Statistical Studies in Mortality.—The statistical study of plague mortality from the point of view of treatment is misleading and unsatisfactory for reasons already given in our discussion of treatment, viz.: failure to secure early recognition and early serum treatment, and the greater incidence of plague in the lower social classes.
Few statistical compilations divide the cases studied into moribund and non-moribund, and indeed such division, being a matter of judgment, largely involves the personal equation of the observer.
The ease with which statistics may be moulded to support theories, or to break them down, all with perfect honesty of purpose, is proverbial.
To me, the spectacle of a single case of plague, apparently ill unto death, recovering under the administration of antiplague serum, is more impressive than the contemplation of statistics; and I have seen more than one such case respond to serum treatment and recover.
So far as it goes, however, the study of statistics supports the view that treatment with antiplague serum is effective.
I have not at hand the records of the last 20 or more cases, but of the first 68 cases of plague in the recent Manila epidemic, 32 were either found dead or died upon the same day that they were found.
If we exclude these cases from consideration there remain 36 cases. All of these patients received serum treatment and ten of them recovered.
It is at once apparent that this percentage of recoveries (27 per cent. plus) is far more favorable than the actual percentage of recovery in the series in which cases found dead and moribund are considered, the recovery percentage here being a little more than 14 per cent. It is also quite fair, it seems to me, to make this separation of cases, or even a more liberal one, if we are to consider the effects of serum treatment statistically.
Dosage and Technique of Serum Administration.—The amount of antiplague serum to be given will vary somewhat with the age and weight of the patient and with the apparent severity of the case.
In general terms it may be said that adults should be given from 300 c.c. to 500 c.c. of serum by injection, 100 c.c. being given every four hours. The injection may be either intramuscular or intravenous.