356
APPENDIX No. IV.
Report on Cases treated with Professor Lustig's
Serum in 1899-1900.
The Bombay Municipal Corporation having accepted, at their meeting of the
8th of May 1899, the Hon'ble Mr. Pherozeshah Mehta's proposition, " that in the .
opinion of the Corporation the experiments with Professor Lustig's serum should
be continued, for a much longer period of time," arrangements were made accord-
ingly by the Municipal Commissioner.
As Professor G. Galeotti had to return to Italy to take up his duties there
Dr. G. Polverini was given charge of the Municipal Laboratory at Parel, where the
serum was being prepared, and Dr. A. Mayr, then at the Imperial Plague Research
Laboratory, was appointed to assist him.
Ten more horses were purchased at different periods, the first in July and the
last in December 1899, nine being country-bred and one Arab. The latter proved
very sensitive, and its immunisation was much delayed, whereas the former stood
the immunising injections very well, recovering quickly and keeping throughout in
good condition, having been ably attended to by Mr. S. N. Ranina, V. S. One of
the country-bred horses on arrival was found to be too small and weak, and was
sold, as was also one of the old horses which had become useless. Another horse
contracted malignant oedema in December 1899 and died. Horse No. 4, which
had always given a strong serum, developed tetanic symptoms in May last and
succumbed also. Two of the newly acquired animals were for a considerable time
sick, independent of the immunisation, which therefore proceeded only in ten horses
without hindrance. In consequence of this the manufacture of the serum could
not keep pace with the demand when the admissions at the Arthur Road Hospital
ran up to twenty a day in the beginning of March last, and the treatment had to
be interrupted for a fortnight. For the same reason only one horse could be
selected, with the sanction of the Municipal Commissioner, for the immunisation by
intravenous injections which, while promising an important improvement, might
have been fatal, and have further reduced the already limited number of horses.
The immunisation of this horse was not taken in hand before it was made sure that
the others would serve their purpose, and although progressing satisfactorily, the
bleeding could not be made in time to try the serum under the alternate treatment.
One patient was treated with this serum at the Modikhana Hospital in July last by
order of Lieutenant-Colonel J. S. Wilkins, I.M.S., who informed us that the patient
did exceedingly well. It was not deemed advisable to experiment upon the other
horses, which had to furnish the serum on the results of which the fate of the serum
treatment depended, and their immunisation was carried on strictly on the lines follow-
ed hitherto. Until the new horses were ready the serum was taken from the old one
which were bled two or three times more. The new horses were all bled once or twice.
During the time covered by this report 72 immunising injections and 22 bleed-
ings were made, the latter yielding 60 litres (15 gallons) of serum—forty-five litres
were used for the treatment of the patients and the remainder is in stock at the
laboratory at Parel.
The total number of patients treated was 566.
The treatment of selected cases having shown that the serum has curative pro-
perties, the second stage of the experiment was to ascertain the average percentage
of cures which could be obtained under those circumstances in which the serum
was chiefly to be used. Hence the patients were no longer selected for the serum
treatment with regard to the possibility of recovery, but taken alternately us they
were admitted into the hospital, an equal number remaining us so called " Controls "
under the ordinary treatment. The difference between the mortality of the two
sides would then be the expression of the efficacy of the serum. The selection was
thus left to the chance of the distribution, and the admissibility of such n selection
rested on the presumption that, according to the law of probability, the admissions