The medical diseases of children . great danger of whooping-cough. During any febrilecomplication the whooping usually ceases. Emphysema is common,but is of a mild type only. Occasionally surgical emphysema maydevelop. Acute bronchiolectasis, as described by Dr. Sharkey, issometimes originated by whooping-cough. Haemorrhages are not uncommon, and are usually seen beneaththe conjunctiva (Fig. 48). Epistaxis is also frequent. Serioushaemorrhages are of the utmost rarity. Nervous signs require special mention. Cerebral haemorrhage isextremely rare. Meningeal haemorrhage, so often mentioned in tex
The medical diseases of children . great danger of whooping-cough. During any febrilecomplication the whooping usually ceases. Emphysema is common,but is of a mild type only. Occasionally surgical emphysema maydevelop. Acute bronchiolectasis, as described by Dr. Sharkey, issometimes originated by whooping-cough. Haemorrhages are not uncommon, and are usually seen beneaththe conjunctiva (Fig. 48). Epistaxis is also frequent. Serioushaemorrhages are of the utmost rarity. Nervous signs require special mention. Cerebral haemorrhage isextremely rare. Meningeal haemorrhage, so often mentioned in text-books, is so rare as to be almost outside the range of practical much greater importance are convulsions, and the meningeal 248 INFECTIVE DISEASES signs of rigidity and head-retraction. These may occur suddenlyafter a severe fit of coughing ; and, with the emaciation produced byconstant vomiting, constitute, after the respiratory complications, thegreat source of danger in pertussis. Their cause is obscure, but they. Fig. 48. —Pertussis : Subconjunctival H/Emorriiagf are associated with meningeal cedema, and possibly with paralyticdistention of the right heart consequent upon the paroxvsm ofcoughing. Post mortem the right ventricle is often found dilated,with its wall thinned, and the brain, which is congested, shows well-marked cedema. Although re-covery is general, cases — moreespecially in wasted children —showing no pulmonary affection,and apparently doing well, maydie from these nervous at all frequent they are ofmost serious import. Sequelae.—The tendency of per-tussis to start a tuberculous infec-tion or to light up some quiescentfocus of tuberculosis is well recog-nized. Occasionally, epilepsy maydate from an attack of whooping-cough. The funnel-chest {Fig. 49)and other thoracic deformities mayfollow pertussis. Diagnosis.—During its initialstages this disease cannot be recog-nized unless the child is known to have been exposed to
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatrics, bookyear1
