Symptoms
When children are affected with croup, they lose their usual cheerfulness and become irritated. There is a high pitched cracking noise with the intake of each breath. Some of them develop barking cough. They complain of a slight obtuse pain in the wind- pipe somewhat below its orifice. Slight swelling is formed on the outer side of the throat opposite the same place. It aches a little when pressed with a finger. The face seems red and looks puffed up. There is fever with hard and very quick pulse. The breathing becomes difficult, frequent and shorter. Some children are obliged to remain in bed, while others feel better at times and are able to walk about. Their voice becomes hoarse and sharp.
In severe croup, fever persists with worsening coryza, sore throat, hoarseness and cough.

Causes
The underlying cause of the disease is virus infection of the larynx, trachea and bronchi. Due to this the small upper airpassage of the infant or child becomes narrow by oedema, secretions and spasms of larynx. In some cases, the cause is diptheric in origin. Influenza virus is a common cause of croup during epidemic periods.
Sudden croup may have developed due to a foreign body in the airway or rarely be caused by spasm of the vocal cords as an effect of calcium deficinecy in the blood stream occuring in severe rickets or coeliac disease.

Treatment
The use of antitoxin for the treatment of this disaese may apparently prove successful, but it is harmful in the long run. The disease can be prevented by following a proper diet and avoidance of indigestion and constipation.
The real treatment for this disease, as with all other fevers, is avoidance of solid foods for first few days of the treatment. The child-patient should be given only orange juice and water in small quantities so long as the fever lasts. Co-operative children can be given warm water enema daily during this period. If a child is unwilling and constipation is present, a glycerine -suppository may be applied.
The child with croup should be kept in bed and isolated from others. Cold-packs applied, after every two hours, to the throat will be effective. The procedure has been explained in the Appendix.
If the child’s breathing becomes difficult and he seems to be struggling to get his breath, immediate action should be taken to provide warm, moist, air to restore the normal himidity of the room. This can be done by boiling a pan of water on a stove in a corner of a small room, adding a few drops of eucalyptus or menthol oil. This will moisten the air and help the child to breathe more easily. In case of a older child, fill a kettle with sprout, half full of hot water, adding a little oil of eucalyptus. The child should be made to inhalr steam ensuing from this water. This simple remedy helps to open the wind-pipes and relieve the congestion.
If the above treatment is faithfully carried out, the fever will run its course without any trouble and complication or serious after- effects. The child can then be placed on an all fruit diet for few days. He may eat fresh juicy fruits like apple, mango, pineapple, papaya, grapes, pear, peach, and melon during this period. Thereafter he may be allowed to gradually adopt a well-balanced diet , according to his age. The emphasis should be on whole grain cereals, raw or lightly-cooked vegetables or fresh fruits.
An excellent home remedy for croup is the use of garlic. Chewing a clove of garlic dissolves the membranes, reduces temperature and relieves the patient. About 15 gms. of garlic can be used in this way after every three or four hours for a week. After the membrane disappears , the same quantity of garlic should be chewed daily. The croup patient has no sense of taste or smell and merely finds the garlic hot.
Onion is another effective home remedy for croup. Onions should be roasted on hot ashes and juice extracted from them. This juice should be taken by the patient in doses of half a teaspoon mixed with equal quantity of honey three times daily.

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