Whooping cough

“ Like measles, one does not generally have two attacks of this disease. In the winter, [Pg 375] and this is the time when the whooping cough is most common, it is often followed by lung troubles, such as bronchitis and pneumonia. The death-rate from whooping cough is as large as from scarlet fever and measles combined, but chiefly because the disease is common among the smallest children. It is not unusual for babies under a year old to have whooping cough, and when their vitality is low, they scarcely ever recover.
Precautions against spread of whooping cough. ”

“ But what I wonder why to babes such suffering is sent.
Though mumps and measles, chicken pox and scarlet fever, too,
Beset the lives of those I love, I still can see them through;
But terror seems to chill my blood the minute that I hear
That awful sign that someone's child with whooping cough is near.
Old women say it has to be, but I grow pale as death
When I behold a boy or girl in anguish fight for breath.
They tell me not to be alarmed, but I'm not made of steel,
And every touch of agony the youngster has, I feel ”

“ There is no way of telling that whooping-cough is present until the child whoops. Most children do not whoop until the expiration of the catarrhal stage, though a very few do from the beginning of the disease. If a child is treated for an ordinary cold with cough and does not respond to treatment, and whooping-cough is epidemic, it is fair to assume that whooping-cough has been contracted. When the cough shows a distinct tendency to be worse at night it is further proof of this assumption. ”

“ Whooping-cough is a highly infectious disease, occurring but once in a lifetime, but at any age, though most frequently in childhood. The frequent belief that children suffering from whooping-cough should be as much as possible in the open air is an entirely mistaken one, as it leads not only to continuing the disease longer, but to danger of bronchitis and pneumonia. As in diphtheria and scarlet fever the mucus is the chief vehicle of contagion, and pocket handkerchiefs should be forbidden, pieces of soft rag being substituted and burned as soon as used. ”

“ Whooping cough is unlike the other three diseases in that it is a nervous trouble, and probably the germ or the poison formed by the germ attacks the nervous system, and particularly one great nerve connecting the lungs and stomach. This is why the spasm of coughing is frequently followed by vomiting, and the only remedy which is of [Pg 374] value in whooping cough is a nerve depressant which will diminish the activity of the nervous system without at the same time interfering with the strength or vigor of the patient. ”

“ Whooping-cough, is eminently contagious. The child may be noticed to have had during one or more weeks occasional but violent fits of coughing, which are most frequent during the night. If no complication be present, there is practically no cough between these spasmodic attacks. Usually a short feeling of general indisposition precedes the attack, during which the child in vain struggles to suppress the cough about to burst, when all at once the trunk and frame are subjected to a violent series of successive throbs almost threatening suffocation. ”

“ Although it is convenient to group whooping-cough among the infectious diseases, and although it is a clear case of a malady that comes in epidemics, yet its pathology is peculiar. It seems to be more a sequel of other diseases than an independent or primary affection. The whoop of the breath, from which it is named, is really proper to any convulsive cough of some infants or children. Adults, having undergone the change in the form and relative size of the larynx at puberty, have the convulsive cough usually without the whoop if they have it at all. ”

“ Probably the disease does not become contagious until the cough starts, and there is no reason why the disease should not be arrested in the first victim, provided proper isolation is practiced. The idea of a child with whooping cough, even when he whoops only once or twice a day, being allowed to attend school and mingle with the other scholars and to distribute the disease among them seems in these days of sanitary knowledge almost criminal. ”

“ Yet whooping cough is one of the simplest and most easily-cured diseases with which zone therapy has to contend. An ordinary case of whooping cough, which has persisted for weeks, can sometimes be cured in from three to five minutes. Rarely are more than four or five treatments necessary. Case after case is recalled in which, after the application of a cotton-tipped probe—held down firmly on the back of the throat (the post-pharyngeal wall) , little patients who had whooped themselves into a state of nervous and physical exhaustion, never had another paroxysm of coughing. ”

“ Treatment.—A host of remedies is used for whooping cough, but no single one is always the best. It is often necessary to try different medicines till we find one which excels. Fresh air is of greatest importance. Patients should be strictly isolated in rooms by themselves, and it is wise to send away children [Pg 242] who have not been exposed. Morally, parents are criminally negligent who allow their children with whooping cough to associate with healthy children. If the coughing fits are severe or there is fever, children should be kept in bed. Usually there is not much fever ”

“ Their intellects, also, have improved—intellects which had been stunted, dwarfed, and ruined by their frequent intermarriages.
WHOOPING COUGH.
According to Dr. Sturges, an English physician, whooping cough is not always to be escaped by preventing contagion, for at a certain age the disposition toward this disease is so great that the child will originate it. He says: "Whooping cough is a nervous disease of immature life, due immediately, like nervous asthma, to a morbid exaltation of sensibility of the bronchial mucous membrane. ”

“ Very few people have reached adult life without having suffered from this disease, as well as measles. This is chiefly due to the carelessness in mixing infected with healthy children. One frequently hears the peculiar and characteristic cough of a child with whooping-cough, in public assemblies, in railway trains, or in the out-patient rooms of hospitals. The contagium of whooping-cough is conveyed chiefly by the expectoration, which becoming dry, may be scattered like that of phthisis, as dust. Clothing conveys infection easily ”

“ This inclusion, under the generic name of cough, of cases that had all the signs of whooping-cough, namely, the paroxysmal seizures, choking fits, and blackness of the face, is found also in the London bills of mortality. Although “coughs” are entered as the cause of a not very large number of deaths in the earlier annual bills, with an occasional special mention of whooping-cough among them, it is not until 1701 that “hooping cough and chincough” becomes a separate item, with six deaths in the year ”

