It would take too long for the present purpose to consider what has been done, not only for the prevention of plague, but also for its cure by a serum treatment. The results obtained by this treatment in India have not been very good; but Yersin and others report better results in other countries. Good results are reported from Amoy (1896), Nhatrang (1898), Oporto (1899), and Buenos Ayres (1899-1900). In Glasgow, the prophylactic use of Yersin's serum seems to have done excellent service: the success of its curative use was not very striking. The curative results at Nhatrang (Yersin, Annales de l'Institut Pasteur, March 1899) are notable. Nhatrang is an Annamese fishing-village; and the plague, when it was left to itself, killed every case that it got:—
"La peste s'est montrée excessivement meurtrière chez les Annamites. Sur 72 cas de peste, 39 personnes chez lesquelles la maladie a évolué normalement, ou qui n'ont été traités que par des médecins indigènes, sont mortes sans exception. Les 33 autres cas ont pu être traités par le sérum, quelquefois dans de bonnes conditions, mais le plus souvent quelques heures seulement avant la mort. Malgré cela, nous avons obtenu 19 guérisons et 14 décès, ce qui fait une mortalité de 42 per cent., chez les traités. Ainsi, d'une part, 100 pour 100 de mortalité chez les non-traités; de l'autre, 42 per cent. chez les malades qui ont reçu du sérum. Ces chiffres confirment les résultats que j'avais obtenu en Chine en 1896."
A long review of this curative treatment, fairly hopeful but nothing more, is given in the Report of the Plague Commission, vol. v., pp. 269-320. The Commissioners are of opinion that it ought not yet to be extended, as a general measure, over all the districts affected with plague; and that there is need of more work in bacteriology before it can be thus extended. "We desire to record our opinion that, though the method of serum-therapy, as applied to plague, has not been crowned with a therapeutic success in any way comparable to that obtained by the application of the serum method to the treatment of diphtheria, none the less the method of serum-therapy is in plague, as in other infectious diseases, the only method which holds forth a prospect of ultimate success."
It is a strange contrast, between this opinion and the statements made by the opponents of all experiments on animals. Some of these statements will be found in Part IV. of this book. Happily for the world, no amount of foul language can hinder the good work; and, when we talk of Empire-building, and of deeds that win the Empire, we must reckon bacteriology among them: as Lord Curzon did, in his speech at Calcutta, March 3, 1899—What is this medical science we bring to you? It is built on the bed-rock of pure irrefutable science; it is a boon which is offered to all, rich and poor, Hindu and Mohammedan, woman and man.
IX
TYPHOID FEVER. MALTA FEVER
Typhoid Fever
The names of Klebs, Eberth, and Koch, are associated with the discovery, in 1880-81, of the bacillus of enteric fever, bacillus typhosus; and it was obtained in pure culture by Gaffky in 1884. It has been studied from every point of view, in man and in animals; in the blood, tissues, and excretions; in earth, air, water, milk, and food; in its distribution, methods of growth, and chemical products. Especially, the study of its chemical products has been directed toward (1) immunisation against the disease, (2) bacteriological diagnosis of the disease at an early stage.
The date of the first protective inoculations against typhoid is July to August 1896: they were made at Netley Hospital, by Professor Wright and Surgeon-Major Semple. The first inoculations in Germany, made by Pfeiffer and Kolle, were published two months later. The story of these famous Netley inoculations is told in the British Medical Journal, 30th January 1897. Eighteen men offered themselves—
"A good deal of fever was developed in all cases, and sleep was a good deal disturbed. These constitutional symptoms had to a great extent passed away by the morning, and laboratory work went on without interruption.... With two exceptions, all these vaccinations were performed upon Medical Officers of the Army or Indian Medical Services, or upon Surgeons on Probation who were preparing to enter those services."