RECENT VIEWS REGARDING 
THE 
PATHOLOGY AND TREATMENT OF PERTUSSIS. 
KY 
EDMUND C. WENDT, M.D., 
VISITING PHYSICIAN ST JOSEPH'S ASYLUM, CURATOR AND PATHOLOGIST OF 
THE ST. FRANCIS HOSPITAL AND THE NEW YORK INFANT ASYLUM, ETC. 
FROM 
THE MEDICAL N£WS, 
June 2, 1888. [Reprinted from The Medical News, June 2, 1888.] 
RECENT VIEWS REGARDING THE PATHOLOGY 
AND TREATMENT OF PERTUSSIS.1 
VISITING PHYSICIAN ST. JOSEPH'S ASYLUM, CURATOR AND PATHOLOGIST OF 
THE ST. FRANCIS HOSPITAL AND THE NEW YORK INFANT ASYLUM, ETC. 
By EDMUND C. WENDT, M.D., 
The present era is one of important and far-reach- 
ing change in medical opinion, more particularly as 
regards the essential nature of many of the most 
prevalent maladies. It is not at all surprising, 
therefore, to find recent views concerning pertussis 
differing materially from those which were accepted 
ten, or even five, years ago. With the advent of 
new ideas on pathology, new methods of treatment 
have naturally arisen. The purpose of this paper is 
to give a brief account of the more important views 
recently enunciated concerning the pathology and 
treatment of pertussis. The inquiry will also be 
pertinent, whether we have made any true progress 
in these directions, or whether we have to do merely 
with the rising tide of popular innovation. 
In the first place, then, What is the nature of per- 
tussis ? 
1 Read before the New York Academy of Medicine, Section on 
Paediatrics, April 25, 1888. 2 
WENDT, 
The drift of modern research runs almost exclu- 
sively in one direction, namely, that of regarding 
whooping-cough as a disease due to the invasion of 
microorganisms. 
But while most modern observers are ready to 
admit the parasitic origin of the affection, consider- 
able differences of opinion obtain regarding the 
particular kind of organism supposed to be specific, 
as well as the precise point of its location within the 
body. 
As long ago as 1870, Letzerich1 described a micro- 
organism alleged to be present in the sputum, and 
on the mucous membrane of the respiratory organs 
of patients having pertussis. His observations were 
soon confirmed by some writers, but others disputed 
his claims. The most recent researches have resulted 
in showing that the organisms of Letzerich are harm- 
less saprophytes, and not the pathogenic microbes 
of pertussis. 
The organism discovered by Tschamer2 is identical 
with the fungus known as capnodium citri, which is 
found on orange-peel and apples. It is certainly not 
the specific microbe of pertussis. 
Deichler,3 of Frankfort, has also discovered an 
organism in this disease. And, strangely enough, 
it is not a minute plant, but an animal belonging to 
the protozoa. This author makes the rather guarded 
statement that, while the animalcule in question 
1 Virchow’s Archiv, vol. xlix. 
2 Deutsche med. Wochenschrift, April 7, 1887, and Jahrbuch 
fiir Kinderheilkunde, vol. x. 
3 Deutsche medizinal Zeitung, No. 37, 1886. TREATMENT OF PERTUSSIS. 
3 
occurs only in pertussis, and evidently has some 
pathogenic significance, it may not be the sole ex- 
citing cause of the disease. It will strike the reader 
that a more modest microorganism has not of late 
years been discovered on German soil, a circum- 
stance which probably accounts for the contempt in 
which it appears to be held by those German writers 
who take the trouble to mention it at all. 
Henke1 has described small round cells, which he 
found in the sputum, and which he supposed to be 
peculiar to pertussis. From his description, how- 
ever, it is clear that they were merely lymph cor- 
puscles, showing in their interior the well-known 
phenomenon of molecular movement. 
Poulet’s'2 monas termo and bacteriiwi termo have 
nothing to do with pertussis, and the Frenchman’s 
claims in an opposite direction cannot be upheld. 
In 1883, Burger3 found a small rod-shaped organ- 
ism in the sputum of patients having pertussis. He 
regards it as the exciting cause of the disease. But 
the methods employed by Burger are not above 
criticism, and Koch has refused to accept his argu- 
ments as convincing.4 Cultures and inoculation 
experiments were not made by Burger. From his 
description it is apparent that he did not see the 
bacillus of Afanasieff, presently to be considered. 
