Hoooping-cough (or WHOOPING-COUGH; technically, Perfrussis) is an infectious and epidemic disease, mostly attacking children under ten, especially in spring and autumn. Its earliest symptoms, which usually appear five or six days after exposure to infection, are those of a common cold, as hoarseness, a watery discharge from the eyes and nose, oppression of the chest, a short dry cough, and more or less feverishness. This stage, which is called the catarrhal, lasts a week or ten days, when the fever remits, and the cough becomes more troublesome, is worse at night, and occurs in paroxysms consisting of a series of short expiratory puffs followed by a deep inspiration of air through the contracted cleft of the glottis (Larynx, q.v.), causing the characteristic 'whoop.' The attack usually terminates in the expectoration of glairy mucus or in vomiting. During the fit of coughing the face becomes red or livid, the eyes project, and the child seizes some person or object near him for support. These paroxysms occur at uncertain intervals, and between them the child returns to his play, takes his food with good appetite, and exhibits little or no sign of illness. The disease reaches its height at about the end of the fourth week, after which the paroxysms diminish in frequency, and the patient shows signs of improvement. The second stage may last from two to eight weeks, and, if no relapse occur, is succeeded by what may be termed the convalescent stage, the duration of which is very variable.
This is one of those diseases which seldom occur more than once in a lifetime; and hence it probably is that, as few children escape it, it is comparatively rarely noticed in adults. Morbid anatomy has failed to throw any direct light upon its special seat. The proportion of deaths to recoveries has not been satisfactorily determined, but when there is a severe epidemic the mortality due to this disease is often very great, the prospect being worse in the very young and in patients affected with rickets. This mortality is in reality due rather to the bronchitis, pneumonia (or inflammation of the lungs), and convulsions, which are frequent complications of hooping-cough, than to the disease itself.
The treatment of hooping-cough consists in general measures to prevent complications, and in special treatment for shortening the disease and diminishing the violence of the spasms. The child should be kept in the house with the temperature about 60° F., while quiet and the avoidance of excitement must be enforced. The diet should be simple, nutritious, and not too starchy. If the natural vomiting be not sufficient to relieve the chest and stomach of mucus an occasional emetic of ipecacuanha or sulphate of copper must be given. The bowels should be kept moderately open. In the catarrhal stage a simple expectorant is all that is needed, but when the whoop is developed give belladonna in large doses. Alkalies are also useful, and bromide of ammonium if nervous symptoms complicate the spasms. As looping-cough has the characteristics of a germ disease, antiseptic inhalations and sprays seem to offer good ground for hope in shortening the malady. Stimulating liniments such as Roche's Embrocation are useful if the catarrh of the chest is severe, and in the stage of decline alum is of benefit internally. During convalescence nothing is so important as a change of air, while precautions are taken against glandular enlargements by building up the system.