WHOOPING-COUGH. 61 



Stimulating expectorants and tonics are now given with decided 

 benefit. Amongst the first class, are included senega, the balsams, 

 ammoniacum, squill, and myrrh; and in the second, improved regi- 

 men, wine, bark,' serpentaria, the preparations of iron, &c. In 

 bad cases of bronchitis, in addition to the internal treatment, counter- 

 irritants should be persisted in for some time. The counter-irritants 

 most employed are, blisters, tartarized antimony ointment, croton 

 oil, the acetum cantharidis, and pitch plasters containing either can- 

 tharides or tartarized antimony. Dr. Stokes recommends a stimu- 

 lating liniment, which, when applied to the chest daily, keeps up an 

 erythematous state of the skin.* He considers that this liniment 

 not only acts beneficially by its counter-irritating properties, but that 

 the ingredients are absorbed by the surface, so as to act on the 

 mucous membrane as direct stimulants. 



In asthenic bro7ichitis, with copious suffocative secretion, our 

 greatest dependence is to be placed on emetics for children ; and for 

 old people, on warm purgatives, blisters, and stimulating expecto- 

 rants, especially senega and ammonia. Diuretics and astringents are 

 afterwards of service. 



Opiates always require caution in bronchitis which is attended 

 with profuse secretion. It is true, they ease the cough ; but then it 

 must be recollected that the cough is the only means of getting rid 

 of that superabundant mucus which is choking the patient, and that 

 if the cough stops, the patient will perish ; drowned, to all intents 

 and purposes. Particular caution must be used if there is any ap- 

 pearance of venous blcod circulating — livid lips, or coma. Yet, as 

 it is right to allay inordinate irritation, small doses of paregoric 

 niay be combined with the stimulant expectorants, to moderate the 

 violence of the cough; and a larger dose may be given at bed 

 time, if the patient is worn out for want of sleep, and can expecto- 

 rate freely. 



PERTUSSIS {WJiooping-CoKgh). 



This affection is contagious; it seldom occurs twice in the same 

 individual, and particularly attacks children ; but adults are liable to 

 it, if they have escaped it in their childhood. 



Symptoms. — It commences with symptoms of common cold, or 

 catarrh, which may last for some days ; the cough then becomes 

 convulsive, and recurs in fits at various intervals. The fits may last 

 a quarter of an hour or more. Each fit is composed of a quick suc- 

 cession of sonorous coughs, with scarcely any perceptible inspiration 

 between ; but at intervals the expirations of coughing are suddenly 

 interrupted by a very deep, sonorous inspiration, or tvhoop, which 

 constitutes the pathognomonic sign of this disease. The peculiar 



* The following is his formula :— R. Sp. terebinth. 3iij. ; Acid acet. ^ss • 

 Vitell. ovi, j,; Aq. rosar. giiss.; Ol.limon. 3j. M. 



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