This is another germ disease caused by an unknown germ. Bordet, of France, thought he found a germ to cause the trouble and called it Baccillus Pertussis.
This trouble is described in medical works as an acute bronchitis. We do not recognize it as a catarrhal affection at all. We regard it as a nervous affection having its origin in disease of the cerebrum or the spine.
The disease derives its name from the long drawn inspiration with a "whoop" which follows a paroxysm of coughing. In ordinary coughing one inhales after each cough. In this condition the patient attempts the impossible task of coughing from fifteen to twenty times during one expiration. Then he draws in the air with a long-drawn inspiration, accompanied with a whoop. But little mucous is expelled and the whole action is evidently NERVOUS.
The trouble begins with a dry, harrassing cough with no apparent excuse for existing. For there is no irritation of the throat or lungs. For about two weeks this spasmodic coughing continues when the characteristic whoop develops. The cough comes in paroxysms and is sometimes so hard that vomiting results. The whooping usually lasts about two weeks, then another two weeks are required for the trouble to decline and end.
During the paroxysms the veins swell, the face becomes blue, the eyes bulge out, their whites are "blood-shot," and the child looks as though it must suffocate.
Swallowing, emotions, or even throat irritations may induce a paroxysm. Hearty eating is almost certain to result in a series of paroxysms. The child (it is usually a child) may have but a few or a hundred paroxysms a day. Children who are otherwise in good physical condition appear to be as well as ever when the paroxysm ends.
The only danger in this condition is the rupture of a blood vessel. The violent paroxysms place a severe strain on the heart and blood vessels. Rupture into the eyes, ears, nose, lungs, brain or skin may occur. The hemorrhage into the brain may result in paralysis or even sudden death. Bleeding from the nose and ears and occasionally from the lungs, occurs in a few cases.
A child that sinks exhausted, becomes fretful and nervous and seemingly fearful of the paroxysm, and presents red spots on the forehead and in the white portion of the eyes is suffering with congestion of the brain and is in danger.
The lungs are injured in rare cases by the severe paroxysms of coughing. Sometimes they become emphysematous (dlstention of the lung tissue with air), sometimes they literally burst.
Bronchopneumonia is a frequently fatal complication known only to medical practice.
Voelker, in his Index to Treatment, says: "The treatment of whooping cough constitutes one of the reproaches of the art of medicine. We have no method by which we can shorten the disease, ### no specific for whooping cough has yet been found. To all those I have tried (and they are over thirty in number). the handwriting on the wall is literally applicable. 'Tekel' ('Thou art weighed in the balance, and art found wanting.')"
Sir Wm. Osler agrees with this, saying: "The treatment is notoriously unsatisfactory. Stock vaccines have been used for treatment with some benefit. (sic) A few patients are promptly cured. (sic) Antiseptic measures have been extensively tried. Quinine holds its own with many practitioners; ### The use of benzoin inhalations is often helpful. For the catarrhal symptoms, moderate doses of ipecac are probably the most satisfactory. Sedatives are by far the most trustworthy drugs in severe cases, and paregoric may be given freely, particularly to give rest at night. Codeia and heroin in doses proper for the age often give relief. Jacobi advises belladona in full doses, ### Other remedies, such as antipyrin and chloral hydrate may be tried. In older children and adults it would be worth while, I think, to try the intratracheal injections of olive oil and iodoform which are sometimes so useful in allaying severe paroxysmal cough ####."
I should think that such treatment would be "notoriously unsatifactory" and "one of the reproaches of the art of medicine." It is a crime to punish sick children in this way. It is wholly symptomatic and suppressive. There is nothing in the treatment to indicate that the medical man even remotely suspicions that there may be a cause for whooping cough.
Dr. Logan, a chiropractic authority, says in his Technic and Practice of Chiropractic: "Pertussis, or Whooping Cough-- Tends to run its course despite adjustments, though some aborted cases are reported. All cases are mild under adjustment, with some liability of complications. A nervous cough is likely to persit for months after the infection has passed. Adjustments seem seldom to prevent contagion."
Chiropractors, according to Firth's Chiropractic Symptomatology, hold that the disease is due to subluxations of the lower cervical and upper dorsal vetebrae and the "kidney place" and, accordingly, "adjust" these points. We may wholly ignore their vague reports of aborted cases, just as we may discount Osler's claim of good coming out of stock vaccines.
Osteopaths used to look to subluxations of the lower cervical and upper dorsal vertebrae as the cause of the trouble. Most of them now look to the germ theory to supply the cause. They are no more successful than chiropractors in caring for this condition.
CARE OF THE PATIENT: As harassing as this condition usually is and as notoriously unsatisfactory as the paregoric, freely given, proctetive vaccines, "large quantities of good nourishing food" and "change of climate," of medical methods, the condition can be made tolerable by giving the children proper care. Dr. Tilden declares:
"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."
How different this is to the wail of the medical man that: "Some children vomit at the end of a paroxysm, and so often during the day that they almost starve."
The "disease" is of the nerve centers, the cough being a "reflex cough," and the nervous system of the child must be looked after. he should be put to bed at once and the feet kept warm. He should be given all the fresh air possible and as much water as thirst calls for, but no food of any kind until complete relaxation is secured. Children that are out-doors all day suffer less than those in the house. Whenever possible the bed should be out-doors. Otherwise, put the child by the open window. The rest and warmth will quiet the nervous system. It is questionable whether the whooping stage will ever develop if this "treatment" is instituted at the beginning of the trouble. Complete relaxation should occur in three or four days.
The commonly unrecognized evils of mental over-stimulation of children is usually very evident in troubles of this nature. This should be particularly avoided. Complete relaxation and rest of the nervous system is very important in this condition.
After full relaxation is had, fruit juices may be given morning, noon, and night for two or three days, after which fresh fruit may be used. If the cough tends to increase after feeding, stop the feeding at once. "It is usually observed," says Page "that the cough grows worse toward evening, and is worst at night. By morning there has been something of a rest of the stomach, and the cough is easier--perhaps disappears entirely. A full meal is often the exciting cause of a fresh and violent paroxysm. Other things equal, the child who is oftenest and most excessively fed will suffer most and have the longest 'run.'" After the paroxysms have ceased gradually return to a normal diet.
Dr. Osler thought that the two most important things in the treatment of the disease are six weeks and a good big bottle of paregoric. Others give quinine instead of paregoric to suppress the cough. Both these drugs depress the nervous centers. Some medical works recommend over fifty drugs for the disease, some of these being used to swab the throat. As well salve the big toe.
CONVALESCENCE, medical men tell us, is tedious. This is their experience. We don't weaken and kill our patients. They tell us that the child must not be allowed to "catch cold." or over do. A change of climate and "large quantities of good nourishing food" (m.eaning by this meat, eggs, pasteurized milk, puddings, white bread, etc.), are recommended for the chronic cough that so frequently follows in medical treated cases.
We recommend an abundance of fresh fruits and green vegetables, sun-shine, fresh air, exercise and rest and sleep. These are the elements of which health is compounded.