nose with a feather, throw cold water on its face or place a hot sponge on the outside of the throat.
A prompt dose of ACONITUM would probably be equally, if not more, effective. The attack may follow an emotional upset and occur during the night. The condition may be associated with rickets, and in any case of repeated attacks adequate medical in¬vestigation is called for.
  siloutec on 2010-11-04
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