Hooping-cough commences as a common cold and cough. The cough, for ten days or a fortnight, increases in intensity; at about which time it puts on the characteristic "hoop." The attack of cough comes on in paroxysms. In a paroxysm, the child coughs so long and so violently, and expires so much air from the lungs without inspiring any, that at times he appears nearly suffocated and exhausted; the veins of his neck swell; his face is nearly purple; his eyes, with the tremendous exertion, almost seem to start from their sockets; at length there is a sudden inspiration of air through the contracted chink of the upper part of the wind-pipe—the glottis—causing the peculiar "hoop;" and after a little more coughing, he brings up some glairy mucus from the chest; and sometimes, by vomiting, food from the stomach; he is at once relieved, until the next paroxysm occur, when the same process is repeated, the child during the intervals, in a favourable case, appearing quite well, and after the cough is over, instantly returning either to his play or to his food. Generally, after a paroxysm he is hungry, unless, indeed, there be severe inflammation either of the chest or of the lungs. Sickness, as I before remarked, frequently accompanies hooping-cough; when it does, it might be looked upon as a good sign. The child usually knows when an attack is coming on; he dreads it, and therefore tries to prevent it; he sometimes partially succeeds; but, if he does, it only makes the attack, when it does come, more severe. All causes of irritation and excitement ought, as much as possible, to be avoided, as passion is apt to bring on a severe paroxysm.
A new-born babe—an infant of one or two months old—commonly escapes the infection; but if, at that tender age, he unfortunately catch hooping-cough, it is likely to fare harder with him than if he were older—the younger the child, the greater the risk. But still, in such a case, do not despair, as I have known numerous instances of new-born infants, with judicious care, recover perfectly from the attack, and thrive after it as though nothing of the kind had ever happened.
A new-born babe, labouring under hooping-cough, is liable to convulsions, which is in this disease one, indeed the great, source of danger. A child, too, who is teething, and labouring under the disease, is also liable to convulsions. When the patient is convalescing, care ought to be taken that he does not catch cold, or the "hoop" might return. Hooping-cough may either precede, attend, or follow an attack of measle.
235. What is the treatment of Hooping-cough?
We will divide the hooping-cough into three stages, and treat each stage separately,
What to do.—In the first stage, the commencement of hooping-cough: For the first ten days give the Ipecacuanha Wine Mixture, [Footnote: For the prescription of the Ipecacuanha Wine Mixture, see page 161.] a tea-spoonful three times a day. If the child be not weaned, keep him entirely to the breast, if he be weaned, to a milk and farinaceous diet. Confine him for the first ten days to the house, more especially if the hooping-cough be attended, as it usually is, with more or less bronchitis. But take care that the rooms be well ventilated; for good air is essential to the cure.
If the bronchitis attending the hooping-cough be severe, confine him to his bed, and treat him as though it were simply a case of bronchitis. [Footnote: For the treatment of bronchitis, see answer to 207th question.]
In the second stage, discontinue the Ipecacuanha Mixture, and give Dr Gibb's remedy—namely, Nitric Acid—which I have found to be an efficacious and valuable one in hooping-cough:—
Take of—Diluted Nitric Acid, two drachms;
Compound Tincture of Cardamons, half a drachm;
Simple Syrup, three ounces;
Water, two ounces and a half:
Make a Mixture. One or two tea-spoonfuls, or a table-spoonful, according to the age of the child—one tea-spoonful for an infant of six months, and two tea-spoonfuls for a child of twelve months, and one table-spoonful for a child of two years, every four hours, first shaking the bottle.