WHOOPING COl'UIZ. 71 



still, and catches hold of the nearest object for support. The cough is loud, severe, 

 and rej>eated live or six times, arid then comes the prolonged whooping inspiration, 

 followed by a fresh series of coughs and a fresh whoop. This is repeated again and 

 again until the child becomes blue in the face, and gasps fur breath. The eyes look 

 bloodshot, and stream with tears. Sticky tenacious mucus is coughed through the 

 mouth and nose, and not unfrequently the straining efforts at coughing are so severe 

 that the contents of the bowels and bladder are discharged. It is very common for 

 an attack of coughing to terminate with vomiting, and whenever a child vomits with 

 a cough, the nurse should suspect that it is suffering from whooping cough. With 

 the vomiting the cough ends, the complexion becomes natural, and ill a few minutes 

 the child is again playing, quite forgetful of the trial it has passed through. These 

 attacks of coughing recur at uncertain intervals, which vary with different indi- 

 viduals. In bad cases, or when the attack is at its height, they may come as 

 frequently as one in half an hour, and as the patient gets better the attacks become 

 not only less severe but less frequent also. The attacks of coughing are brought on 

 by anything which irritates the child, and if ever it be allowable to spoil a cliild, the 

 j>eriod of its whooping cough is one of those times. Any sudden rebuke, or rapid 

 and sudden movement, will to a certainty induce an attack, and occasionally even 

 the slight irritation caused by taking food is sufficient to produce them. The disease 

 is one of very uncertain duration, and often proves very trying to the friends by its 

 obstinate persistence, for as long as any member of a family has whooping cough, the 

 whole of the household is placed in quarantine by its social circle. In favourable cases 

 the disease completely subsides in about three weeks ; but it is no unusual thing for 

 it to }>ersist for twice as many months. It is commonly supposed, and with reason, 

 that the whooping noise occasionally lasts long after the infectious period of the 

 disease has passed away, and that consequently many a child with pronounced 

 whooping inspiration might with perfect safety mix with its fellows at school and 

 elsewhere. It is impossible, however, in our present state of knowledge to say where 

 the infectious period of the disease ends and the noii-iiifectious begins, so that it is 

 better to be on the safe side, and to keep a child entirely separated until it has 

 absolutely ceased to whoop. Any cliild who is whooping would certainly get the 

 credit of spreading the disease should any children with which it had come in 

 contact succumb to whooping cough. 



Whooping cough must at all times be looked upon as a serious disease, and the 

 slightest attacks must be a source of some uneasiness to the friends of children. It 

 is a more common cause of infant mortality than is generally supposed ; but when it 

 is fatal, it is so usually by the complications which are apt to be established during its 

 continuance. Thus, the bronchitis, which is always present to a certain extent, may 

 become unduly severe, and may attack the fine tubes of the lung, in which case the 

 gasping for breath becomes a marked feature, the respiration is hurried, the cough 

 frequent, and the countenance livid, according to the amount of suffocation which is 

 present. True inflammation of the lung may be set up, and when this is the case 

 the characteristic features of whooping cough subside until the inflammatory attack 

 has passed off. Bleeding from the lungs or nose will sometimes occur, and prove very 

 weakening to the patient. 



