Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

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    wish to he successful. The when to do, and the when not to do, in a disease with such rapid changes as Cholera, requires much more discrimination and knowledge than is usually possessed by nurses or friends. The case requires throughout, the constant guidance and vigilance of the surgeon, and he must specially assume this action during the critical periods of the disease. Good nursing is always of the utmost value, hut patients in Cholera need that this should he frequently superintended. In military and civil hospitals, especially in India, in which the nursing must be confided to native servants or to the comrades of the sick man, the surgeon is obliged to be doubly watchful. All patients with Cholera should be treated in well-ventilated rooms or wards. On account of the sad spectacle presented to the patients with other diseases in hospitals, when a large number of patients are brought in for treatment, and to avoid all possible chance of diffusion of the disease, small though that chance may be, it is desirable that all Cholera cases should be treated in separate wards, and with ample space and ventilation about them. Should there not be such wards or rooms, tents should be used. I prefer rooms to tents if they are well-ventilated, and have non-absorbing floors and walls that can be washed with water and chemical solutions. Tents, unless they are thoroughly cleansed and purified, are as likely to spread dis- ease as hospitals are. They are colder than rooms, and the attendants and patients themselves are likely to keep them shut up, and from their size the air within them is sooner rendered impure than in an airy ward. Those surgeons who remember the severity of hospital gangrene at Ferozepore, in the Sutlej campaign of 1845-46, know that tents present no immunity from hospital evils. The only real advan- tage of a tent is the power of changing its floor by shifting the ground, but against this are to be placed the coldness at night, and the discomfort find consequent diminished efficiency of attendants. Of course there are times when the tent must be accepted, but I should in preference select to treat my Cholera patients in airy wards, in which I could regulate the temperature, in which I could wash and scrub the floors and walls, which permit of economical use of nurses and attendants, and in which they have that comfort and warmth which promotes their efficiency. In speaking of tents, of course I refer to their use in warm climates ; in cold climates, except in summer, they could hardly be used. In India, in the warm seasons, too, we are subject to heavy storms, which render tents most uncomfortable, and I have seen several tents, with wounded men, blown down in one nip'ht. Those only who have spent weeks under