Whooping-cough is usually seen in young children. It may, however, affect a person at any age. It is contagious. During infancy it is one of the most fatal diseases. During adult life it is a dangerous condition, while in childhood it is simply regarded as a mildly contagious disease.
It is most contagious during the catarrhal stage,—the first ten days. Children suffering from whooping-cough should not be allowed to mix or play with other children for two months. After an exposure to the disease it takes about fourteen days for a case to develop. The danger of whooping-cough is the tendency to develop pneumonia or bronchitis.
Symptoms.—During the first ten days the child acts as if suffering from an ordinary catarrhal cold with cough. This is called the catarrhal stage. 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.
When they begin to cough in paroxysms, and whoop, the second, or spasmodic stage begins. These fits of paroxysmal coughing are much more severe than spells of ordinary coughing. These may only be three or four attacks daily, or the child may have from forty to fifty such attacks. When children feel these attacks coming on they seek support, holding on to chairs or they stand by the mother's knee. The coughing is explosive, rapid, and forceful, the child fails to catch its breath and is compelled to take a deep inspiration, which is the whoop; it then goes on coughing more. The face may become purple, the eyes protrude, and the veins of the face swell up. Near the end of the attack the child raises, or vomits a mass of stringy, glutinous mucus. After it is over the child is exhausted, there is a more or less profuse perspiration, and he may be quite dazed. These attacks are, as a rule, more frequent and more severe during the night. This stage lasts about one month and is then followed by the stage of decline, during which the disease subsides into what appears as an ordinary bronchial cold.
It is quite common for these children to get relapses, especially during inclement winter weather, and go on whooping for two or three months longer. Their vitality suffers because their sleep and nourishment is interfered with, and they become nervous and difficult to manage.
Treatment.—Inasmuch as there is no remedy known that will cure whooping-cough, the best we can do is to render the patient physically efficient to stand the severe strain of coughing, which is the worst feature of the disease. Experience has taught us that those children do best who spend their entire time out of doors. We, therefore, advise parents to encourage their children to play in the open air. There is no exception to this rule, even in winter weather, unless it is particularly inclement. If the weather is wet or raw, or if the child has bronchitis, or is running a fever, it would be more safe to keep the child indoors, in a well-aired room, until the temporary conditions pass over, when they could again resume the open-air treatment.
Naturally delicate children if under two years of age should not risk staying out of doors too much in very cold or raw weather, even if not suffering from any of the above complications.
The bedrooms of children suffering from whooping-cough should be large and thoroughly aired day and night.
The nourishment in these cases is of great importance. They should be carefully fed, and if they vomit with the paroxysms of coughing, they should be fed small quantities frequently. Any form of digestive disturbance is very apt to accentuate the frequency of coughing. A fluid diet of milk is the best. Milk punches aid in keeping up the strength; malted milk and eggs beaten in milk are nutritious and easily digested.
So far as internal medication is concerned, I have found pertussin to be the most efficacious remedy. If it is begun early and in sufficient dosage, it not only favors an early termination of the disease, but it lessens the frequency and the severity of the paroxysms. If it is suspected that the child has been exposed to whooping-cough, pertussin may be given during the catarrhal stage with the advantage that it will render the whole course of the disease milder. If it is given during the course of an ordinary catarrhal cold, it will in most cases be as effectual as any ordinary cough remedy. The dosage should be large enough to produce results. I have found a teaspoonful every two hours to a child of three years to be the average dose. In older children I give two teaspoonfuls every three hours. It is necessary to continue its use throughout the disease. The taste of pertussin is pleasant and young children take it willingly.