373
favoured the controls, and with respect to the manifestation of the disease, the serum
treatment. There is no aim in urging that clinically the advantages on the control
side were more important, and we are satisfied if it be admitted that the distribu-
tion was not in favour of the serum,
Now we can accept the results at the Arthur Road Hospital as correct without
fear of being contradicted by any one whose syllogisms are directed by the princi-
ples of logic, and we can say that cures have been effected by the serum treatment,
which could not have been effected by any other known means. Compared with
that fundamental fact the percentage of the cures is of minor importance, as it is a
variable quantity which can change only in one direction—in the direction of
progress. The treatment of plague with Professor Lustig's serum has thus passed
once for all the stage of experiment, its efficacy has become an established fact,
against which scepticism would no longer be legitimate.
Hence the serum treatment of plague will be an acknowledged implement in
the armoury of the physician, restoring life and health to many, and will rank side
by side with that of diphtheria as a great achievement which represents a further and
important step towards the solution of the problems of serotherapeutics, it being the
second instance in which indisputable evidence has been brought forward for the
efficacy of serotherapy in human beings.
Having demonstrated the efficacy of the serum we shall analyse the results
obtained in order to solve a question of practical importance, viz., under what
circumstances the serum was most efficacious. From a priori considerations we
have to expect that the mortality under the serum treatment followed on a lower
level closely the fluctuations of the general mortality from plague. Indeed, should
we not find any indication of this principle in the course of our investigations, we
could even doubt the proofs furnished hitherto, On the other hand, we cannot
exclude that there might be considerable deviations from that rule, due to the
peculiarity of the remedy or the disease, or to other influences which it would be
necessary to trace. If we find such deviations we shall have to ascertain whether
they were accidental or the expression of a law governing the application of the
serum. In order to answer our query we shall resort again to the statistics. With
regard to them we have to remember that the information we may get might not
always be of an absolute but only of a comparative value, or even valueless owing
to the small number of observations on which the statistics might be based in single
instances. In such a case we might be obliged to control our statistics by those
drawn from larger figures. On the whole, we shall find that the results on the serum
side are more congruous with those of the general statistics, as the action of the
serum and the larger number of recoveries tended to neutralise disturbing influences,
of which the distribution of the convalescents was the most important one on the
control side. We shall go through our statistics in the same order as before and
begin with that showing the results according to the caste :—
Ciste.
Hindus
Mussulmans...
...
Native Christians ...
Parsees
Total ...
Serum patients.
Number
of
patients.
404
21
47
8
480
Died.
282
14
26
6
328
Recov-
ered.
122
7
21
2
152
Percentage
of
mortality.
69.80
66.66
55.52
75.00
68.33
Control patients.
Number
of
patients.
405
27
40
8
480
Died.
326
20
29
7
382
Recov-
ered.
79
7
11
1
98
Percentage
of
mortality.
80.49
74.07
72.5
87.5
79.58