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When I was a very new paediatric doctor I worked in a unit that routinely used steam to treat children who had croup. It was a fantastic treatment—you could tell that you were doing something seriously efficacious; you would open the cubicle door to review the child and walk into this thick humid atmosphere—you could almost hear the witches chanting ‘Double, double toil and trouble; Fire burn, and caldron bubble’ in the distance. There was just one problem. It was rubbish. This was roundly demonstrated when new smoke detector systems were installed which were triggered by the steam, so we had to stop using it; it made absolutely no difference to the children we were treating. The evidence that steam …