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concurring illness, the disease of a fatal rapidity and with a mortality of 80 per cent. !
Truly it is the case of two vessels, the one steaming in smooth waters and with a
favourable breeze, and the other against a hurricane and heavy seas, yet both make
the same headway ; but can there be any doubt which one has the more powerful
engines ? We see we are wrong, it cannot be the comparison with the results in
other diseases that makes our 11 per cent. not acceptable. Then perhaps the costs
are out of proportion to the gain ? Although to the humanitarian such a considera-
tion might be repulsive, we cannot overlook the fact that in practice this must
carry weight, and we think it not without advantage to discuss the matter from this
point of view.
With the 'manufacture of the serum, as with any other manufacture, the
cost decreases when the output rises. The cost of the experiments were neces-
sarily disproportionately larger than the manufacture on an adequate scale would
be. Moreover, the cost could be considerably reduced if only suitable patients be
treated and a charge be made for the serum in those cases where the patients can
afford it. We think the last point of importance also, because the charge would
do away with the impression that the serum is still on its trial. Provided the above
conditions be fulfilled the costs of the manufacture of the serum will not be out
of proportion to the gain, and we can safely say that the results of the serum
treatment of plague, as they are at present, will be acceptable also from a pecuniary
standpoint.
That these results have been obtained in a relatively short time and under
difficult circumstances is first of all due to the liberality and perseverance of the
Municipality and the help of the Government of Bombay who provided the means
for the manufacture of the serum, and to the insight of their advisers, who, in spite
of adverse criticism, never lost confidence in, or interfered with, the conduct of the
experiments. We may be allowed to mention specially Mr. W. L. Harvey, I. C. S.,
the Municipal Commissioner, who was ever ready to meet our requirements, and to
him we are moreover much indebted personally for the kind indulgence he has
always shown to us, little versed as we were in language and official ways. It is
due to the steady support of the lato Health Officer of Bombay, Col. T. S. Weir,
I.M.S., who has also the merit of having done his best for the introduction of
the prophylactic treatment of plague, and to the assistance of Lieut.-Col. J. S.
Wilkins, I.M.S., D.S.O., Special Medical Officer, Plague Operations, one amongst
the few of the medical profession who thought it incumbent to form an opinion based
on personal experience. It is due to the untiring energy of Khan Bahadur N. H.
Choksy, M.D., Hon. Causa, of Freiburg, on whom the treatment with the serum
devolved. Three qualities fitted him best for the task entrusted to him : his unique
experience of plague, his interest in the experiments, and the scientific spirit in
which he approached the problem. Although an advocate of the treatment, ha
was always critical, ever on his guard against self-deception and errors. He has
well deserved the satisfaction of the success after the two years' arduous work. We
take here the opportunity to tender our hearty thanks to Dr. Choksy for his
invaluable collaboration and to his assistants, Dr. D. S. Fraser and Dr. D. C. Setna,
and the whole staff of the Arthur Road Hospital for the zeal with which they
carried out their duties in connection with the serum treatment. Our thanks
are also to all those who have taken interest in, or given aid to, the serum treatment
and whose names it would take too long to mention.
G. POLVERINI; M.D.
A. MEYR, M.D.