the day preceding the night on which it suddenly wakes up all at once ill with alarming signs of threatening suffocation, attended with loud, clamorous coughing and a clear voice. Here no false membrane is present in the throat, nor are the glands about the jaw swollen. False croup is generally mild, and it is not contagious.
Dysentery may be contagious. It is distinguished by a frequent, sometimes a continual, desire to seek relief in the closet, where in spite even of severe straining the child succeeds in passing only a little slime or mucus, often colored by small quantities of blood. General indisposition and colicky pains in the belly soon compel the child with dysentery to leave the school. To stop infection, no child suffering with dysentery should be allowed to use the general school water or other closet. Dysentery is not to be confounded with diarrhœa, where there are more or less frequent liquid motions.
Typhoid fever is infectious, and is apt to set in or to sneak in with ill-defined signs. For some days the child may have lost its appetite and its general energy, it is fatigued and "done up." Then the fever is next ushered in with great pain, noises and confusion in the head; the hearing becomes obtuse; giddiness occurs, with great difficulty to keep any upright position. There is often bleeding from the nose generally followed up by colicky pains in and swelling of the belly associated with some diarrhœa. The skin is dry, parched and hot; the tongue fouled, with red tip and sides. However, the child before this has been compelled by its state of indisposition to cease attending the school.
Whooping-cough, is eminently contagious. The child may be noticed to have had during one or more weeks occasional but violent fits of coughing, which are most frequent during the night. If no complication be present, there is practically no cough between these spasmodic attacks. Usually a short feeling of general indisposition precedes the attack, during which the child in vain struggles to suppress the cough about to burst, when all at once the trunk and frame are subjected to a violent series of successive throbs almost threatening suffocation. At this epoch a few deep drawings-in of the breath are followed by a whistling and almost convulsive inspiration, which may again be succeeded by boisterous coughing. Then in most cases, after a brief moment's repose, a second but a less severe and a shorter onslaught than the first is noticed. Lastly, the fit is terminated by the child's partly spitting and partly swallowing some thick mucus, often at the same time vomiting up any matter present in the stomach.
The time occupied by these seizures to their termination by expectoration varies from sixteen seconds to a couple of minutes.
Owing to the grave and fatal complications often associated even with apparently mild cases of whooping-cough, most especially in very young children, immediate isolation of the sufferer from its schoolfellows is necessary.
