359
In this table we have to point out two facts—first, that the serum treatment
shows only in two series, viz., 4 and 18, which total 31 patients, a higher mortality
than the average death-rate of the controls ; secondly, that in four series, viz.,
3, 14, 18 and 21, the mortality of the serum patients is higher than that of the
controls. Still, in three of these series, vis., 3, 14 and 21, the mortality of the
controls is far below their average mortality, and the reduction, therefore, is accidental
and due to the distribution of the convalescents, as could be shown from the charts
of temperature. Looking at the total mortality in the three series, which is also
well below the average mortality of the controls, there can be no doubt that the
serum was effective in these three series. On the other hand, the lower mortality on
the serum side does not always correspond to a reduction of the total mortality of
the series. Thus the total mortality is higher than the average death-rate of the
controls in six series, viz., 4, 7, 12, 18, 19 and 22, which indicates clearly that, the serum
was without effect in these series, although the differences between the mortality
of the serum patients and the controls are very considerable in four of the series,
viz., 7, 12, 19 and 22, being 16 per cent., 23 per cent., 20 per cent. and 26 per
cent., respectively, and they point to a great efficacy of the serum. We aro thus con-
fronted with the peculiar fact that the serum was effective when the difference
between the results ou both sides suggested that it was not, and that the serum had
no effect when the difference made us believe that it was very efficacious. This
seems rather striking, and an explanation will be necessary. With regard to the
effects of the serum treatment and non-serum treatment we can divide the total
plague admissions into three classes—first, patients who die under either treatment :
secondly, patients who recover under either treatment ; and thirdly, patients who but
for the serum will die. If we take 200 plague admissions and distribute them
by alternation, as was done at the Arthur Road Hospital, and if we suppose, as is
the case, that the mortality from plague is 80 per cent., and that the serum can
reduce this mortality to 70 per cent., we might have the following distributions and
results ;—
TABLE 1.
Serum Patients.
Patients
who die un-
der either
treatment.
100
Percentage
of
Mortality.
100
Patients
who die un-
der either
treatment.
40
Control Patient3.
Patients who
but for the
serum die.
20
Patients
who recover
under either
treatment.
40
Percentage
of
Mortality.
60
All Patient?,
Percentage
of
Mortality.
80
Although the serum had no chance of exercising any influence, the comparison
between the two sides allows only one conclusion, viz., that the serum does harm.
TABLE 2.
Serum Patients.
Patients
who die un-
der either
treatment.
80
Patients who
but for the
serum would
die.
20
Percentage
of
Mortality.
80
Control Patients.
Patients
who die un-
der either
treatment.
60
Patients
who recover
under either
treatment.
40
Percentage
of
Mortality.
60
All Patients.
Percentage
of
Mortality.
70
Although the serum has cured all who can be cured by it, the comparison
between the two sides allows again only one conclusion, viz , that the serum
does harm.