Multiple myeloma treated with stilbamidine and pentamidine.

BRmsD Approximately 40% of the infants admitted to the unit required intravenous therapy. This could have been administered only in a hospital with the necessary facilities. The success of treatment is therefore dependent on (1) recognition of dehydration in its early stages and admission to hospital of all but the mildly dehydrated; (2) correct assessment of the degree of dehydration in relation to the requirements of treatment; (3) a team of trained and experienced staff to carry out the necessary treatment. These requirements are best fulfilled by the establishment of self-contained hospital units for the treatment of enteritis. The recognition of dehydration in its early stages is within the province of all medical practitioners, and the need for early treatment should be more widely appreciated. The assessment of the degree of dehydration and the treatment required in each case is essentially dependent on clinical judgment gained through practical experience. The successful application of these methods of treatment depends upon the training of the medical and nursing staff of the unit. The figures shown in Table III lend support to this view. The fall in fatality rates after the first six months of 1945 appears to be directly related to the training of the nursing staff, since the technique of treatment was the same throughout the two years and the degree of severity of the cases did not vary from one year to the next. The distribution in age groups did not vary significantly in successive periods, nor during the first six-months period was there any preponderance of the younger age groups, in which a higher fatality rate might be expected. Owing to necessarily frequent changes of staff, in approximately six months most of the nurses in the hospital had worked in the enteritis unit and had become familiar with the routine management and treatment established there. Thereafter, although shortage of staff became a serious problem, all the available nurses were acquainted with the nursing and treatment of the dehydrated infant and were able to maintain the high standard of care necessary for these babies. In this series 112 infants relapsed with dehydration. Since the nature of the infecting organism or organisms in diarrhoea and vomiting is not yet known, it is not possible to say what proportion of these relapses was due to cross-infection or to re-infection. The possibility of such an occurrence, especially in an open ward, must, however, …