Serum-therapy of plague in India : a record of work brought up to date / by Khan Bahadur N. H. Choksy.

  • Choksy, Khan Bahadur N. H.
Date:
1907
Catalogue details

Licence: In copyright

Credit: Serum-therapy of plague in India : a record of work brought up to date / by Khan Bahadur N. H. Choksy. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    10/58 (page 10)
    to bo subsoqnontly instituted, it was not so much tor its statistical value as tor showing what etl'oct the serum had in lowering the mortality rate in those cases tliat were really fit for serum treatment and not beyond all hope. On this basis the results obtained were such as to demand carotul consi- deration as they indicated a distinct lowering of mortality. And »o also in the 130 cases treated in private practice by 10 medical gentlemen, the rate ot mortality was as low as 44'61 per cent. These results have been similarly ignored. No attempt has been made to explain how it was that tliero was such a great reduction in the mortality. The e<lit6r contents himself simply by re- marking “No contrasting cases.” But there could not be any, as a matter of course, among private patients I The above observa- tions with Lustig’s serum left no doubt on the minds of those who observed them from day to day that it exerted a distinctly beneficial influence on the course of the disease, ameliorated the symptoms and saved more lives. The details in connection with this I have fully described in my book on the treatment of Plague with Prof. Lustig’s serum, a copy of which I had the pleasure to forward to the Sanitary Commissioner some time back. 7. If we now turn to the first table it gives food for much reflection. The observations with the alternate system have been summarized by the editor from a luo.st ingenious, elaborate and strictly arithmetical analysis—the invention of Haffkine—in which each case has to be analysed into 8 tabulations and docket- ted into something like eight to ten times as many sub-divisions. It is a most intricate system ^Lere the thermometrical readings, the frequency of the pulse and the number of respirations—all numbers—play the most important role and where the results of such an inexact -science as medicine have been made to justify themselves by the test of the exact science of numbers. Such a system may be a good exerciise at arithmetic, but it certainly is not and cannot be called medicine. And so far as we are aware it has not been adopted in analysing results obtained by medical or serum treatment in tlie case of any other disease. Too much importance—far more than what is actually deserved as any cli- nician can testify—has been attached to the range of tempera- ture, to the frequency of the pulse and to the number of respira- tions. A high temperature in plague may be and generally is an index of the gravity of the case, hut a low temperature does not mean the converse. In every case of plague there is a remission of temperature on the third day and although the previous read- ing may be as high as 105% the lower reading of 101* or even so low as 98’ or 97“ does not imply that the patient was not in a serious state if he happened to be admitted at the time. It is only by thorough familiarity with and constant attendance on plague patients that any valid analysis of the range of temperature can be of use, as there are so many causes slight, a.s well as grave, that send up the temperature in a plague patient both during the