But although most imprudent for a parent to assume the office of the physician, her aid is essentially necessary in carrying out the measures prescribed.  By her watchfulness and care the duration of the disease may not only be abridged, but, what is of much greater importance, a more serious and aggravated form of disease prevented; for although hooping-cough in itself is not a dangerous disorder, still the most simple and slight case, if neglected or mismanaged, may quickly be converted into one both complicated and dangerous.

Description of the disease.—­Hooping-cough commences with the symptoms of a common cold, which is more or less frequent.  These symptoms continue from five days to fifteen; at the end of which time the cough changes its character, and assumes the convulsive form, which distinguishes the disorder.  It occurs in paroxysms, varying with the severity of the disease from five to six in the twenty-four hours to one every ten or fifteen minutes; being generally more severe and frequent during the night than in the day.

During a paroxysm the expirations are made with such violence, and repeated in such quick succession, that the child cannot breathe, and seems in danger of suffocation.  The face and neck become swollen and purple from suffusion; and the eyes prominent, injected, arid full of tears.  The little one, with a forewarning of the attack, which it dreads, falls on his knees, or clings closely to any thing near him.  The paroxysm terminates with one or two long inspirations, attended with that peculiar noise, or “whoop,” from which the disease has derived its designation.

Sometimes the fit of coughing is interrupted for a minute or two, so that a little rest is obtained; and is then succeeded by another fit of coughing and another hoop, until after a succession of these actions the paroxysm terminates by vomiting, or a discharge of mucus from the lungs, or both.

The disease having continued at its height for two or three weeks, it begins naturally to decline; the paroxysms become less frequent and violent; the expectoration increases; the cough loses its characteristic hoop, and gradually wears away altogether; until at length, in two or three months from the first onset of the disease, the child is restored to perfect health.  Sometimes, however, particularly in the autumn, and at other seasons on the occurrence of easterly winds, the paroxysms of cough will return,—­it will assume its spasmodic character, and be accompanied with the “whoop,” after a month, or even two or three months, of perfect and apparent recovery.  Errors in diet will sometimes alone have a similar effect.

It is a disease which usually occurs during childhood, rarely affects the same individual twice, and is seldom seen in the very young infant.

In reference to the probable result of the disease, when it occurs in its mild and simple form in a healthy child, the termination is usually favourable; but it may at first assume this form, and afterwards become complicated, and consequently more or less dangerous, owing to injudicious management, or to various influences over which the mother has no control.