m five to twelve days. In some cases there is
never a whoop. The child has a severe spasmodic cough, followed by
vomiting. Usually at the close of this stage the incessant cough causes
slight puffiness of the eyelids and slight bloating of the face.

[182 MOTHERS' REMEDIES]

Spasmodic or Second Stage.--The peculiar whoop is now present. The cough
is spasmodic. The child has distinct paroxysms of coughing which begin
with an inspiration (in-breathing) followed by several expulsive,
explosive coughs, after which there is a deep, long-drawn inspiration
which is characterized by a loud crowing called the "whoop." This paroxysm
may be followed by a number of similar ones. When the paroxysm is coming
on the face assumes an anxious expression, and the child runs to the
nearest person or to some article of furniture and grasps him or it with
both hands. It is so severe sometimes that the child will fall or claw the
air, convulsively. In the severest and most dangerous types, a convulsion
may come on in a moderate degree, the face is red or livid, the eyes bulge
and when the paroxysm ends a quantity of sticky tenacious mucus is spit
up. In other cases there is vomiting at the end of the paroxysm. There is
frequently nose-bleed. In the intervals the face is pale or bluish,
eyelids are puffy and face swollen. There is little bronchitis at this
period in the majority of cases. In some cases the number of paroxysms may
be few. There are generally quite a number during the twenty-four hours.

Stage of the Decline.--In this stage the number and severity or the
paroxysms lessen. They may subside suddenly or gradually after four to
twelve weeks. The whoop may reappear at times. The cough may persist, more
or less, for weeks after the whoop is entirely gone.

Complications.--Bronchitis is common, it may be mild or severe. It may run
into capillary bronchitis and this is dangerous.

Diagnosis.--Continued cough, getting worse and spasmodic, worse at night,
livid face when coughing, causes great suspicion as to its being
whooping-cough. The whoop will confirm it.

Mortality is quoted as twenty-five per cent during the first year. Between
first and fifth year about five per cent, from fifth to tenth year about
one per cent. Rickets, or wasting disease (marasmus) and poor hygienic
surroundings makes the outlook less favorable.

MOTHERS' REMEDIES. 1. Whooping-Cough, Chestnut Leaves for.--"Steep
chestnut leaves, strain, add sugar accordin