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Regarding the treatment of the disease, I think we can speak more
hopefully this }*ear. The experiments on Lustig's serum were continued
at the 'Arthur Road Hospital and also at the Maratta and Modikhana
Hospitals. This subject is fully entered into my Report on the serum,
attached. I have tried to compile a full history of this treatment in
continuation of last year's report.
In summing up the results of the effect of Lustig's serum, I am of
opinion that it is of the greatest value as a curative agent if employed iu
the early stages of the disease. The injections if given in sufficient quantity,
say, 100 ccs. the first day and again repeated on the second day, and in
smaller quantities subsequently, is of great value in reducing the size of
the glands and the infiltration around them, and consequently in reduc-
ing the pain from these inflamed glands. The secondary rise of
temperature which is usual about the 3rd or 4th day is controlled if not
prevented, and so the period of the disease cut short. Life is undoubted-
ly prolonged by the injections, and so valuable time gained. The serum
is a valuable curative agent, but a great deal depends on the conditions
in which the patient is situated, Every endeavour must be taken that
the sanitary conditions of the room is as good as possible, and above all
effective nursing is requisite to enable the patient to take advantage of
every chance of recovery. The serum cannot be of very much use
when the above requisites are neglected and patients, with hearts which
we know are in the condition which this disease brings on, are allowed
to get out of bed instead of never moving from the prone position.
I regret to have to add that I think the results obtained by the
serum treatment at the Modikhana Hospital valueless. The question has
been thoroughly gone into by myself, and I cannot help saying that, for all
intents and purposes, the observations are useless, as they were carried
on without any system. I think this is in a great measure due to the
fact that the medical officer of the hospital had double duties to perform
and could not give the time necessary for closer observation and care.
The nursing arrangements in the various hospitals have been intelli-
gently and carefully carried out to meet the heavy demands in the Muni-
cipal and other hospitals. Thirty more English nurses were obtained from
England. The nurses attached to the various hospitals earned the praise
of all who have worked with them and they deserve every recognition.
I have to thank Drs. Hunt and Taylor for the great help they have been
to me and the medical officers of the hospitals ; their reports are attached.
In conclusion I have to thank Dr. Choksey for his hearty interest
in everything concerning the welfare of his hospital. His work in
connection with the Lustig's serum is well known and no further comments
are necessary. Drs. Dargalkar and Turkhud have also been hard working
and managed their hospitals with success during a very trying year,
and Sirdar Mjr Abdulali as usual is the life of the Maratta Hospital which
owes its prosperity to his unwearying support, and his interest in
suffering humanity; also to Rao Bahadur Trimbuck Vaidya for his
exertions on behalf of the Hindoo Hospital.
J. S. WILKINS, LT.-COL,, I.M.S.,
Special Medical Officer, Plague Operations, Bombay.