367
A number of patients is put down as convalescent in the lists, viz., 28 among
the serum patients, and 33 among the controls. They have no value in the
experiment, as they were admitted on such a late day of illness that the influence of
the serum was excluded. The number of convalescents recorded here does not tally
exactly with that given by Dr. Choksy, viz,, 28 for the serum side and 38 for the
controls. Dr. Choksy's criterion of the convalescence was a clinical one, whereas
we call all those patients convalescent who had passed the acute stage of plague
when they were admitted. Although our distinction means a numerical gain to the
control side we have preferred it because it gives the possibility of proving, the num-
ber of convalescents from the figures in the lists. We gather from the lists that the
serum treatment gave 152 recoveries * and the ordinary treatment 98 recoveries, and
that one-fourth of all the patients who recovered was convalescent on admission.
As the efficacy of the serum must be judged by the results obtained on patients
who were actually sick with plague, the convalescents must be excluded from our
account. We give in the following table the original figures and the corrected
ones :—
SERUM PATIENTS.
Admitted.
480
Original figures|(28 con vales-
Corrected
figures.
cents.)
452
(no convales-
cents.)
Died.
328
328
Recovered.
152
(28 convales-
cents.)
124
(no convales-
cents.)
CONTROL PATIENTS.
Admitted.
480
(33 convales-
cents.)
447
(no convales-
cents.
Died.
382
382
Recovered.
98
(33 convales-
cents.)
65
(no convales-
cents.)
Calculating the ratio between the recoveries of either side, we find that for
every 100 patients who recovered by the serum 53 patients recovered by ordinary
methods. If we take the ratio between the recoveries amongst the patients admitted
on the first five days of illness, viz., admitted during the acute stage of the disease, it-
is still more in favour of the serum, as for every 100 serum patients who recovered
only 49 recovered amongst the controls. We can, therefore, say that the serum has
doubled the recoveries for the acute stage of plague. We see further from the-
lists that 59 buboes suppurated under the serum treatment and 40 under the ordi-
nary treatment corresponding to 38.50 per cent. and 41.00 per cent., respectively.
The difference seems trifling, but it increases considerably if we take into account only
the patients admitted on the first and second clay of illness. We have then 33
patients with 10 suppurating buboes on the serum side and 18 patients with 10
suppurating buboes on the control side. The statistics thus confirm the clinical
observation that buboes reabsorb oftener in serum patients. It is natural that
the serum treatment should prevent the suppuration only in the patients of
the earlier days.
In order to show how the serum was administered, how it acted, and also for the
sake of comparison, there are attached the charts of the first 30 patients who
recovered during the alternate treatment, one chart of a patient treated in private
practice with the serum and two charts of patients who died under the serum
treatment. No other clinical details are given than the temperature during the
acute stage of the disease. Considerations of economy forbade the publication
of more charts which would have furnished the best proof for the efficacy of the
serum. We draw the attention to chart No 12 of a patient who received the serum
treatment although no sure signs of plague were found when it was commenced.
Cases of a similar nature had previously been observed and considered as extra cases,
* One patient died when this report was being prepared.