All these observations (as well as a number of 
others that need not be mentioned here) were unde- 
1 Deutsches Archiv furklin. Med., vol. xii. p. 630. 
* Comptes Rendus de l’Acad. des Sciences. 
3 Berliner klin. Wochenschrift, No. 1, 1883. 
* Fortschritte der Medicin., vol. i. p. 108. 4 
WENDT, 
niably prompted by the a priori consideration that 
pertussis ought to be due to the presence of a micro- 
organism. Indeed, not a few authors have taken the 
ground that while we might not yet know all about 
the presumed microbe, treatment, in order to be 
rational and effectual, must be chiefly of the anti- 
parasitic kind. 
So long as ten years ago Hagenbach1 maintained 
that whooping-cough was a catarrhal affection of the 
mucous membrane of the respiratory tract, associated 
with the invasion of fungi. According to this 
author, the characteristic paroxysms of cough are 
due to reflex action, starting from irritation of the 
terminal filaments of the superior laryngeal nerve. 
Widerhofer2 describes whooping-cough as a broncho- 
mycosis. 
Baginsky3 places the disease among the constitu- 
tional infectious maladies. But by calling it an 
infectious catarrh of the mucous membrane of the 
respiratory passages, he admits that it may just as well 
be classed with the “local contagious” maladies. 
Michael,4 of Hamburg, following the suggestions 
of Hack, Schadewald, Sommerbrodt, Wille, and 
others, asserts that the disease is due to reflex dis- 
turbances, caused by the presence of microbes in the 
mucous membrane of the nose. This has led to the 
nasal treatment of the malady, a method which has 
found many followers. 
1 Gerhardt’s Handbuch der Kinderkrankheiten, vol. ii. p. 551. 
i Allgemeine Wiener med. Zeitung, August 10, 1886. 
3 Lehrbuch der Kinderkrankheiten, 1883. 
* Deutsche med. Wochenschrift, No. 5. 1886. TREATMENT OF PERTUSSIS. 
5 
The discussion on whooping-cough, which oc- 
curred last year at the German Congress of Internal 
Medicine,1 was an interesting debate on a very 
debatable subject. Vogel, Hagenbach, Michael, 
Heubner, Prior, Schliep, Sonnenberger, Binz, and 
Cohen, were the principal speakers. As already 
pointed out, the drift of opinion was in the direction 
of assuming the parasitic origin of the disease. No 
noteworthy discovery was announced, however, and 
as for treatment, there were about as many different 
opinions as there were participants in the discussion. 
We come finally to the most recent pathological 
announcement, that of Afanasieff, which appeared 
in four successive numbers of the St. Petersburger 
medicinische Wochenschrift, in October, 1887. Bor- 
rowing the language of the Lancet (modified in a 
few particulars), this author 
“ has succeeded in finding and cultivating what he 
believes to be the true bacillus of whooping-cough. 
This microbe differs distinctly from all other bacteria 
which have been described (Fig. 1). It is somewhat 
like Friedlander’s pneumonia bacillus, but is shorter 
and thinner than the latter; besides, in gelatine it 
does not form nail-shaped cultures, those which are 
produced having no hemispherical head. Its potato 
cultures, too, are quite different from those obtained 
from Friedlander’s bacillus. Afanasieff’s bacillus 
exhibits a remarkable degree of vitality, for jelly 
cultures that have become dry and have been kept 
for four months, appearing under the microscope to 
be more or less destroyed, are still capable of produc- 
1 Deutsche medizinal Zeitung, May 2, 1887. 6 
W ENDT, 
Sputum from a case of pertussis. P, pus corpuscle containing the specific bacilli; N, nuclei from broken- 
down corpuscles; B, group of bacilli. (The ordinary atmospheric bacteria, often found in the sputum, have 
been omitted from this drawing.) 
Fiu. i. TREATMENT OF PERTUSSIS. 
7 
ing fresh cultures when fresh media are inoculated 
from the dried mass. Dr. Afanasieff’s researches 
were chiefly made from the sputum of some of his 
own children, who were affected with whooping- 
cough. The mouth was well washed out with a per- 
manganate of potash solution, and the mucus coughed 
up after the next paroxysm or two examined. In 
this mucus, after staining with methyl-violet, and 
occasionally in the pus-corpuscles contained in it, 
the bacilli could be seen with a magnifying power 
of from 700 to 1000 (Zeiss’s eye-piece 3 or 4, y oil 
immersion objective) as short rods (Figs. 2 and 3), 
Fig. 2. 
