WHOOPING-COUGH TREATMENT. 105 



which hardly owes its virtue to the cochineal. Half a tumbler of soda 

 and water, drunk occasionally, would probably produce about the same 

 result This mixture should not be given as a matter of routine, " a 

 teaspoonful every two hours," or the like, but only when there is a 

 collection of viscid mucus in the throat, and when a paroxysm is ap- 

 proaching. Prescribed in the latter way, parents are glad to use it, as 

 they soon find out that it renders the attacks milder and shorter, or, as 

 they say, " loosens the cough." 



Narcotics have also been prescribed to shorten the coughing-fits and 

 reduce their number, and there is scarcely an article of this large class 

 of drugs which has not been recommended in whooping-cough, and 

 even vaunted as a specific. This is especially the case with belladonna. 

 We have already expressed ourselves in favor of a bolder use of nar- 

 cotics in treatment of catarrhs, and hence approve of their use in whoop- 

 ing-cough, which we regard merely as a catarrh complicated with an 

 especially intense hyperaesthesia of the air-passages; but we cannot 

 admit that any narcotic whatever (belladonna included) has any speci- 

 fic action against this disease. If they render the course of whooping- 

 cough briefer, they act by mitigating and lessening the frequence of the 

 paroxysms, which are perpetuating the irritation. Since, however, as 

 as a general rule, narcotics are not well borne by children, being apt to 

 cause hyperaemia of the brain, we should restrict their use to those 

 cases in which danger from the disease outweighs danger from the 

 remedy. Should the treatment, given above, prove ineffective, should 

 the child empty its stomach with every paroxysm, should his nutritive 

 condition begin to suffer, from constant vomiting and from sleepless 

 nights, should convulsions or signs of actual suffocation occur during the 

 seizures, the administration of narcotics is indicated. Belladonna enjoys 

 this advantage over opium, that, in the condition of the pupil, we have 

 an index for regulation of the dose. To children, between the ages of 

 two and four years, we may give the eighth of a grain of the drug, night 

 and morning, gradually increasing the dose up to half a grain, or until 

 the pupil begins to dilate. Trousseau preferred not to divide the daily 

 dose, but gave it all at once, and he thought it useless to push the dose 

 to the point of incipient narcotism. For older children, to whom the 

 exhibition of opium is less hazardous, we may prescribe small doses of 

 morphia (gr. -fa \ in die), dissolved in some liquid like the aqua 

 amygdalarum, so much lauded by West, or we may give a few 

 drops of laudanum. 



[ Von Bintz and others have derived decided benefit from the 

 use of muriate of quinine if given in pretty large doses, say from 

 one to twenty grains daily, according to the age of the patient. 

 The value of chloral and of the bromides of potassium and ammo- 



