Diseases Complicated by this. Seat, Abundance. Duration, Sequels,
Symptoms, sudden dyspnœa, swelling of throat, pits on pressure,
differentiation from croup. Treatment, cold, ice, astringents,
scarification, tracheotomy.
This is usually a complication of acute laryngitis, but it may be a
manifestation of other forms of local disease—tuberculosis, glanders,
purpura hemorrhagica, pseudo-membranous inflammation,—or it may be a
result of a more distant affection, like disease of the heart, lungs, or
kidneys. As a complication of local inflammation it consists in an
excessive serous exudation into the submucosa, around the base of the
epiglottis and extending to the whole larnyx and pharnyx. It may thicken
the parts by half an inch, causing complete closure of the glottis. In
favorable cases it may subside as rapidly as it rose, while in others it
may result in ulceration or abscess. The infiltration has usually a
clear watery aspect, but is sometimes a dull red. When incised an
abundance of serum escapes mixed in certain cases with pus.
_Symptoms._ In the course of one of the above named affections there
comes on suddenly extreme dyspnœa, with stertorous breathing, a
suffocative cough, and intense anxiety. The stridor is first with
inspiration and later with expiration as well. The eyes are bloodshot
and protruding, the pulse small and rapid, the movements uncertain, and
the skin moist with sweat. There is manifest swelling of the throat and
manipulation leaves the imprint of the finger.
When symptomatic of some distant affection it is at once slower in its
result and more persistent.
The local pasty swelling and the absence of any false membrane suffice
usually to distinguish it from croup which it so closely resembles in
the suddenness of its onset, and the violence of its manifestations.
The less urgent cases may be treated by application of cold water or ice
to the throat, and the injection of solutions of chloride of iron or
alum into the fauces. Or the throat may be painted with tincture of
iodine and rubbed with the palm to favor distribution and absorption of
the exudate. In dogs the mouth may be opened widely and the dropsical
membrane pricked at intervals to drain off the liquid. In the most acute
cases the prompt adoption of tracheotomy is the only means of saving
life.