Fig. 3 
Pure culture of the bacillus 
pertussis on agar-agar, twenty- 
three days old. (After Afana- 
sieff.) 
Pure culture of the bacillus 
pertussis on potato eleven days 
old. (After Afanasieff.) 
sometime single, sometime in twos, or even in short 
chains running in the direction of the mucus, some- 
times again in small clusters. Their length was from 
to 2.2ii. Other bacteria were also found. But 
they were numerically insignificant, as compared 
with the bacilli under consideration. 8 
WENDT, 
Pure cultures were easily made on agar-agar, meat- 
peptone jelly, potato, etc. Dogs and rabbits were 
inoculated with a fluid culture mixed with chloride 
of sodium solution, some by means of injections into 
the trachea, others by direct injections into the 
lungs. All the animals were seriously affected, 
and many of them died. The symptoms were some- 
Fig. 4. 
Specimen taken from a patch of broncho-pneumonia artificially 
induced in a rabbit. K, pus corpuscle; B, bacilli pertussis. (After 
Afanasieff.) 
what similar to those of whooping-cough, including 
cough, dyspnoea, and redness of the eyes. Many of 
the cases were complicated by broncho-pneumonia. 
On examining the bodies of those animals which 
died, the mucous membrane of the air-passages was 
found much reddened, and coated with a tenacious 
clear mucus, in which, as well as in the pneumonic 
patches in the lungs, the bacilli were found (Fig. 4). 
Similar appearances and the same bacilli were ob- TREATMENT OF PERTUSSIS. 
9 
served in the bodies of children who had died from 
whooping-cough.’ ’ 
In my opinion the bacteriological researches of 
this Russian observer are far more important and 
convincing than any hitherto undertaken.1 
The discovery of Afanasieff has been confirmed by 
a Russian observer, Semchenko. His papers were 
published in the Vrach, and the Lancet of January 
7, 1888, mentions his views as follows: 
“ Dr. Semchenko, having investigated the whoop- 
ing-cough bacteria described by Professor Afanasieff, 
has satisfied himself that they are the true specific 
cause of the affection. They appear in the sputum 
on the fourth day of the disease, if not still earlier. 
They go on developing in the tissues of the body, 
and simultaneously with their multiplication the 
severity of the disease increases. The bacteria dis- 
appear before the paroxysms of whooping-cough 
have ceased, generally when these have been reduced 
to from two to four in the twenty-four hours. When 
complications, such as catarrhal pneumonia, arise, 
they are accompanied by a great increase in the 
number of whooping-cough bacilli found in the 
sputum, the pneumonia developed under these cir- 
cumstances having, according to Dr. Semchenko, 
several points of difference from ordinary attacks of 
1 If I may be permitted a personal remark in this place, it is 
that I know the author to be a most careful, painstaking, and con- 
scientious observer. Twelve years ago while we were studying 
together at Strasburg, under the supervision of Waldeyer and v. 
Recklinghausen, I had ample opportunities to admire the excel- 
lence of all his laboratory work. Afanasieff is the author of nume- 
rous contributions to histology and pathology, that have always 
been favorably received by recognized authorities. 10 
WENDT, 
catarrhal pneumonia. The examination of the spu- 
tum of whooping cough patients is apparently useful, 
not only for diagnostic purposes, but also as a guide 
to the prognosis of the course of the disease.” 
My own experience with the bacillus described by 
Afanasieff permits me to state that it is probably 
always present in pertussis. In the few cases in 
which I failed to find it, the method of obtaining 
the sputum was very likely at fault. I am unable, 
however, to confirm the assertion of Afanasieff, that 
the small pellet of mucus which is coughed up at 
the end of a paroxysm contains the pertussis bacilli 
in almost pure culture. I have invariably found 
other varieties of bacteria (such as commonly occur 
in the sputum of bronchitis) along with those of 
whooping-cough. 
Moreover, it has not been my fortune to be able 
to demonstrate the bacillus pertussis, except in those 
cases where the clinical features of the disease were 
already so well marked, that a microscopical con- 
firmation was not needed. Hence, I cannot agree 
with Semchenko in ascribing any great diagnostic 
significance to the discovery of these bacilli in a 
given case. 
