Contagious Diseases - New Methods Of Treatment Used For Whooping Cough
( Originally Published 1936 )
The old-fashioned treatment of whooping cough was largely aimed at symptoms, and was designed to help the child during the paroxysm of coughing and to reduce the number of these paroxysms.
Two methods in the treatment of whooping cough which are new are along this line. One is the carbon dioxide treatment. The other is the use of ether in oil. Both are aimed at reducing the irritability of the nervous system and lowering the number and duration of the coughing spells.
The use of carbon dioxide has been popularized by Professor Yandell Henderson of Yale University. After numerous experiments with this gas, Dr. Henderson concluded that it had a marked effect upon the respiratory center in the central nervous system. In whooping cough it is used several times a day, for 10 or 15 minutes at a time, and the treatment is said to reduce the number of paroxysms. The only disadvantage is that it means the introduction of an apparatus in the home. This, besides being expensive, may frighten the child and do more harm than good.
The use of ether in oil has received enthusiastic support from many physicians. A small amount of oil, about a teaspoonful and a half, in which ether has been dissolved, is introduced into the bowel by an enema tube. In children one year and under, 25 per cent of ether is used; in older children, 50 per cent. In larger amounts and stronger doses, ether has been used in this way for many years for purposes of general anaesthesia in surgical operations and to induce twilight sleep. In whooping cough it quiets the nervous centers and prevents unnecessary paroxysms of coughing which tend to occur when the nerve centers have become irritable from long continuance of the accumulation of secretions in the throat.
Other new methods of treatment for whooping cough which have been reported are designed to shorten the course of the disease. The use of x-rays brings about a rapid and distinct change, and often complete recovery in a few days. The first symptom to yield is the vomiting. The night after the first treatment the child usually sleeps well, the attacks of coughing become shorter and less intense within 24 hours. The amount of x-ray used is, of course, small, and two applications are usually sufficient.
The vaccine treatment of whooping cough is still considerably used, although the late reports seem to indicate that it is extremely irregular in its operations. Perhaps it may be said that about 60 per cent of the patients are benefited and the rest are not affected one way or the other. The vaccines do not appear to do any harm.
DANGERS OF WHOOPING COUGH AND How INFECTION SPREADS
Parents are likely to regard whooping cough as a minor and harmless malady.
It is, on the contrary, one of the most dangerous infections of childhood. It is particularly likely to affect the youngest member of the family. Many cases occur in infants of six months or less. Its death rate is by no means low.
Whooping cough is spread by coughing, sneezing, etc. The causative germ which has been identified is in the secretions of the nose and throat and may be present in the early stages before the whoop has developed.
Any child with a cold, who is sneezing or coughing, should be kept away from other children. Parents should not caress a sick child indiscriminately, as the germ may be spread by the parents' kissing first the sick child and then a child who is uninfected. It is well to keep children away from other children in the neighborhood who have coughs and colds, for the same reason.
Any cold that hangs on in a child, and which is characterized by severe coughing, should be suspected. The characteristic whoop may not occur for several weeks.
When fully developed, the disease is unmistakable. The whoop is simply a long inspiratory crow, due to the fact that the child has coughed until all the breath is out of its body so that when it begins to breathe in again the larynx is in spasm and the child has to suck the air past the closed larynx. This creates a characteristic crowing sound.
The first stage of whooping cough—the catarrhal stage—lasts about two weeks. At this time it is almost universally regarded as a bad cold. The first suspicion should come when the cough gets worse instead of better during the second week. Then, it will be noticed, that the cough is worse at night and that after a prolonged spell of coughing the child will vomit. This vomiting is due simply to gagging and not because the child is nauseated. The vomiting, however, is a serious detriment to health, as it may cause grave nutritional disturbance. So true is this that these children should be fed after each vomiting spell in order to keep their nutrition at par.
Whooping cough is likely to last a long time. From six weeks to three months. This is one of the dangers of the disease, as the long course leads to exhaustion and lowered nutrition.
The most serious complication of the disease is bronchial pneumonia, which is caused by an extension of the infection in the bronchial tubes to the lung tissue itself.