THE TREATMENT OF ASIATIC CHOLERA. 91 



VI. HOSPITAL MANAGEMENT. 



As is the case in most cholera epidemics, this one was im^expected 

 and it was some time before the accommodations, the number of physi- 

 cians and nurses, and the supply of apparatus and medicines were such as 

 would have been provided could the epidemic have been foreseen. In 

 an ideal cholera hospital the following conditions should exist: There 

 should be three classes of medium-sized and accessible wards for handling 

 the worst cases among men, women, and children either at the time of 

 their admission or as they develop. In each ward for every six patients 

 there should be one nurse, one helper, one physician (or medical student 

 under the direction of a physician) and all the necessary apparatus. 

 There should be larger wards for mild and convalescent cases and a 

 separate ward for cholera suspects. A definite system for disinfecting 

 and storing patients' effects : sterilization of linen and good laundry 

 facilities should be in force. Large sized toilet rooms which are easily 

 disinfected and kept clean and readily accessible are absolutely necessary, 

 as is also sufficient help to scrub thoroughly the floors of the wards with 

 some strong disinfectant at least twice a day. A small laboratory for 

 bacteriologic diagnosis and urinary analysis should be at hand. 



VII. CONCLUSIONS. 



1. With regard to sex and age cholera occurred in proportion to the 

 population with an excess of cases in children under 10 years. 



2. Intravenous injection saved about 80 per cent of the cases from 

 collapse. 



3. Nearly half of those who survived the stage of collapse showed some 

 symptoms of ui-aemia and nearly one-third died of this complication. 



4. In general, the intravenous injection of saline solution greatly 

 reduces the mortality from collapse; the more often the patients survive 

 collapse, the more important becomes the treatment of the subsequent 

 uraemia; with the present methods of treating urgemia only about one- 

 third of the cases recover. 



(For the discussion of this paper before the Philippine Islands Medical 

 Association see p. 141.) 



