Definition

Characterized by a convulsive cough of long-drawn inspirations, with a whooping sound.

Symptoms

It is said that the incubation for this disease is from seven to ten days. It is described as catarrhal, and paroxysmal stages can be recognized. I do not recognize it as a catarrhal disease. It is strictly a nervous affection. The base of the trouble is cerebral and spinal. It starts with a dry, harassing cough, which seems to have no excuse for existence, as there is no irritation of the throat or lungs. This spasmodic cough lasts for two weeks. Then the characteristic whoop begins. Patients cough in paroxysms. The coughing is so hard that it often ends in vomiting--just a slight amount from the stomach, perhaps mucus, or food if there is any food in the stomach. After two weeks of whooping, the disease requires about two weeks more to decline and come to an end.

This disease is very harassing, but it can be made tolerable by giving the children the proper care. If it starts in children who already have deranged digestion, and they are then fed, not allowing them to miss a meal, complications are liable to occur, such as tremendous engorgement of the brain during the paroxysms. The blood-vessels will stand out like whip-cords on the forehead, and when the child is over the paroxysm it is completely exhausted. Unless such a case is fasted, the cough grows more severe; the stomach derangement increases, causing more and heavier coughing, until there is danger of bringing on a brain complication. Children who are in very good condition will, of course, become flushed in the face, the eyes will become suffused, and they will cough until they gag; but as soon as the paroxysm is over they appear to be as well as ever. The child, however, that sinks down exhausted, and becomes fretful and nervous, and seemingly afraid of an approaching paroxysm, is in danger. In such cases there is congestion of the brain. This condition of the brain is marked by red spots on the forehead and ecchymosis of the conjunctiva, which means red spots on the whites of the eyes, caused by rupture of a capillary blood-vessel. Bleeding from the nose and ears, and occasionally from the lungs, takes place. Sudden death has been known to occur from hemorrhage of the brain.

Treatment

In a recent system of medicine there were nearly fifty drugs recommended for use in this disease. Whooping cough is considered very grave in the centers of population, but, as in the case of all other children's diseases, the mortality is due to the care and treatment. Dr. Osler, in his latest work on practice, declares that the treatment is notoriously unsatisfactory. He further says that, if he were asked the two most important things in the treatment of this disease, it would be six weeks and a good big bottle of paregoric. Some practitioners are foolish enough to give quinine, which, of course, produces more or less irritation of the nervous system. Certain remedies have been recommended to be used as a swab in the throat. Indeed, it would be just as rational to rub salve on the end of a dog's tail for a sore ear, as to swab the throat to control the coughing in whooping-cough; for whooping-cough is a disease of the nerve centers--brain and spinal cord--and the cough is strictly a reflex irritation.

The excessive coughing disturbs the stomach and causes vomiting; but to use remedies for the stomach and to swab the throat is the height of folly. The child's nervous system must be taken care of. Children with whooping cough must be sent to bed. The feet should be kept warm--not toasted too much, but they should be looked after and kept comfortable. The rest in bed will quiet down the nervous system. If this treatment is adopted on the onset of the disease, it is doubtful if the child will ever reach the stage of whooping.

No food should be given until full relaxation has been brought about. That ought to occur in two or three days. The bowels should be emptied by using the enemas. About the fourth day a little fruit juice and water, half and half, may be given in the morning; also at noon and at night. But if, after this eating, there is a tendency for the cough to grow worse, stop the feeding. By managing the child in this way, there will be no danger of any complications leading to death. The mortality in this disease, when the epidemic or endemic is of the mildest form, is about six percent. Death is unnecessary if children are sent to bed and fasted. When the symptoms have subsided and the case is convalescing, give fruit juices diluted for a day or so; then fruit morning and night, and a salad at noon.

Gentle rubbing to the spine several times a day, and especially at night, will quiet down the child so that it should sleep. In very restless cases, a hot bath two or three times a day, until the nervousness is controlled, will be found very efficient. A child nursed and cared for in this way will not need to be watched closely when the stage of convalescence is reached, for fear a fatal bronchial pneumonia will develop; for that disease is induced by wrong nursing and feeding.