70 DISEASES OF CHILDREN. 



the child loses flesh steadily. The duration of such cases, which are (happily perhaps) 

 generally fatal, is from one to three years, but now and again they live on into adult 

 life. 



Great care must be taken to distinguish this condition from the large head of 

 rickets, which is not by any means so serious a condition. In rickets we find the 

 other signs of the constitutional state in other parts of the child's body, and although 

 the fontanels are late in closing in rickets, they do not remain so widely open as in 

 chronic hydrocephalus ; and a further distinction is found in the fact that the bones 

 in rickets are rather thicker than ordinary. The peculiarity of the eyes present in 

 hydrocephalus is not present in rickets. 



The treatment of these cases does not usually afford much ground for hope. The 

 general health of the child must be carefully attended to. Tonic and alterative 

 medicines may be given, and its general hygienic arrangements must be carefully 

 supervised. Iodine, in the form of iodide of iron or iodide of potassium, has been 

 highly recommended. The head has been blistered with advantage, and the adminis- 

 tration of diuretic medicines, such as carbonate of potash, acetate of potash, and 

 infusion of broom, has been supposed to assist in the reduction of the fluid. In some 

 constitutional states the administration of mercury might be highly advisable. The 

 head may be tapped, and some cases have of late years been published which show 

 the advantage of this form of treatment. The tapping is best done by means of an 

 instrument called an. aspirator, and as the fluid is drawn off the head should be 

 compressed slightly by means of a bandage. These are of course measures which can 

 only be done by persons thoroughly conversant with disease ; and, indeed, the 

 treatment generally of this very grave disorder must be left entirely in the hands of 

 professional advisers. 



Whooping Cough. This disease owes its name to the loud whooping, crowing 

 sound with which the sufferer draws breath after a violent attack of coughing. The 

 whoop is a very variable symptom of the disease. It may be very loud, and consti- 

 tute the principal feature, or, which is important to bear in mind, it may be absent 

 altogether. Whooping cough seems to be more infectious even than measles, and, as 

 mentioned while discussing the last-named disease, it is often established during its con- 

 tinuance or the subsequent convalescence. It should be borne in mind that whooping 

 cough is a general disease a disease, that is, affecting the whole body, and although 

 the symptoms are mainly referable to the lungs and windpipe, the disease is by no 

 means limited to those parts. The disease is most common in childhood, but is not 

 confined to that period of life. The phenomenon of an old person suffering from 

 whooping cough is far from uncommon. 



The attack begins generally as a common cough an ordinary attack of bronchitis. 

 The child has attacks of coughing, and wheezing can not unfrequently be both heard 

 and felt in its chest. After this ordinary cough has lasted for ten days or a fortnight, 

 it becomes violently spasmodic in character, and the well-known sound is developed. 

 To see a child during a severe paroxysm of whooping cough is a truly piteous sight. 

 It is probably playing with its fellows, and enjoying its game as much as the others, 

 when suddenly it is conscious of the approaching trouble. It ceases to play, stands 



