e. This agent is thought
to reside in the sputum and the secretions of the nose and air passages of
the patient. It is very contagious at the height of the attack. The sputum
of the first or catarrhal stage is thought to be highly contagious. The
sputum in the stage of decline is also thought to be capable of carrying
the disease. It prevails in all countries and climates. During the winter
and spring months it is most frequent. At times it prevails as an
epidemic. It occurs most frequently in infancy and childhood, but a person
can take it at any age. Second attacks are rare. It is most frequent
between the first and second year; next most frequent between the sixth
and twelfth month. After the fifth year the frequency diminishes up to the
tenth year, after which the disease is very infrequent. Not everyone who
is exposed contracts the disease. It seems that whooping-cough, measles,
and influenza frequently follow one another in epidemic form. This is one
of the diseases much dreaded by parents. It is very tedious and endangers
the life of weak and young children by exhaustion. It is a terrible thing
to watch one with this disease, day in and day out. It can be known by the
impetuous, continuous and frequent coughing spells, following each other
rapidly until the patient is out of breath, with a tendency to end in
vomiting. When it comes in the fall or winter months there will likely be
spasmodic coughing until summer through the usual colds contracted. Summer
is the best time to have it.

Symptoms.--There is an incubation stage, but it is hard to determine its
length. After the appearance of the symptoms there are three stages; the
catarrhal, the spasmodic, and the stage of decline.

The First Stage.--This is characterized by a cough which is more
troublesome at night. One can be suspicious, when instead of getting
better in a few days, it gets worse and more frequent, without any seeming
cause. After four or five days the cough may be accompanied by vomiting,
especially if the cough occurs after eating. There may be some bronchitis,
and if so there will be one or more degrees of fever. Fever is present as
a rule, only during the first few days, unless there is bronchitis. As the
case passes into the spasmodic or second stage, the paroxysms of coughing
last longer, the child becomes red in the face and spits up a larger
amount of mucus than in ordinary bronchitis. This period of the cough
without a whoop, may last fro