e breathing. In these cases
the cough is frequent, and so violent that the child becomes livid
during each paroxysm, and that instead of ending in a loud hoop it
finishes by a fit of convulsions or by the child sinking into a state of
semi-insensibility. Increased violence of the cough, with suppression of
the hoop, is always a bad omen in hooping-cough.

On the other hand, when the cough becomes complicated with bronchitis,
it ceases to recur in distinct fits which leave behind them intervals of
comparative, or of absolute ease. The hurried breathing which precedes
and follows a fit of coughing never entirely subsides, while each
returning cough aggravates the irritation and inflammation of the
air-tubes, and the child's condition becomes the very dangerous one of
hooping-cough complicated with bronchitis.

So long as a child seems pretty well in the intervals between the fits
of coughing, as the hurried breathing subsides after each to a natural
frequency, as a long loud hoop follows each cough, as vomiting takes
place only after a fit of coughing and never in the intervals, as the
child becomes flushed only and not livid during a cough, and recovers
itself perfectly afterwards, as it does not complain of constant
headache, nor spits blood, nor has nose-bleeding, nor is feverish, nor
depressed, nor drowsy, you may feel happy about it. When any of the
symptoms just enumerated show themselves you have reason for grave
solicitude, and the child requires daily medical watching.

One word in conclusion. A child who has recently had hooping-cough is
more liable than another to be attacked by chicken-pox or measles; and,
moreover, imperfect recovery from hooping-cough is apt, especially if
there is any tendency to consumption in the family, to be followed by
consumptive disease.

=Asthma.=--_Asthma_, attended by distress of breathing quite as
considerable as in the grown person, is by no means unusual in the
child. Recovery from it is far more likely to take place in the latter,
since it is almost always independent of those diseases of the heart or
lungs, which in the former occasion or aggravate it. It belongs to the
class of what has been termed nervous asthma and is observed with
special frequency in children who, when younger, had been liable to
catarrhal croup; spasm of the air-tubes having taken the place of the
previous spasm of the windpipe. Independently of that antecedent it
comes on sometimes about the time o