332
In this connection I should like to correct an error regarding this distribution
which occurs in Capt. Childe's report, dated the 4th of April 1899, No. 226, to Sur-
geon-General G. Bainbridge, M.D., concerning 148 patients treated with Prof. Lus-
tig's serum from February 2nd to March 27th. Capt. Childe gives on page 19 a
table showing the number of patients treated on the different days of illness. Ac-
cording to this table, out of a total of 148 patients, 30 received treatment on the first
day of illness. He states further, on page 20, para. 6, that 22 of them died, the mor-
tality being 73.3 per cent. and demonstrates that, contrary to the axiom of serothera-
peutics, the mortality of the patients treated on the first day is higher than that of all
the patients who underwent the treatment; the figures being 73.3 per cent. and 69.7
per cent. respectively, and continues by saying "that this points to the same conclusion,
namely, that treatment by Prof. Lustig's serum has not much influence on the
course of plague."
These statistics need rectification. By looking closer through Capt. Childe's
report one will find that of the 30 patients admitted on the first day of disease 4 re-
ceived the treatment on the day after admission, that is, on the second day of disease.
On the first day there were therefore 26 patients treated, of whom 18 died and 8 re-
covered; the mortality being 69.2 per cent.
Hence the mortality of the patients who received treatment on the first day
was lower than the mortality of all the patients who underwent the treatment; the
figures being 69.2 per cent. and 69.7 per cent. respectively, instead of 73.3 per cent.
and 69.7 per cent. as stated by Capt. Childe.
This error to consider the day of admission as identical with the day of the
beginning of the treatment amounts to 11 for the patients admitted on the second
day of illness and has vitiated the corresponding statistics and the conclusions drawn
from them, which latter had in any case a very limited value indeed, based as they
were on results which could be materially altered by an error of 4.
It is worth mentioning here that in Capt. Childe's report the Maratha Hospital
shows 9 patients treated on the first day, in a total of 12, and the Arthur Road
Hospital only 12 such patients in a total of 125.
After this necessary digression I return to my subject. The relation between
recoveries and days of illness on which the treatment, commenced, is shown in the
following table:-
Days of illness.
No. of
patients
treated.
Recoveries.
Percentage of
recovery.
1st
37
34
37.8
2nd
140
49
35.
3rd
117
39
33.3
4th
54
26
48.1
5th
24
12
50.
6th
13
6
46.1
7th
18
8
44.4
403
154
38.21
In remarking on the above it is surprising that so few patients received
treatment on the first day of illness. The reason is that only about 6 per cent. of the
admissions are patients in this early stage, at least at the Arthur Road Hospital.
These patients are moreover mostly in a very bad condition. Their mortality is
very high and many of them die soon after admission.