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Question:—How can I tell that my child has not Whooping
Cough?
Answer:—The answer is that you cannot, and the answer is that a
doctor cannot, apart from what may be a very prolonged examination.
This examination may include waiting with a plate of specially prepared
jelly and often-times waiting and waiting until the child coughs in a
particular way. The plate is then held in front of the child's mouth,
and if you get a certain growth on the plate then you can say this child has
Whooping Cough.
Now although I believe in being painfully frank in these my remarks,
I do not wish it to be thought that we cannot come to a very shrewd
opinion without the necessity of going through what can only be a very
long study of an individual case—a study which takes up so much time
that it is impracticable to use it in a large number of cases.
What we want to remember is that it is not every child who whoops
who has Whooping Cough, and it is not every child who does not whoop
who has not got Whooping Cough. In coming to a shrewd opinion it is
the nature of the cough which indicates whether the child has, or has not,
Whooping Cough.
Once heard, the type of cough is never forgotten, and you can stand
in one ward and make the shrewd diagnosis of a child in another ward if
you happen to hear the child cough. If you are musically inclined I can
explain this in two or three words—the cough is a crescendo. If you
are not musically inclined, let me explain this in a little further detail.
The cough starts with a little cough at the back of the throat as though the
child has a tickling at the back of the throat; it then increases and
increases and increases in violence so that the child is breathing out more
than he is breathing in, with the result that he has lost more air from the
lungs than is normal, and just when the child is trying to breathe in he
coughs again—making it impossible to do so. The child goes red in the
face; purple in the face, and fortunately in—of course—the vast majority
of instances, the cough does stop and the child takes in one deep
breath. It is this (which may be spoken of as "forced inspiration,"
although it is not a good term) which can—and in so many cases does—
lead to the whoop for which Whooping Cough is so named.
Question:—What is the risk of my child suffering from
Infantile Paralysis?
Answer:—The risk in Barking last year, as well as the average for
the last five years, was less than one in two thousand.
One thing is quite clear, however, and that is we are going to get
an apparent increase in the cases of Infantile Paralysis or, as I prefer to
call it, Anterior Poliomyelitis.
It is now commonly known that Infantile Paralysis is a very bad
name for the disease ; firstly because it is by no means confined to infants
and, secondly, because not all the cases—by any manner of means—show
paralysis.
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