84 



NICHOLS AND ANDREWS. 



treated by the subcutaneous and intravenous methods and shows that 

 the latter method gave better results regardless of the age of the patient, 

 but that this was least apparent in the cases under 10 and over 60 years 

 of age. 



The average number of intravenous injections of salt solution given 

 to those who recovered was 1.8, the average number given to those who 

 died was 2.6. The highest number of injections given to those who 

 recovered was 5 ; to those who died 6. The average nuniber of injections 

 given by the subcutaneous method was 1.4 for both those who died and 

 for those who recovered. The highest number of subcutaneous injections 

 given among those who recovered was 3, among those who died 5. 

 Undoubtedly if the method of subcutaneous injection had been employed 

 more frequently, more cases would have been saved, but the maximum 

 activity of physicians and nurses was reached as it was. 



The apparatus used in administering the injections intravenously is 

 illustrated in fig. 5 ; it is believed to be of the 

 greatest value in the treatment of cases of 

 cholera. The salt solution employed (0.85 per 

 cent) was prepared in the Biological Labora- 

 tory of the Bureau of Science and was sterilized 

 and sealed in 1- and 2-liter bottles. It was 

 brought to the hospital as needed. Wlien a 

 bottle was to be used the cork was loosened 

 and the bottle heated in the hotwater bath to 

 about 43° C. A two-way rubber cork with one 

 long glass tube for the admission of air and 

 a short one to which a piece of rubber tubing 

 was attached, was kept in a weak carbolic solu- 

 tion and when required for use, was firmly 

 inserted into the neck of the bottle, immediately ' 

 after the withdrawal of the original cork; the 

 bottle was next inverted in the rack and the 

 solution allowed to run from the tube until 

 warm. For insertion into the vein only a few 

 instruments are necessary : a sharp scalpel, a 

 thumb forcep, a grooved director or other 

 similar instrument for introduction under the 

 vein, ligatures preferably of silk, and a medium- 

 sized hypodermic needle, or canula. After the 

 bottle of salt solution had been prepared as 

 stated above, the method of procedure was 

 as follows : ^'°- ^• 



A clean towel was placed under the foot or arm of the patient to protect 

 it from the bed clothing, the skin over the site of the operation was cleansed 

 by a cotton or gauze sponge wet with alcohol. Usually the long saphenus vein 



