CHOLERA IN CHILDREN. 371 



liquid stool at 7 p. m. Slept well. Passed roundworm. September 24, yellow 

 liquid stool, face flushed, pulse full, respiration somewhat labored, voiding of 

 urine normal. Did not retain nourishment. September 2.5, sliglit rigidity of 

 muscles of neck, patient insists on lying on back. Sleeps better, apparently 

 recovering. Examination of intestinal contents positive for cholera spirillum. 



Case 20. — ^R. V. — Age, I year 4 months. Female. Duration of illness at 

 time of admission to hospital, five hours. Mother stricken with cholera the day 

 before. Admitted to hospital September 19. Condition upon admission ap- 

 parently fair. Temperature 102, pulse 140, respirations 5.5. An enema was 

 administered and when passed small flakes and guava seeds were present. 

 Voiding of urine normal. Abdomen greatly distended on the evening of the 

 19th. Patient frequently vomited nourishment. The temperature varied between 

 102° and 99.4° but registered 103.6° on September 25 at 5 p. m. The stools as 

 a rule were greenish and liquid. Stool specimen of September 19 was positive for 

 the cholera vibrio. The patient recovered. 



Case 21. — F. M. — Age, 1 year 3 months. Male. History and diagnosis of 

 acute enteritis by Dr. G., municipal physician. September 21 had j^ellow stools. 

 No fever. September 22, slight diarrhoea continued; no fever. September 23 

 and 24, child much better. September 25, one soft yellow stool ; sample from 

 this was positive for cholera vibrios. Admitted to San Lazaro Hospital September 

 26, at 10.50 a. m. No symptoms. Child apparently well. Held awaiting 

 disappearance of vibrios from intestinal tract. 



Case 22. — M. B. — Age, 1 year 4 months. Female. History by Dr. B., medical 

 inspector. Bureau of Health. September 21, diarrhoea and passing of worms. 

 Stomach distended, also vomited a roundworm. Dr. R. was called and diagnosed 

 acute gastro-enteritis. Specimen was taken and the Bureau of Science reported 

 positive for cholera. Dr. B. noted the following: Eyes slightly sunken, lids 

 slightly drooping; fitful and restless; very slight wrinkling of skin of fingers 

 and toes; abdomen distended; diarrhoea had ceased, pulse rapid, temperature 

 normal, body warm, urine not suppressed. Admitted to San Lazaro Hospital 

 September 24, 9.45 a. m. 



On admission, patient's condition M'as fairly good; irritable all afternoon of 

 24th; stools liquid; temperature varies from 98.6° to 100.2°. Voids urine freely. 

 September 25, temperature 99.8°, pulse 144, respiration 28. Pulse intermittent. 

 September 27, quiet, slept most of night. Temperature 98.4°, pulse 102. General 

 condition practically normal. 



The average number of deaths from enteritis, meningitis and dysen- 

 tery diu-ing months in which cholera is not reported in IManila varies 

 about as follows : 



Enteritis 



Meningitis 



Dysenterj' 



Total 70-100 



This is the death rate which may be expected when cholera is not 

 present officially. By examination of the tables, it M'ill be noted that 

 whenever cholera is present the increase in the number of cases of 

 enteritis, dysentery and meningitis is remarkable: so that one may say 

 that if the total for these three diseases exceeds 100 cases per month 

 there is probably cholera in Manila. (See Table IV.) 



Cases per 

 month. 



40- 



50 



20- 



30 



10- 



20 



