402
16. In accordance witli a wish expressed by me that Dr. Choksy
would undertake to try Lustig's serum treatment on every alternate
case admitted into the Arthur Road Hospital, he very kindly undertook
to carry this plan out, and his letter No. 625 is herewith appended. The
-experiments being not yet completed, it is impossible to give any de-
finite opinion on this subject.
No. 625 OF 1899.
ARTHUR ROAD HOSPITAL,
BOMBAY, 12iA June 1899.
To THE MUNICIPAL COMMISSIONER,
SIR,·—I have the honour to submit the following report on the observations con-
ducted by treating every alternate case of plague \vith Professor Lustig's serum :—
1. Although I had fully expressed my views on the method of investigating
the serum treatment by treating every alternate case in my report for April last, still
in deference to the wishes of Lieutnant-Colonel J. S. "Wilkins, D.S.O., I.M.S., the
Special Medical Officer, a series of observations was conducted last month. And the
results are just as I had anticipated, fully bearing out and confirming the conclusions I
had arrived at in the report above mentioned as to the best way of conducting similar
investigations. However attractive and plausibly fair the method of the treatment of
every alternate case may appear on the surface, when tested with rigid scientific
accuracy it falls to the ground and exposes the fallacies incidental to it, even in a
small series of 4ß cases as the present.
2. In this series observations were conducted on 46 plague patients, and every
alternate case was treated with the serum, irrespective of the type of the disease, the
-state of the patient, the duration of illness, the position of buboes, and irrespective
also of age, sex and caste, etc., etc., conditions which are absolutely necessary for
proper control cases, and which even Professor Wright of the Indian Plague Com-
mission had to admit to be the most reliable and the least open to error.
Under these circumstances the serum had to be wasted in 7 moribund cases and
-also in one convalescent case that did not actually require it, and had to be injected
with a small quantity in order to fulfil the conditions of the experiment.
3. The results of these observations are no less interesting than instructive, and
illustrate in a way the errors that tend to vitiate the results of all such observation*.
Of the 23 cases treated with the serum, 15 died and 8 recovered ; in the 23 alternate
cases not so treated, the results were the same. But the conditions in these two
series were not identical; for whereas the series of cases, not treated with the serum,
had the advantage in their favour of 4 convalescent cases, there was only one such
convalescent case included amongst the serum cases ; moreover, the latter had 7 mori-
bund cases to 6 in the former. And as all the moribund cases died, and all the con-
valescent oases recovered in both the series, the serum series had one convalescent
case only in its favour, and one more moribund against it, as contrasted with the non-
serum series that had 4 conval e scents and one less moribund, and proportionately,
therefore, the results in the latter series preponderated in its favour to the above
•extent:—
No.
Convalescent
Total
Serum cases.
23
1
... 15
Non-serum cases.
23
4
6
13