of telling that whooping-cough is present until
the child whoops. Most children do not whoop until the expiration of the
catarrhal stage, though a very few do from the beginning of the disease.
If a child is treated for an ordinary cold with cough and does not
respond to treatment, and whooping-cough is epidemic, it is fair to
assume that whooping-cough has been contracted. When the cough shows a
distinct tendency to be worse at night it is further proof of this
assumption.

When they begin to cough in paroxysms, and whoop, the second, or
spasmodic stage begins. These fits of paroxysmal coughing are much more
severe than spells of ordinary coughing. These may only be three or four
attacks daily, or the child may have from forty to fifty such attacks.
When children feel these attacks coming on they seek support, holding on
to chairs or they stand by the mother's knee. The coughing is explosive,
rapid, and forceful, the child fails to catch its breath and is
compelled to take a deep inspiration, which is the whoop; it then goes
on coughing more. The face may become purple, the eyes protrude, and the
veins of the face swell up. Near the end of the attack the child raises,
or vomits a mass of stringy, glutinous mucus. After it is over the child
is exhausted, there is a more or less profuse perspiration, and he may
be quite dazed. These attacks are, as a rule, more frequent and more
severe during the night. This stage lasts about one month and is then
followed by the stage of decline, during which the disease subsides into
what appears as an ordinary bronchial cold.

It is quite common for these children to get relapses, especially during
inclement winter weather, and go on whooping for two or three months
longer. Their vitality suffers because their sleep and nourishment is
interfered with, and they become nervous and difficult to manage.

Treatment.--Inasmuch as there is no remedy known that will cure
whooping-cough, the best we can do is to render the patient physically
efficient to stand the severe strain of coughing, which is the worst
feature of the disease. Experience has taught us that those children do
best who spend their entire time out of doors. We, therefore, advise
parents to encourage their children to play in the open air. There is no
exception to this rule, even in winter weather, unless it is
particularly inclement. If the weather is wet or raw, or if the child
has bronchitis, or is running a fever, it w