Statistical studies in immunity : a discussion of the means of estimating the severity of cases of acute disease / by John Brownlee.

  • John Brownlee
Date:
1907
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Licence: In copyright

Credit: Statistical studies in immunity : a discussion of the means of estimating the severity of cases of acute disease / by John Brownlee. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    [All Riyhtii reserved.'\ STATISTICAL STUDIES IN IMMUNITY. A DISCUSSION OF THE MEANS OF ESTIMATING THE SEVERITY OF CASES OF ACUTE DISEASE. By JOHN BROWNLEE, M.A., D.Sc., Gla.sgow. To the physician in the full practice of his profession there conies a consider- able power of accurate prognosis. Of two persons apparently equally ill to the unpractised eye he is probably generally able to state which is likely to get better and which to die. This power exists most markedly among those whose practice largely consists of attendance on acute disease. The process by which the opinion is arrived at cannot be accurately described; it is largely subconscious. Due w’eight is given to a great number of symptoms and the favourable and unfavourable balanced against one another, but the conclusion is a personal opinion of the man himself. Were such a person’s opinion taken as a criterion of the severity of a disease, it would probably be as accurate as anything human can be. Unfortunately physicians with this power highly developed are not common, and for statistical purposes other criteria of the severity must be sought. A number suggest themselves at once, and those which are most useful are the following:— (a) The length of illness; (6) the mean temperature; (c) the day on which stimulation is first found to be necessary; (d) the age of the patient; and (e) in the eruptive fevers, the amount of eruption. Now while each of these except pei’haps (rf) might be taken d 'priori as a fair measure of severity, and while there is no doubt that each does sort out the cases of the disease in grades of severity, yet none of them provides a complete test. The real test of severity is the percentage mortalit}'. This represents a fact subject only to the error of random selection, and provides a means of estimating the access of severity occasioned by an alteration in some other circumstance. The evidence for this will become apparent later on in this paper; in the meantime it will be shown that each criterion of severity, while sorting out the cases in degrees of severity as gauged by the death rates, does so quite independently of any other.
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