“ Not everyone who is exposed contracts the disease. It seems that whooping-cough, measles, and influenza frequently follow one another in epidemic form. This is one of the diseases much dreaded by parents. It is very tedious and endangers the life of weak and young children by exhaustion. It is a terrible thing to watch one with this disease, day in and day out. It can be known by the impetuous, continuous and frequent coughing spells, following each other rapidly until the patient is out of breath, with a tendency to end in vomiting. ”

“ Then, if they are very young or delicate, it is liable to produce convulsions or some other complication, and a medical man should always be called in. In many children a paroxysm of coughing brings on bleeding at the nose, and in some cases retching, but neither will do any harm. Very often the child who is sick with the cough gets over it quickest. As a rule whooping cough lasts three or four months; I have known it to continue for six. A change to the seaside will nearly always take it away. In fact, any change is beneficial, and will, in nine cases out of ten, cure it completely. ”

“ A child of the proper age with catarrh and cough is thus on the very brink of whooping cough. A large proportion of such children will develop the disease for themselves upon casual provocation, all contagion and all epidemic influence apart." Therefore he does not think contagion plays the important part generally supposed, and the assumption of a specific morbid poison is in his opinion entirely gratuitous. ”

“ The epidemicity of whooping-cough presents no more difficulty if the malady be viewed as the sequel or dregs of something else than if it be taken for an independent primary affection. The many infants and children that suffer from it together may have equally been suffering together from one or other of the various things of which it is assumed to be the sequel—influenza, measles, sore-throat, the bronchitis of rickets, simple bronchial catarrh of the winter, simple coryza. Again, it may be a secondary or residual affection with many, but a communicable disease to others. ”

“ Much of the whooping-cough of an epidemic is believed by good authorities, such as Bouchut and Struges [1246] , to be simply mimetic, or a habit of coughing acquired by hearing other children coughing in a particular way, just as chorea is sometimes acquired in schools or hospital-wards through the mere spectacle of it. ”

“ WHOOPING COUGH.—A contagious disease characterized by fits of coughing, during which a whooping or crowing sound is made following a long-drawn breath. Whooping cough is generally taken through direct contact with the sick, rarely through exposure to the sick room, or to persons or clothing used by the sick. ”

“ Outlook.—Owing to the numerous complications, whooping cough must be looked upon as a very serious disease, especially in infants under two years, and in weak, delicate children. It causes one-fourth of all deaths among children, the death rate varying from three to fifteen per cent in different times and under different circumstances. For this reason a physician's services should always be secured when possible. ”

“ There have been internal and external remedies, inhalations and inunctions, as well as many less likely methods of treatment. Practically none has maintained itself. Whooping cough is likely to run a rather long course. We know now that as a consequence of the strain upon the lungs tuberculosis not infrequently develops. Whenever this is true the tendency to cough is likely to be {25} prolonged far beyond the natural period, and from habit ingrained upon the nervous system the "whoop" is likely to continue, though there is no necessity for it. ”

“ Thus, in records of death, it is very common to see reported pneumonia as the cause underlying and fundamental, when the cause was really typhoid fever, the patient yielding to the former disease because of the enfeebled condition due to the latter. Again, many children contract diseases like measles or whooping cough because of reduced vitality due to insufficient nourishment, lack of clothing, and neglect, and their illness is said to be due to measles or whooping cough when under [Pg 296] proper conditions of care and attention they would not have the disease at all. ”

“ When the disease is inclined to a protracted course, or when the cough does not subside, especially during unfavorable weather, it is of great importance to send the child away. A change of climate, preferably to the seashore, even for a short time, will act like a charm, and will cure the cough of whooping-cough quicker than any other possible measure. ”

“ In Gloucestershire roasted mouse is considered a specific for whooping cough; though in Yorkshire the same diet cure is adopted for croup, while rat pie is the one to be used for whooping cough. The Norfolk peasants tie up a common house spider in a piece of muslin, and when the luckless long-legged spinner dies, the cough will soon disappear. ”

“ MORBID ANATOMY.—Although whooping cough is a serious disease, the cause of death is generally found to be dependent upon its complications, and there is no lesion at all characteristic of it. The chief complications and sequelæ are—bronchitis, which may become capillary; lobular collapse, which, according to Alderson,5 is frequently found; emphysema, usually marginal, probably due, as suggested by Jenner, to violent expiratory exertions; rupture of air-vesicles, with subcutaneous emphysema; catarrhal pneumonia, pleurisy, phthisis, acute tuberculosis, croup, cerebral apoplexy, meningitis, etc. ”

“ Through intestinal secretions; e.g., typhoid fever, cholera, dysentery, etc.
The first group, which includes practically all the ordinary diseases like measles, mumps, whooping cough, influenza, colds, pneumonia, scarlet fever, diphtheria, etc., is conveyed in most cases by one infected person transmitting directly to another person,—through coughing, spitting or sneezing,—germs present in the nose and mouth secretions. ”

“ One half of the sickness in our land is catching sickness. That is, it is sickness which passes from one person to another and is caused by tiny germs or microbes. A catching sickness is called a contagious disease. Some of the common catching diseases are sore throat, colds, diphtheria, pneumonia, typhoid fever, measles, grippe, and whooping cough.
How we get a Catching Sickness.—We get a catching sickness by taking into our bodies the germs from some other person. The germs of the sick do not pass off in the breath, but in the spit or anything else which comes from their bodies. ”