I had occasion to examine the sputum from a few 
cases of suspicious cough, that later developed into 
characteristic pertussis, but in none of them could I 
find the bacillus of Afanasieff, during that early 
stage. 
Again, in two cases that were on the high-road 
to recovery I still found as many bacilli as during TREATMENT OF PERTUSSIS. 
11 
the height of the disease. In this respect also, my 
own observations are at variance with those reported 
by Semchenko. 
I, nevertheless, have no doubt concerning the 
etiological significance of Afanasieff’s discovery. 
But what practical benefit will result therefrom to 
the practitioner of medicine remains to be seen. 
We certainly require no bacillus for diagnostic pur- 
poses. And in cases which are as yet doubtful, the 
bacillus is not found. At least such has been my 
rather limited experience. 
Before closing this short account of recent patho- 
logical views on whooping-cough, mention should 
be made of the observations of v. Herfif,1 which are 
not without interest. This author, while suffering 
from pertussis, studied the appearance of his own 
larynx. According to him, there exists, during the 
entire course of the malady, a moderate amount of 
inflammation of the mucous membrane of the respira- 
tory organs, from the posterior nares down to the 
bifurcation of the trachea. At the outset of the dis- 
ease, this inflammation is but a mild catarrhal one. 
It gradually increases in severity, and again abates 
during the period of defervescence. In his own 
case, the inflammatory action was quite intense at the 
arytenoid cartilages and those of Wrisberg and San- 
torini. But the posterior wall of the larynx between 
the vocal cords, and the under surface of the epi- 
glottis, were most severely affected. The vocal cords 
themselves appeared intact. 
1 Deutsches Archiv f. klin. Medizin.vol. xxxix. 12 
WENDT 
During the paroxysms, v. Herff claims to have 
seen a small pellet of mucus on the posterior aspect 
of the larynx, and on a level with the vocal cords. 
On removing this pellet the paroxysm came to an 
end at once. Irritation of this part of the larynx 
induced an attack. But a paroxysm was not pro- 
duced by irritating other parts of the larynx. The 
author maintains, therefore, that this inflammatory 
action in the interarytenoid space is responsible 
for the spasmodic attacks characterizing pertussis. 
About the probable lodgement of microbes at this 
point he is strangely silent for a modern observer. 
On examining the modern therapy of pertussis, 
we shall find that, in addition to the countless old 
remedies, almost every new drug has been tried. 
That the curability of an affection varies inversely 
in proportion to the number of remedies employed 
in its treatment is a trite experience. Judged by 
this rule, whooping-cough must still be regarded as 
a very intractable malady. 
For obvious reasons, no attempt will be made, in 
this place, even to mention all the drugs that have 
been tried and recommended in pertussis, let alone 
discuss their merits. 
Whatever is regarded by physicians as the essential 
something of the disease, that they have proceeded 
to attack. Those who look upon the infectious ele- 
ment as the chief factor of the disorder, naturally 
chose, and still choose other means of treatment 
than those who consider the respiratory catarrh as 
most important, or than those who hold that the 
morbidly heightened nervous irritability is chiefly TREATMENT OF PERTUSSIS. 
13 
responsible for the trouble. Those, finally, who 
believe in the parasitic origin of pertussis have 
recourse to one or another of the various antiseptics 
or parasiticides. Mention has already been made of 
the nasalists, who direct all their efforts against the 
offending mucous membrane of the nose. They 
employ for this purpose sprays and insufflations of 
various antiseptics and sedatives. This treatment is 
said to prove very successful. In an editorial notice 
touching the nasal treatment of pertussis, the Lancet 
of January 15, 1887, says, “It is doubtful whether 
the theory of this fashionable method is correct; 
but, supposing it should be, it is equally dubious 
whether the good that results may not be from the 
mere treatment of catarrh as such, apart from its 
supposed cause.” I fully concur in this view of the 
alleged success attending this method of treatment 
in whooping-cough. 
It was at first proposed to place the various reme- 
dies in groups, a plan which has been followed by 
Cheron.1 But the groups soon grew to such formid- 
able proportions that the limits of this paper would 
have been unnecessarily extended, had that idea been 
carried out. I have preferred, for this reason, to 
examine only a few methods of treatment, and to 
present for consideration my personal views as to 
what constitutes rational therapy in the present state 
of our knowledge. 
