ms aside from the whoop are the difficulty
of taking breath and the great prostration after the paroxysm and the
frequent vomiting of the food, brought on by the violent coughing.

In very young infants the whoop does not always occur. But the child
coughs and holds its breath until it is blue in the face. At times
young babies may have convulsions. The so-called spasmodic stage,
during which the child may have from a few to a great number of
paroxysms of coughing a day, lasts from a month to six weeks, and in
some cases even longer. As the disease declines the cough gradually
disappears and the child appears to be suffering with ordinary
bronchitis. The characteristic whoop may return at any time during the
ensuing six months or year if the child has an attack of bronchitis
and is inclined to cough.

~Complications and After-effects.~--The complications and
after-effects of whooping cough give it a serious character.
Hemorrhage may occur from the nose. According to Ruhraeh: "Paralysis
may follow from meningeal hemorrhage, broncho-pneumonia, acute
emphysema, and collapse of the lung may occur. Diarrhea, convulsions,
and albuminuria are also met with. Tuberculosis and chronic bronchitis
may follow."[90]

~Dietetic Treatment.~--The diet plays an important part in whooping
cough. The serious complications and after-effects of this disease
upon children necessitate a rigid observance of dietary laws. With
infants it is always best, when it is possible, to give breast milk.
As this is the natural food it requires less effort on the part of the
digestive apparatus to become available. It has been proved that even
during the time when the baby is nursing the milk is projected in
spurts into the duodenum without waiting to be attacked by digestive
enzymes in the stomach, and for this reason the breast-fed infant is
more apt to be efficiently nourished than the artificially fed baby,
who loses his dinner by vomiting before absorption has had a chance to
occur.

~Diet under Ten Years of Age.~--For children under ten years, a fluid
diet is necessary, at least in the beginning of the disease while
there is a fever, and later, if the vomiting is persistent. Milk,
buttermilk, koumiss, broths, albuminized beverages, and cereal gruels
such as barley and oatmeal gruel and arrowroot gruel can be given.
Later, if the fluids are retained, cream of wheat, farina, junket,
soft custards, and soft-cooked eggs may be added. Care must be ta