EBVIEW TEOPICAL MEDICINE, ETC. 233 



Whooping Cough. Notwithstanding the large number of investigations in 

 connection with this disease the etiology of whooping cough has not as yet been determined. 

 That it is an undoubtedly infectious, transmissible disease is more or less recognised owing 

 to its frequent epidemic character and its endemicity in certain cities ; furthermore, it has a 

 definite incubation period. It occurs in the Sudan, but is not very common. 



According to Ager^* the disease certainly spreads by contact between children, and 

 Baginsky states positively that he has observed transmission by a third person. The virus 

 seems to adhere to rooms and furniture, and one attack usually confers immunity. The 

 literature ou the bacteriology of this disease is as confusing as it is extensive, the most 

 striking feature being the lack of unanimity in the results. 



Spengler-* was the first to describe an organism in pertussis sputum closely resembling 

 the influenza bacillus in its morphological and biological aspects. 



Czaplewski and HenseP* found a small, short, polar-staining bacillus slightly larger than 

 the influenza bacillus but which grew upon non-lasemoglobiu media. This organism was 

 isolated from sputum on blood-serum plates. Morphologically, it resembles very closely the 

 influenza-like organisms of Spengler, Jochmann and Vinceuzi ; Czaplewski's results were 

 confirmed by Zusch. Davis* examined the sputum of 61 cases, and his observations point to 

 the fact that there is almost constantly present an organism which culturally and morpho- 

 logically is identified with the influenza bacillus occurring in greater numbers than any 

 other organism. This organism was not abundant during the spasmodic stage of the disease. 

 It has been found several days before the whoop began, and as long as six months after the 

 disease. 



There is not, however, sufficient evidence for or against the specificity of this organism 

 for whooping cough. Bordet and Gengou found in pieces of membrane brought up by 

 patients during coughing paroxysms, very numerous delicate ovoid bacteria usually in pure 

 culture, together with numerous leucocytes. These bacteria were sometimes tapering and 

 sometimes so short as to resemble cocei. They were Gram-negative. In favour of the 

 causal relationship of the micro-organism it is to be noted that well-marked agglutination 

 occuri'ed with sera of convalescents from the disease but not with the sera of healthy persons. 

 Similarly, the phenomenon of the deflection of complements was shown in a very high degree 

 by this microbe. 



Jochmann and Krause, in 1901, found influenza-like bacilli in the sputum of pertussis 

 cases. These organisms belonged to three different classes. A, B and C, as determined by 

 their reaction to Gram's stain and by their biological properties. Glass A contained non- 

 Gram-staining, influenza-like bacilli, growing only in the presence of haemoglobin ; this they 

 called the B. pertussis eppendorf. In four cases they found similar bacilli which, however, 

 grew on haemoglobin-free media. They considered this organism the same as that 

 described by Czaplewski and Hensel. Class C contains a Gram-staining bacillus growing 

 without the presence of haemoglobin. Magerims believes that the disease is due to 

 a bacillus growing on the Schneiderian membrane of the nose. 



With all these observations the proof that these different organisms are the true cause 

 of the disease is still wanting. It is of interest to note that influenza-like organisms have 

 been found in normal throats, and also in several other diseases, amongst which may be 

 mentioned measles, epidemic cerebro-spinal meningitis and varicella. In these diseases 

 influenza-like organisms have been isolated in pure culture from the sputum and from 

 throat swabs. 



Macewen" successfully conveyed the virus to a healthy cat by feeding it with milk 

 containing the sputum and vomited material of typical pertussis cases. The cat developed 

 whooping cough 17 days afterwards. This experiment appears to show that cats may be 

 the means of disseminating the disease. According to Arnhein, who has made numerous 

 post mortems, there is a marked desquamative catarrh of the larynx and trachea, with 

 swelling of the neighbouring lymph glands. In the diagnosis of pertussis in its early stages, 



' Ager, L. C. (November, 1905). Brooklyn Medical Journal. 



■' Spengler, C. (1897). Deutsche Med. Woeh., 23, p. 830. 



» Czaplewski, E., and Hensel, R. (1897). Deutsche Med. JVoch., 23, p. 586. 



■■ Davis, D. & J. (March 2n(l, 1906), " Bacteriology of Whooping Cough." Journal of Iiifcetiou^ Diseases. 



'■> Maccweu, H. A. (Januaiy 18th, 1908), "The Conveyance of Whooping Cough from Man to Animal.i by 

 direct E.\perimeut." British Medical Journal. 



* Article not consulted in the original. 



