Page:The physical training of children (IA 39002011126464.med.yale.edu).pdf/225

 weeks—sometimes for a much longer period, more especially if proper means are not employed to relieve it.

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, seem almost to start from their sockets; at length there is a sudden inspiration of air through the contracted chink of the upper part of the windpipe—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 occurs, when the same process is repeated, the child during the intervals, in a favorable 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