M 95
Table I.
Total Deaths Recoveries Percentage mortality Under 5 Males 8 2 6 25 Females 4 1 3 25 1-5 Males 4 2 2 50 Females 3 2 1 66 5-15 Males 11 5 6 45 Females 8 3 5 38 15-30 Males 89 39 50 44 Females 46 23 23 50 30-60 Males 204 126 78 62 Females 97 49 48 50 60 and over Males 17 16 1 94 Females 21 13 8 623. The mortality rate for the series as a whole is 55 per centum. The mortality for males is slightly less than that for females, but the difference is not significant, the male mortality being 54 per centum, the female 57 per centum. The incidence of the disease was much higher in males, and this is so in every age group except the oldest, sixty or over. 333 males and 184 females were attacked by the disease.
4. The two greatest dangers to life in cholera are hyperpyrexia in the reaction stage, especially after the infusion of saline, and anuria following on the suppression of the collapse stage. Until measures were adopted such as the half-hourly charting of the rectal temperature during the infusion of saline and the application of ice packs when necessary, several deaths occurred from hyperpyrexia. In the first two months of the epidemic, June and July, several cases were admitted in hyperpyrexia; that is to say with a rectal temperature of 104° or over on admission. Such cases are uniformly fatal. The principal measure of value in the promotion of diuresis was found to be the six-hourly intravenous infusion of equal quantities—usually 1,200 c.c. of sodium bicarbonate saline (grs. 160 to 1 pint) and normal saline.
5. The complications noted were parotitis going on to suppuration in five cases, keratitis, skin sepsis, boils, cellulitis in two cases and cholecystitis. Various pulmonary conditions such as bronchopneumonia and bronchitis were also observed and one patient died of a purulent bronchitis which supervened during convalescence. Though naked eye renal changes appear to be rare in cholera, one man recovered from cholera only to perish a fortnight later of a right-sided pyonephrosis. Diphtheria occurred as a sequela in one patient and led to a fatal issue. The commonest mistaken diagnoses were bacillary dysentery, gastro-enteritis and food poisoning. Two cases were seen in which bacillary dysentery and cholera co-existed. One ruptured ectopic gestation and one meningococcal meningitis were also sent in as cholera. Five Europeans were admitted suffering from cholera, and of these one died in anuria and four recovered.
6. The saline solutions used were 2 per centum glucose saline, normal saline and bicarbonate saline (grs. 160 to 1 pint). All patients had bacteriological examinations made from rectal swabs taken on admission and no patient was discharged until he had had two consecutive negative reports. Vibrios persisted in