No parent or anyone else with feeling can possibly witness, un­moved, the fight for breath a child has to make when in the throes of a choking spasm occasioned by that intractible and most dis­tressing complaint of whooping cough and the onlooker not being able to do anything to relieve the condition. All is well after the spasm is over, i.e., until another attack occurs, and another, and so on, for a long period of time. What a boon it would be for parents and others to know of a method whereby such spasms could be cut short or ameliorated!

Now, such a method I discovered in a German medical book I read some time ago, which was devised by a German doctor many years back, and which is very much akin to osteopathy as we know it to-day. This method comprises three alternative mani­pulations, either of which, so the doctor claims, can prove success­ful in cutting short the choking bout or at least lessening the severity of the attack and the total period that it usually takes for the whooping cough trouble to clear up—no mean achievement! The method can easily be learned by any member of the household, and even carried out by the victim himself, that is, of course, if he be not too young.

Of the three alternative methods now to be described, choose the one that you find most suited to your own particular aptitude, and to the child himself.

Method 1—Stand in front of the patient and firmly grasp the top of the ascending rami* of the lower jaw bone immediately below the cheek bone slightly in front of the ears with the fore­finger and middle finger of each hand, placing the thumbs on the chin, and then pull the chin forwards and downwards strongly but with care.

Method 2—This manipulation is effected by hooking the thumb on to the lower incisor teeth, and with the rest of the fingers, grasping under the chin and then drawing the whole of the lower jaw forward and downward. The other hand is laid upon the fore­head of the patient to effect a counter-pull. Naturally caution must be exercised not to exert too much pressure upon the teeth, but rather upon the lower jaw.

* Each side of the lower jaw is roughly L shape, the upright branch each constitutes the ascending ramus (plural rami) at the top of which are two prominences, one of which articulates with the lower part of the temporal bone of the skull, slightly in front of the lower part of the ear, where movement can be felt in the joint by placing a finger there.

Method 3—In this method you stand behind the patient and position each thumb just above the angle of the jaw, then place the forefinger and middle finger of each hand on the chin and push the lower jaw downward and forward, or the fore-finger may press down on the lower back teeth to accomplish the same movement of the lower jaw.

As soon as any one of these manipulations is performed the child must take in a deep breath, and when this happens the spasm ceases at once.

The manipulation is so simple in itself that any reasonably intelligent mother, brother or sister, or anybody else who happens to be at hand at the time when an attack is on, can do it. It can be carried out without causing any further distress to the child, and once he has experienced the wonderful relief it is said to bring, he will lose no time in running to someone in the know as soon as he feels the cough coming on. It often is the case that even the youngest will try to carry out the manipulation on himself once he has experienced what it can do for him in the way of ridding himself of the spasm.

Whenever there appears to be much whooping cough about, parents and children should lose no time in practising these hand manipulations, for as it is claimed over and over again, the excellent results obtained by this simple method make the trouble in acquir­ing efficiency in it more than worth while, for after only a few seconds following upon effective manipulation the choking spasm is cut short, and the vomiting—a usual accompaniment of whooping cough—haemorrhages and other complications which the increased blood pressure can produce do not occur. Even though the disease is not checked by the cutting short of the spasms, its duration will be considerably curtailed, and its character will be of a milder nature throughout its shortened course.

The doctor who devised the aforementioned manipulations explains their effect upon the choking attack as due, in the main, to relaxation of the neck musculature. The effectiveness of them has been confirmed in German medical journals, so I understand in which it has also been stated that sensible, older children, who have carried out the manipulations on themselves have invariably reacted well and at once, but of course they must be done by others for the very young ones.

The fundamental object of this manipulative procedure is to break the spasm while the child is compelled to take in a breath.

Another German doctor achieves this by this method. Have the child kneeling on the floor. Stand behind him with the right leg between the knees of the child; stretch both arms of the child upwards and grasp them with both hands, drawing the thorax upwards and over the slightly bent right knee, which is pressed against the child's back. Care must be exercised in carrying out this movement.

A small child may stand, say, on a stool. You are to stand behind him and place both hands, with the thumbs upwards, flat upon both sides of the child under his armpits; he is then to be lifted up and his shoulders drawn over your own chest backwards.

For those readers who might be uncertain about these mani­pulations it would, undoubtedly, be a good idea for them to ask their respective osteopath, should there be one in the district, to show them how the holds should be made and the movements done.

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