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Still, as the charts are written with all the modifications due to the serum, there
are only 27 charts that could be marked "mild ; " whereas from the charts of the
non-serum patients 54 had to be put down as "mild." Special attention is drawn to the
chart No. 22 of a patient who came a few hours after the appearance of the first,
symptoms to the treatment. The curve of temperature under the influence of the
serum suggests a mild attack ; but, as a matter of fact, the case was a desperate
one, with numerous plague bacilli in the blood.
Careful examination and comparison of the charts leave only two alternatives
open : either the recoveries on the serum side have been obtained in patients who
were on the average more gravely affected than the patients on the other side, or
that the more severe course shown by the charts is due to the serum.
Although no less an authority than Dr. Ruffer, of the Indian Plague Commission,
hinted that the high mortality at the Arthur Road Hospital—it was still higher at
other hospitals—may be in causal connection with the application of the serum, I do
not think it necessary to deal seriously with such an assertion. It is not only
contradicted by all facts contradicted in this report, but also by all experience of the
serum treatment in other diseases.
No curative serum has yet proved harmful as long as it was sterile and not
used in doses in which blood serum in general may sometimes be injurious. The
inocuousness guaranteed, the prejudice against the serum treatment seems very
strange, and stranger still it seems that this prejudice is prevalent just amongst that
part of the population which ought to know better and would eventually benefit the
most by the treatment.
For completeness sake it may be mentioned that Lustig's serum has been tried
in pneumonia, malaria, relapsing fever and streptococic infection in order to
demonstrate its specific action. As was expected it showed neither good nor ill
effects. It was further tried on healthy persons without causing the slightest
inconvenience.
The patients treated outside the Arthur Road Hospital do not call for many
remarks. Sixteen were treated in 1898 and 12 in 1899 at the Maratha Hospital.
The recoveries were 8 and 3 respectively. The clinical notes show that the cases were,
with few exceptions, of a very severe type, and that the Marathas seemed to answer
better to the serum than to the patients of the Arthur Road Hospital.
Twelve patients were treated at the Parel Hospital in 1898 with the serum of
horse No. 1, three of them recovering, eight patients who had been taken as control,
all died.
Of more interest are 32 patients, treated in private practice, 19 of whom
recovered. They were from the middle classes and of different nationalities.
Some were hopeless and only treated at urgent request. Still the number of
recoveries indicates clearly how much more effective the serum treatment is when
applied under better conditions of life.
I pass now on to the clinical features of the serum treatment. Foremost
in evidence is the antithermic action of the serum which is seldom wanting
even in patients who in the end die. The increase of the arterial pressure
and the improvement in the condition of the heart can be demonstrated by the
sphygmograph. Delirium and headache very often subside considerably and the