he to
guard? Lest other disease insidiously come on, and advance to an
irremediable degree, masked by the cough, without attracting her
attention. This is the great source of danger in hooping-cough. The
physician, in a case of simple hooping-cough, is not in daily
attendance upon his patient, and therefore not present to notice the
commencement or first symptoms of those diseases which so frequently
occur at this time, and the successful treatment of which will mainly
depend upon their early detection, and the decision with which they are
treated. When you hear of a child or several children in a family dying
of hooping-cough, it is not this disease which proves fatal; but death
is caused by some disease of lungs or brain, which has been super-added
to the hooping-cough. The progress of hooping-cough, then, must be
closely attended to by the parent, even in the most favourable cases.

The most frequent complication with hooping-cough is inflammation of
the air-tubes of the lungs. This is extremely frequent during spring
and winter, especially in the months of February, March, and April,
owing to the prevalence of easterly winds at this season. It is not my
intention to detail the symptoms of this affection, only to point out
those which will enable a parent to recognise its approach. A parent
then may take warning, and fear the approach of mischief, when she
observes the fits of coughing become more frequent and more distressing
to the child, and the breathing hurried in the intervals of the
paroxysm; when any exertion or speaking causes increased difficulty of
breathing or panting; when the expectoration becomes less abundant, and
difficult to get up; when there is no longer, or at all events less
frequent, vomiting after the cough, and more or less febrile symptoms
present.

If the lungs themselves are attacked by inflammation, most of the
symptoms already pointed out will occur; the cough will be frequent,
in short paroxysms; the vomiting will not take place; the breathing
will be very quick and hurried; and as the disease advances the hoop
will cease.

If hooping-cough attack a child whilst teething, or from six months to
two or three years of age, it is very common for the brain to suffer,
and convulsions and water on the head to occur, particularly if the
latter disease prevails in the family. Whenever the paroxysm of cough
is increased in violence, the characteristic hoop disappearing, and the
face becomes v