WHOOPING-COUGH. 95 



cyanosis becomes extreme ; the pulse grows small, the skin cool, and in 

 severe cases death may take place during the seizure. In more fortu- 

 nate cases, after a longer or shorter duration, the spasm subsides gradu- 

 ally, the cyanosis fades, the dyspnoea ceases, the abatement, however, 

 being unaccompanied by any cough or expectoration, such as usually 

 arises at the end of a fit of bronchial asthma. 



In the cases reported by JSamberger the patient derived relief 

 chiefly from use of the cold douche, inhalation of chloroform, and subcu- 

 taneous injection of morphia; but he eventually succumbed to the 

 disease. 



Bamberger is of the opinion that some forms of asthenia may pro- 

 ceed from spasm of other muscles of inspiration, and possibly, too, from 

 fmasm of the expiratory muscles. 



CHAPTEE V. 



WHOOPING-COUGH. STICK-HUSTEN. COQUELUCHE. 



ETIOLOGY. According to our views, whooping-cough is a catarrh 

 of the respiratory mucous membrane, distinguishable, however, from 

 other catarrhs of this membrane, both by its mode of origin and by fits 

 of spasmodic cough, which depend upon a peculiar hyperaesthesia of the 

 air-passages. 



The dependence of whooping-cough upon an unknown, but un- 

 doubtedly specific cause, the frequent epidemic appearance of the dis- 

 ease, its propagation by infection, the almost positive protection against 

 the malady afforded by a previous attack, remind us in many respects 

 of the origin and propagation of measles, scarlet-fever, small-pox, and 

 other forms of the so-called acute infectious disorders, of which we shall 

 hereafter treat in detail. The circumstance, however, that the sole 

 result of the specific exciting cause of whooping-cough is a local affec- 

 tion, while the rubeolar, scarlatinous, and typhous poisons involve the 

 entire system, is a reason for distinguishing whooping-cough from these 

 maladies. At the same time, it is not to be denied that even whooping- 

 cough, as well tis other epidemic contagious disorders, whose effects are 

 merely local, is produced by the action of specific poison. Indeed, we 

 regard this mode of origin not only as possible, but even as the proba- 

 ble one ; but the nature and material of the infection in the disease in 

 question must vary essentially from that of infectious diseases, in the 

 narrower sense of the term, since their results are so very different. 3 

 Inasmuch, however, as we have no definite knowledge regarding these 

 morbid processes, and since all the symptoms of this disease are easily 

 traceable to local disorder of the respiratory mucous membrane, it wilJ 



