72 DISEASES OF CHILDREN. 



Convulsions are a serious complication, and are very frequently fatal. The 

 lungs, from the incessant cough, may drift into the condition which is technically 

 known as emphysema i.e., they become over-blown, a state analogous to " broken 

 wind " in the horse. In this case the child remains short-breathed and asthmatic, 

 and this condition once established is very liable to be permanent. Tubercular 

 disease is very often established during whooping cough, and the patient may be- 

 come consumptive or suffer from tubercle of the brain, and die with symptoms of 

 hydrocephalus, or drift into the condition which is known as marasmus or atrophy. 



The treatment of whooping cough varies according to the stage of the disease. 

 These stages may be considered as three in number. (1) the febrile stage, in which 

 cough and cold are the ordinary symptoms ; (2) the paroxysmal stage, in which the 

 patient is tormented with cough and spasm ; and (3) the nervous stage, in which the 

 other symptoms having passed away the whoop alone remains. During the first 

 stage it is necessary to carefully regulate the diet and clothing of the invalid, and to 

 guard him as much as possible from the effects of cold. Perspiration should be 

 encouraged at night by the administration of warm drinks, and the chest should be 

 wrapped in flannel or cotton wool, and covered with oiled silk. If the bronchitic 

 symptoms be severe, some spirits of camphor or spirit of turpentine may be 

 previously sprinkled upon the wool or flannel. It is necessary to regulate the 

 action of the bowels, and it is usually advisable to restrict the patient to a slop 

 diet if the amount of the febrile symptoms be considerable. The next thing 

 necessary is to encourage expectoration. If old enough, patients should be told 

 to expectorate, and not to swallow the secretion which is coughed from the lungs, 

 and medicines should be given in order to loosen the phlegm. The best of these, 

 perhaps, are ipecacuanha, squills, syrup of tolu, and ammonia, and these drugs may 

 be administered singly or combined. Sometimes, when the lungs are much choked 

 with secretion, great advantage is derived from the administration of an emetic, 

 such as warm mustard and water, but these are points which can only be decided 

 by the practised judgment of a medical man. When the febrile stage has passed, 

 we may; try to allay the spasm and paroxysmal cough, and here we think we may 

 well give a word of warning as to the danger of having recourse to patent quieting 

 medicines, of whose composition we are ignorant. Nearly all of these preparations 

 contain laudanum or opium in some form or another, and we have no hesitation 

 in saying that opium has been the cause of some thousands of deaths when 

 administered ignorantly and thoughtlessly for the relief of the severe troubles of 

 whooping cough. Children are at all times peculiarly susceptible to the influence 

 of narcotic medicines, and they are particularly so when their breathing power is 

 impaired by disease of the lungs. A child who is under the influence of opium, 

 even though its lung-tubes be filled with secretion, has its sensibility so dulled 

 that it "forgets" to cough, and to forget to cough in such a plight is to die. 

 The child who is incessantly coughing becomes quiet, and the conclusion drawn 

 is that it is better, whereas, as a matter of fact, it is being slowly suffocated by the 

 secretion in its lungs. Soothing medicines, and especially opium, should never 

 be given without authoritative advice ; and, indeed, we hardly know of any 

 condition in which it is warrantable to give opium to very young children. Few 



