Quinine is held by many authorities to possess specific bactericida powers in pertussis. Its bitter taste is an insurmountable barrier to it internal administration to children, and the writer has ceased to employ it on this account, except in cases where there is a high temperature, and where the previously mentioned remedies have failed. It tends to dry up the secretion of the bronchial tubes, and in this way it increases the difficulties of expectoration, and hence it should be very cautiously given where there is much bronchial catarrh. The sulphate, muriate, or tannate may be given per rectum in two full daily doses. A child three years old may get 4 or 5 grs. in this way in the 24 hours if the paroxysms are very frequent and severe. These doses appear to diminish reflex Baron gives r grs. for each year of the child's life three times daily. It is most useful in the later stages of the affection. The plan of spraying the nostrils and fauces with a dilute solution of the drug has been already referred to. Euquinine is nearly tasteless, but weaker than the sulphate.
Butler extols Iodised Calcium (2 to 2 grs.), and Rothe uses a solution of Iodised Phenol for internal administration. The following is a modifica tion of his formula: Acidi Carbolici Purif., gr. xv.; Spiritus Chloroformi, Tincturx Belladonnw, litxxx.; Tincturx Iodi M., 111x.; Syrupi et Aquae ad Misce. Fiat mistura. Of this he gives a teaspoonful every two hours to children between 2 and 12 years. Of carbolic acid the dose seems a large one, and of belladonna the amount is too small. There is no doubt that small doses of carbolic acid are useful. r min, of the glycerin may be given every 3 hours to a child 2 or 3 years old. Creosote and Guaiacol are favourite internal remedies with many physicians.
Richardson advocated the administration of Peroxide of Hydrogen in the form of Ozonic Ether as almost a specific for whooping-cough, and Oxygen inhalation is recommended by Weill when the paroxysms are severe, and he maintains that it prevents the advent of broncho-pneu monia.
Yeo advocates a mixture consisting of Benzogte of Soda, 72 grs.; Bicarbonate of Soda, 48 grs.; Chloride of Ammonium, 24 grs.; Chloroform Water, r oz.; Anise Water to 3 oz., of which i to 4 drs., according to age, is given every 4 hours.
Alum, Sulphate and Oxide of Zinc. Chloride and Carbonate of Ammonia, Camphor, Valerian, Asafcetida, Ergot, Grindelia, Indian Hemp, Resorcin, are but a few of the host of internal agents now seldom relied upon. Indeed there is a difficulty in collecting any great number of the older drugs which have not at some time or other been vaunted as specifics for whooping-cough.
Gemmel's specific was OuabaIn—a crystalline glucoside from ouabaio wood allied to strophanthin. When one reflects that its dose is only gr. for infants the danger of prescribing such a potent agent is obvious. Aqua Fluoroform (21- per cent.) is a supposed specific; it apparently is of little use even when given in drachm doses every hour.
Chloroform may be employed to induce light anaesthesia when the paroxysms are very formidable, and Nitrite of Amyl occasionally has been found to cut shorto severe seizure of coughing.
lierguete discords all drugs, and relies upon the efficacy of the hot bath to F.) every 6, 8, or r a hours, and maintains that this not only modifies considerably the severity of the paroxysms, hut that when freely resorted to in the catarrhal stage it may cause the disease to abort.
I hiring the declining stage of the disease with its protracted convales cence the most potent agent for hastening recovery is a change of air. This was fully recognised in the past when children were brought in numbers to the gas-works in order to inhale the odours of sulphuretted lime. The sulphuretted hydrogen may have had some beneficial action since it is a valuable expectorant, and possesses bactericidal properties, hut probably the mere removal from the unhealthy, ill-ventilated sleeping room was the more potent factor.
Various plans are in vogue for carrying out this treatment at home; the inhalation of coal gas and 11,,S is attended with deadly peril, since coal gas is now charged with water gas.
The safest procedure is the method of Sulphurous Acid fumigation, as carried out by Mohn. This consists in removing the patient from his sleeping-room in the morning, after which Sulphur is freely burned in the room (61 drs. per cubic metre of air space), with the door and windows closely shut for at least five hours. After opening all outlets and inlets, ventilating the room till the air can he safely breathed, the patient, with clean linen garments, is to he brought back in the evening and put to bed, and Mohn maintains that he often awakes cured next morning. Certainly, sometimes the paroxysms appear to rapidly diminish after this procedure. Some authorities burn small quantities of sulphur constantly in the sick chamber all through the attack, hut this must be done with great caution owing to the irritating action of the fumes on the bronchial membrane unless so largely diluted with air as to be useless, and this remark applies to Formalin fumigation, which is sometimes substituted for the sulphur process when the room is empty.
Vaccine treatment is still upon its trial, the vaccine heing prepared by cultivating the microbes isolated by Hornet and Gengon, and Fleming reports favourably of this. The treatment of the various complications as broncho-pneumonia or capillary bronchitis, collapse of the pulmonary tissue, &c., must he promptly carried out on the approved principles laid down in the special articles dealing with the treatment of these conditions; Oxygen inhalations may he freely used in all cases in addition to the other remedies indicated.
Convulsions occurring during the disease may be treated by Lumbar Puncture on the recommendation of Eckert, who at the same time gives Chloral I hydrate by the bowel. !hiring convalescence the diet must be most generous. Cod-Liver Oil, Malt Extracts, Syr. Ferri fod. may be given, open-air life should he insisted upon, and the dangers of phthisis or other forms of tuberculosis occurring as :t sequela must he guarded against by every agent which tends to improve nutrition and strengthen the defensive mechanism of the body.