To begin with, whether we accept the parasitic 
doctrine of the disease or not, I believe that the 
1 L’Union M6dicale, October 18 and 20, 1887. 14 
WENDT, 
policy of absolute non-interference, still persistently 
advocated in some quarters, should be emphatically 
condemned. If we cannot attack the affection at 
its roots, something can surely be done to mitigate 
its severity and to reduce the frequency of complica- 
tions. There is probably not one among us who 
has not witnessed the sad plight that neglected cases 
will sometimes fall into. I would ask -whether the 
large mortality still ascribed to pertussis is not, in a 
great measure, due to irrational medication rather 
than, as some maintain, to over-treatment? 
It goes without saying that proper alimentation and 
the best hygienic conditions attainable, will always 
contribute toward the success of any plan of treat- 
ment. How difficult of accomplishment these 
measures are among the poor and shiftless, is only 
too wgll known. But, even among the better classes, 
the necessity of pure light, of fresh air, and of proper 
food, furnishes a text for almost daily preaching. 
I am a firm believer also, in the propriety, or 
rather the necessity, of employing every possible 
means of protection for the unaffected members of a 
family. The time is surely past when the profession 
can countenance the opposite custom of encouraging 
the contagious diseases of childhood to affect as 
many members of one family at a time as possible. 
The mother maybe anxious “to be done” with a 
particular disease for her offspring. But I conceive 
it to be our duty to oppose energetically all such 
dangerous nonsense, even at the risk of incurring 
the wrath of some wiseacre guardian of the nursery. 
As to particular drugs in the management of TREATMENT OF PERTUSSIS. 
15 
pertussis, I believe that individual preferences in 
respect are often the result of accidental causes. 
We certainly possess no specific for pertussis. It is 
to be remembered that there are seasonal and other 
variations in the intensity of the disease. If we 
accept the bacterial origin of pertussis, this varying 
degree of severity would depend upon the degree of 
infection. Some such explanation certainly appears 
necessary, in view of the fact that equally honest 
observers do not obtain equally good results from 
the same drugs. 
Turning now to medicines, we find that narcotics 
and sedatives are as largely employed as ever. 
Many new combinations have indeed been put for- 
ward, but it does not appear that special virtues 
belong to any particular drug. 
Vetlesen1 has warmly advocated the use of bella- 
donna combined with cannabis indica. He tells us 
that in 116 cases he obtained excellent results 83 
times. In 30 patients the disease lasted only from 
8 to 14 days. I have no personal experience to 
record with this combination, but on general prin- 
ciples I am hopelessly sceptical concerning such sur- 
prising results. I may say, in this connection, that 
I have employed belladonna unstintingly, a few times 
unwillingly, to the danger-point. Yet, I have never 
seen it shorten the duration of the disease, although 
the severity of the spasmodic cough was favorably 
influenced. 
The bromides and chloral have found favor with 
1 Norsk Mag. f. Laegevidenskaben, No. 6, 1886. 16 
many writers. For myself I have come to regard 
them as indispensable in the severer cases. I have 
fearlessly employed them alone or in combination. 
The action of cocaine, locally as well as internally, 
is extolled by numerous observers. Prior recom- 
mends as highly efficacious, solutions having a 
strength up to 30 per cent., to be applied with a 
brush, to the pharynx and larynx. I have feared to 
employ the stronger solutions of cocaine, and the 
weaker ones (up to 4 per cent) have not given me 
much satisfaction. 
By several writers the various salts of quinine 
(Binz, for example, favoring large doses of the tannate) 
have been strongly urged for internal as well as local 
use. My own experience with quinine is so slight 
that I am not justified in commenting on its utility. 
Carbolic acid, iodoform, corrosive sublimate, re- 
sorcin, the salicylates, pure benzol, eucalyptus, thy- 
mol, boric acid, in fact every known antiseptic and 
parasiticide, has found its champion. Why any 
particular member of this group should be so much 
more beneficial than all the others, I am unable to 
comprehend. The use of antiseptic sprays, pro- 
vided always that the patients are old enough to 
tolerate the necessary manipulations, would appear 
to be a rational means of procedure. I am bound 
to confess, however, that in my hands they have 
yielded less flattering results than I anticipated, 
after reading the glowing accounts of the successes 
of others. 
