60

REPORT ON A SERIES OF 68 CASES OF PLAGUE TREATED WITH
ROUX' ANTI-PLAGUE SERUM.

By W. G. WEST, M.R.C.S. (Eng.), L.R.C.P. (Lond.), M.D. (Geneva),
Attached to the Plague Research Laboratory, Bombay.

THE serum was sent from the Pasteur Institute, Paris, in the middle
of March 1904, by Dr. Roux, in response to a telegram from
Mr. Haffkine, and was received here in the beginning of the following month.
Twenty litres of serum were sent out in bottles containing 100 c.c. each,
secured by India-rubber caps and stoppers.

         The experiment was in all its details planned by Mr. Haffkine, before his
departure from India, but the watching of the patients and administration of
the serum was carried out in hospital by the present writer.

         The patients treated were those admitted to the Maratha Municipal Plague
hospital (under the care of Dr. N. H. Choksy) between the 8th of April and
the 5th of May 1904. Between these dates 160 cases were admitted, 80 were
placed in the serum group and 80 alternate cases in the control group. Twelve
patients of the serum group were either moribund or convalescent on admission
and were therefore not injected. These 12 cases, as well as the 12
corresponding control cases, have therefore been excluded from the 160 cases,
thus leaving a total of 68 cases on each side.

         As regards the doses given, Professor Roux' recent recommendations
(vide page 63, Roux' letter) were as far as possible carried out, viz. :—

            (i) Subcutaneously, large doses were injected, the initial dose for an adult
                 being in the large majority of cases 100 c.c. followed in 12 hours
                 by a similar quantity. The total quantity of serum injected
                 generally amounted to 300 c.c. and more.

            (ii) Intravenously, the initial dose was in the greater number of cases
                 40 c.c., followed by another injection of the same quantity 12
                 hours later, the total quantity of serum injected intravenously
                 amounting generally to about 120 c.c.

            Of the 68 serum-injected patients—

            (a) 43 were injected only subcutaneously, the initial dose being (as
                  before mentioned) mostly 100 c.c. and the total up to 300 or
                  more, and in one case 700 c.c. Of these, 29 died, giving a
                  mortality of 67.44 per cent.;