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TChe influence of the serum 'treatment showed itself not only in the saving of
life but also in the prolongation of life in patients who eventually died. The
prolongation of life is proved by the reduction of the total deaths within the first
48 hours after admission, which amounts to 8 per cent., the corresponding figures
being 57 per cent, for the intermediate period and 49 per cent, for the whole serum
period.
The demonstration for the time of the alternative treatment is simple. From
April, 1899, to April of this year, 361 patients received specific treatment and had
122 recoveries -or a rate of &3'8 per cent. An equal number was under the ordinary
treatment and had 77 recoveries or 21*3 per cent. The recovery-rate on the serum
side shows, therefore, an absolute increase of 12'5 per cent. It might properly be
objected—and that is one of the drawbacks of the alternative method—that the
evidence is not conclusive, if it cannot be shown that the total recovery-rate at the
Arthur Road Hospital was higher than in other hospitals. In order to compare the
total recovery-rate of the Arthur Road Hospital with that of other hospitals we have
•to add to the 722 cases treated alternately, 36 cases with only 5 recoveries in which
cases the diagnosis could not be made in time to take them for the alternate treatment.
(Only such cases were dealt with which under diagnosis showed undoubted symptoms
of plague.) The total admissions stand thus at 758 with 204 recoveries, the rate
being 26'9 per cent.
The Maratha Hospital had 2,131 admissions with 455 recoveries, the rate being
21'35 per cent., almost identical with the rate of the non-serum patients of the
Arthur Road Hospital. The total recovery-rate at the Arthur Road Hospital was,
therefore, in the same proportion, higher than that of the other hospital, as the
difference of 12'5 per cent, between serum and non-serum case? lead to expect. As
the Maratha Hospital had 3,378 admissions with 646 recoveries or 19*1 per cent,
during the time of selection.the figures for the whole time of the serum treatment
stand thus : 5,509 admissions with 1,101 recoveries or 19 - 9 per cent, at the Maratha
Hospital and 2,351 admissions with 591 recoveries or 25 per cent, at the Arthur
Road Hospital. The Arthur Road Hospital gave therefore 5 per cent, more chances
of recovery since the beginning of the serum treatment, although only one-third of
the patients received it. The patients of the Arthur Road Hospital belonging almost
exclusively to the lowest castes have, moreover, less individual resistance than the
Marathas.
Although the concurrence of all this evidence pointing to one conclusion is
sufficient to put the efficacy of the serum beyond any reasonable doubt, I will not
omit to mention another fact which was conclusive to the experimenters themselves,
at a time when statistics were not available. I refer to the marked difference in the
curative results obtained by sera derived from different horses. Whereas the serum
of horse No. 1 immunised in Italy gave 27 per cent, recoveries in 90 treated patients,
the three other horses, also immunised in Italy, gave 53 per cent, in 155 treated
cases. Similar differences are observed in the results obtained by the sera prepared
here. Thus, the serum of horse No. 1, gave 34 recoveries in 122 patients, and the
serum of horse No. 4, gave 51 recoveries in 125 patients. The differences are so
remarkable that they cannot be due to the chances of distribution, but must be
explained by a varying degree of efficacy. 1 do not think it necessary to add more
to the above. There is material enough for an unbiassed mind to form a judgment
upon, and I now pass on to the application of the serum and to the clinical features
of the treatment.
First of all I should like to state emphatically that the serum is perfectly
innocuous even in larger doses than are needed for treatment. There seems to
.exist a superstitious fear of the serum, which is warranted neither by our experience