I would put these questions before you: If per- 
tussis is due to the irritation of toxic substances 
WENDT, TREATMENT OF PERTUSSIS. 
17 
(ptomaines) produced by specific microbes, are we 
really fulfilling the indications of the disease, by in- 
corporating other poisons into the system, impotent 
to kill the bacteria, but yet powerful enough to 
harm the young patients ? 
In other words, is not this much-vaunted specific 
medication of pertussis an illusion and a snare? 
Is it not, after all, more rational so to fortify the 
system, that in what has been termed the “ cellulo- 
microbian warfare,” the cells may be the victors and 
not the vanquished ? 
Is it not safer and easier to assist the cells to fight 
their battle, than to attempt to kill the rapidly mul- 
tiplying bacteria that are already lodged within them ? 
Although I have deprecated the habit of recom- 
mending particular drugs on the strength of gratify- 
ing personal experience, I cannot refrain from 
alluding to the use of antipyrin in pertussis. Dr. 
Sonnenberger,1 of Worms, was the first to call 
attention to this new drug in the treatment of 
whooping-cough. He claimed such surprisingly 
good results from its employment that my sceptical 
faculty was immediately fanned into activity. Never- 
theless, so far as my own limited experience goes, 
I must own that antipyrin has with me a better 
record than any other one drug. I can claim no 
cures from antipyrin. But what the drug has ap- 
peared to me to favor, was an easy course of the 
disease to final recovery, a mitigation of the parox- 
ysms, especially at night, possibly a reduction in 
1 Deutsche med. Wochenschrift, April 7, 1887. 18 
WENDT, 
their number, and certainly a freedom from compli- 
cations. This is higher praise than I can conscien- 
tiously bestow upon any other method of treatment. 
But I am far from claiming as much as Sonnen- 
berger, for antipyrin, that author asserting it to be 
distinctly curative. As to the method of its em- 
ployment, I have followed the directions of Sonnen- 
berger, who gives one-seventh of a grain to very 
young children, and gradually increases the dose 
according to the age of the child. To adults he 
gives fifteen grains. The medicine is administered 
three times daily, and sometimes once during the 
night. Children take it readily when dissolved in a 
little water and raspberry syrup. The remedy should 
be continued throughout the attack. 
I have said nothing about fumigation with sul- 
phurous acid, a method urged for adoption by Mohn,1 
because I have not tried it. Antiseptic inhalations 
and others, in the pneumatic cabinet, as particularly 
advocated by a Dutch physician,2 may also be men- 
tioned here. I have not employed this method, and 
doubt whether it will find favor with the profession. 
When a French physician asserts in all seriousness, 
that he cures whooping-cough by cauterizing the 
ulcerations on the under surface of the tongue,3 we 
can only assure him that French pertussis and Ameri- 
can pertussis are distinct and different maladies. As 
1 Revue des Sciences m6dicales, and London Medical Record, 
February 15, 1887. 
2 Arntzenius, in Weekbl. von het Nederl., etc., No. 67, 1887. 
See Therapeutic Gazette, October 15, 1887. 
8 Gazette des hopitaux, and Revue de Laryngol. TREATMENT OF PERTUSSIS. 
19 
a summary allow me to submit the following conclu- 
sions : 
1. There is constantly associated with whooping- 
cough a special microorganism, discovered by Afana- 
sieff. 
2. This microbe is a small bacillus, having pro- 
perties that distinguish it from all other known 
bacteria. 
3. The “bacillus pertussis” (bacillus tussis con- 
vu/sivce Afanasieff) can be readily demonstrated in 
the sputum of patients having the disease. 
4. While its etiological significance appears estab- 
lished, it does not possess much diagnostic impor- 
tance, since it is found only after the clinical features 
of the disease are already well marked. 
5. The treatment of pertussis has not yet been 
materially advanced by this discovery. 
6. Antiseptics locally applied do not appear to 
shorten the duration of the disease. 
7. Hygiene and judicious alimentation are, in the 
present state of our knowledge, of, at least, equal 
importance with medicinal treatment. 
8. Antipyrin and the bromides are reliable symp- 
tomatic drugs, and are devoid of danger. 
9. A specific has not yet been found. 
10. Abortive forms of pertussis may occur, but no 
plan of treatment now known can claim to have 
abortive efficacy. 
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