?Isolation of Patients.]                 37
with imported cases or with an outbreak in a small place
upon which it is possible to concentrate a sufficiently strong
establishment, the first measure to adopt is the compulsory
removal of the sick to hospital. In dealing with early
indigenous cases the same policy may be advisable. But if this
policy prove unsuccessful in a large place, a point may soon
be reached where the authorities will not succeed in getting
the bulk of the cases. When this point is reached, the fact
must be faced that the evils of leaving the sick in their houses
are being incurred and that the attempt to remove them to
hospital may be super-adding to these the evils that result
from carrying about sick persons from house to house. At this
stage the less the sick are interfered with the better. All
that can then be done is to endeavour to palliate the evils
that result from leaving people in their houses by arranging
for continual visitation of the sick at home, the frequent dis-
infection of the infected room, and the encouragement of
inoculation among persons left in the houses with the sick.
16.  Except in the cases mentioned above, the removal of
patients to hospital should not be made compulsory.    Every
effort   should, however, be made to induce patients  to go
voluntarily to hospital and to lessen the aversion to hospital
by the following means-(1) by encouraging the establish-
ment of private and caste hospitals; (2) by locating hospitals
near to infected quarters;  (3) by limiting the size of hospitals
so that patients may receive more individual attention, and
accommodation may be more readily made available for their
immediate families and friends; (4) by arranging for the pro-
vision  of  an adequate number of medical attendants and
nurses  and   of  ample  and comfortable accommodation for
patients; (5) by permitting at least two friends to be in
attendance on each patient so that the patient may never be
left alone; (6) by allowing the patients to have their own food
and medicines and  to  receive  visits from  their  relations,
friends and religious instructors; (7) by taking care  that all
arrangements for observance of caste customs and for the
comfort and convenience of patients  and  their attendants
are completed before inviting admission to hospitals.
17.  Moribund patients should never be removed to hospital
except at the express wish of the friends or relations of the
patients.    The risk of leaving in his house a patient whose
case is so serious that the medical officer thinks he has not a
fair chance of recovery is not great since, as the existence of
the case will have become known, there will be no difficulty