By a proper ventilation of the bedroom at night any increase in the num ber of paroxysmal attacks during the night can always be avoided. The temperature of the room must not be allowed to fall below 52° F. nor to exceed 60°F. The child is to be kept in bed if the course of the disease is very severe and debilitating, and particularly if there are febrile compli cations. During the cool season it is often advisable to warm the night clothes and the bed during the night.
The clothing of the child afflicted with whooping-cough should correspond to the season of the year and not depart therefrom in any direction. The fastening of the clothes must be such that suspenders, braces, strings, bands, or straps do not interfere with the respiratory function and the mechanism of coughing.
It is important to counteract any failure of the nutritive condition by a judicious regulation of the meals, both with regard to their frequency and quantity and quality. All crusted, hard, too strongly tasting or smelling food (which gives rise to paroxysms) must be avoided. Too copious meals easily incite coughing. Frequent small meals are there fore advisable. Many children can readily retain, without fits of cough ing, food of the consistency of gruel or pap, while others do better with more liquid food. This factor must not be left out of consideration. The best time for administering food is after a paroxysm. Medication recommended for the whooping-cough should display either an expec torant influence or an antizymotic or antispasmodic action. With re gard to the mode of application, it may consist of inhalations, insuffla tions, pencilling of the pharynx, nose, or larynx, embrocations, internal remedies, and in physical curative methods.
For inhalation carbolic acid is much used, in a to 2 per cent. solu tion, by means of an inhaling apparatus or by suspending cloths dipped into a 10 per cent. solution; aqua picea, oleum terebinthinfe, lignosul phite, salicylic acid to 2 per cent.), thymol (0.02 per cent.), beuzol, (0.01 per cent.), naphthalin, chloroform (2 to 4 drops in a cup of warm water), formalin (hygeia lamp), cypress oil (according to Soltmann 10 to 15 drops of a 20 per cent. alcoholic solution to be dripped on bed clothes and underwear), etc.
Insufflations of boric acid, benzoin, sodium sozo-iodolate, orthoform, quinine (1 : magn. ust. 10), are on account of their cough-inciting prop erties a two-edged medicament; likewise pencilling with solutions of quinine CIO per cent.), resorcin (2 to 3 per cent.), cocaine (10 to 20 per
cent.), and sublimate (one per cent.) which may be used for older chil dren. Among the external methods of treatment are included inunction with antitussin (difluor de phenyl, a piece of the size of a pea over the skin of the back) and the administration of enemata (quinine).
More frequent and usually more successful is the use of the internal remedies, as an auxiliary of which sometimes one or the other of the ..bove methods is employed. The transitory success of the medicaments recommended is often observed and makes a repeated change of the prescription advisable, but none of these insures any safe and lasting benefit.
In the catarrhal stage mild expectorants bring relief—liquor am mon. anisat., senega, ipecacuanha, etc.; when the cough is more intense, such antispasmodics as are customary for childhood (as althorn, bella donna, and very small doses of codeine or morphine). In the paroxys mal stage we may select one or the other of the antizymotics and nar cotics.
A favorite remedy, in use for a long time, is quinine and its deri vates: quinine [sulphate of quinine 0.05 to 0.07 Gm. (1 gr.) for children below one year; 0.07 to 0.15 Gm. (1-2 gr.) for the second and third years; 0.15 to 0.25 Gin. (2-3 gr.) for the fourth year and above, one powder three times daily]; euquinine [tasteless, 0.1 t.o 0.5 Gm. (1-7/ gr.) three times daily]; aristochin [three times daily as many decigrams as the child is years, maximum daily dose 1.2 Gm. (1S gr.)]. The quinine preparations are best given in full doses for three days, after which in half doses for six days, and then discontinued for a few days. They may also be administered in suppositories, to spare the stomach.
Among remedies having an action similar to that of quinine, but a more distinct one on the nervous system and the heart, and favorably influencing the number of 'paroxysms, may be mentioned: antipyrin, tussol [amygdalate of antipyrin, 0.05 to 0.5 Gm. (1-7/ gr.) three times daily], citrophen, salipyrin, antispasmin (1.0 : aqu. amygdal. dulc. 10.0, three to four times daily 5 to 20 drops), pertussin (3 to 4 teaspoonfuls a day) coclussin (10 to 25 drops several times a day). The antispasmodics are frequently used as whooping-cough remedies, among which bella donna and its derivates are the most prominent.