On prophylactic inoculation against plague and pneumonia.

  • Waldemar Haffkine
Date:
1914
Catalogue details

Licence: In copyright

Credit: On prophylactic inoculation against plague and pneumonia. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    was investigated in relation to the age, sex, nationality and caste of the patients ; their condition as to previous inoculation; the duration of illness prior to admission to hospital and prior to the application of the specific treatment; the state of consciousness or coma on admission ; the type of the illness, viz., the presence or absence of outward lesions (buboes) ; the number and mode of distribution of these, if present ; the condition as to pneumonic symptoms; the detection or otherwise of germs in the circulation at stated periods of the disease ; the tem- perature, pulse and respiration at the time of arrival at hospital and of commencement of treat- ment ; the variation of these particulars after the first administration of serum and throughout the time of observation ; the duration of febrile symptoms in recovery cases ; the recurrences, if any, of high temperature and high rates of pulse and breathing subsequent to the first restoration of normal conditions; the recovery rate corresponding to variations of treatment; and the prolon- gation, if any, of life in fatal cases. The relative gravity of each of the above symptoms was at the same time minutely enquired into. Of the observations which, at that period, were taken and recorded in Indian Plague Hospitals, I omitted, for the time being, to take account only of those which conveyed general impressions of the observers, or were based on mental records, that is, those in the estimation of which personal incHnation and idiosyncrasies, not admitting of control and verification, played an important part. In no case, however, were impressions of this nature required for forming definite conclusions. The studies here referred to were made with the serum of Professor Lustig of Florence, which was used in Bombay in 1899-1900 ; with Drs. Terni and Bandi's serum, from Messina, used in 1903 and 1904 ; and with Dr. Vital Brazil's serum, from San Paolo, Brazil, and Drs. Roux and Yersin's serum, from Paris, which were tried in 1904. Detailed reports, in each case, were submitted to government, and a budget of these was subsequently edited and published, during my absence from India, in the Scientific Memoirs hy Officers of the Medical and Sanitary Departments of the Government of India, No. 20, under the title of Serum-Therapy of Plague in India, reports by W. M. HafEkine and Ofiicers of the Plague Research Laboratory, Bombay. (Ofiice of the Superintendent of Government Printing, India, Calcutta, 1905.) Subsequently, I made analogous experiments with the sera prepared by Dr. Macfadyen and Professor R. T. Hewlett for the treatment of plague and of cholera. A certain number of facts estabhshed in these investigations will be briefly recalled here with the object of indicating the nature of the information thus obtained. The result showed that injection of serum tended to mitigate the symptoms of the disease, to an extent which was carefully determined with regard to each symptom. At the same time the fact first communicated to the Plague Commission was observed again, viz., that the remedy had no appreciable efiect on the mortahty from plague. In the case of Dr. Lustig's serum, the patients, 484 in number, presented the most marked difierence in the rate of mortality as compared with the 484 patients not treated with serum. The proportion was 68-18 per cent, of deaths amongst the serum treated patients, and 79-55 per cent, amongst the others. Examination showed, however, that]the patients who had received serum included a clearly defined preponderance of cases which had, from the first, comparatively benign symptoms, whilst those left without serum had a preponderance of grave cases. The average survival in hospital of the patients treated with serum, but who ultimately succumbed, was 3-89, days, while that of the non-serum patients was 2-76 days. Among the patients admitted with