308
But these results are not strictly accurate, inasmuch as they Lave been rendered fal-
lacious by the inclusion in unequal numbers of raoribunds and convalescents in both the
series, and hence they do not represent the full value of serum treatment. When tha
alternate system was begun, attention to this source of error was drawn, but it was then
anticipated that by the time these observations were completed, the numbers of con-
valescents and moribunds would equalise in both the series, and thus eliminate all errors.
This anticipation has, however, not been realised in actual practice and hence the inac-
curacy of the above results. It appears that the serum cases had 139 moribunds, and
the controls 145, so that the former had an advantage of 6 less deaths over the latter.
The convalescents numbered 28 on the serum side, whereas there were 38 on the
control, and here the latter had an advantage of 10 more recoveries over the former.
The only way, therefore, to arrive at strict and right accuracy is to exclude all the
moribunds and all the convalescents- from both sides, and then to compare the results
in the remaining-. And if that is done, the results stand as follows :—
Scrum cases
Non-serum cases ...
No.
813
297
Died.
189
237
Recovered.
124
60
Percentage
of Mortality.
CO-3S
79-79
Percentage
of Recovery
39-62
20-21
There remains, after exclusion, 313 serum cases, and of these 189 died, and 121
recovered, showing a mortality rate of 60*38 per cent, and, therefore, a recovery
rate of 39'62 per cent. Similarly the non-serum cases total 297, and of these 237
died, and 60 recovered, showing a mortality rate of 79*79 per cent, and therefore a
recovery rate of 20'21 per cent.
The difference, therefore, in favour of the serum treatment is 19'41- per cent,
and this represents the actual value of the serum in those cases that are really acute
and fit for treatment, and it is 8*16 per cent, higher than that in all cases where
these disturbing factors are-not eliminated,
These differences in the mortality or recovery rates do not represent the fult
value of the serum treatment and that could only be arrived at by adopting Professor
Haffkine's system (which has been approved of by the leading medical journals of
Great Britain) of calculating the rates of recovery ratio between the inoculated and
the non-inoculated. If that procedure is adopted for the serum and non-serum cases,
it works out that the ratio of recovery is as 1*55 of serum to one of control and 1*9(>
of serum to 1 of control in all cases, and after the exclusion of moribunds and
convalescents in both, respectively. That is, if out of a given number^ 100 patients
recover under ordinary treatment, the same number, if treated with the serum, would
give 155 recoveries in one case and 196 in the other, or to put it in another way, the
.serum treatment increases the'recovery rate by 55 per cent, in all cases and by 96
per cent, if the- moribunds and convalescents be excluded.
These results must be considered sufficiently satisfactory in the light of our
knowledge of Plague, and its high mortality, regard being had to the fact that the
serum treatment of Plague is still in its infancy and requires further research and
observation in order to put it on a proper basis.
Mortality rates by castes.—In the last report, the mortality rate by castes was
tabulated up to the end of May 1899'. The- following table gives the figures for
12 months ending 31st May 1900:—
Castes.
Hindus
...
Mussulmans
Native Christians ....
Parsees
Beni Israel
Total
NO.
883
48
82
16
1,029
Died.
671
34
52
14
771
Recovered.
212
14
80
2
258
Percentage of
Mortality.
79-50
70-83
63-41
87-50
......
74'92