Haffkine's prophylactic against plague is found to reduce liability to attack 75 per cent. Editorial (Indian Lancet, Nov. 16, '97).
Epidemic of plague in Lower Damaun stated to be one of the most virulent observed in India. Inoculations tried on a large scale. Results are estimated on the 2189 authenticated deaths, thus avoiding any possibility of exaggerating the power of the prophylactic. Alto gether, 2297 persons were at different times inoculated. Between March 2Gth and the end of May 6033 uninoculated had 1432 deaths; that is, 24.6 per cent.; while 2297 inoculated had 36 deaths, or 1.6 per cent. With the same death-rate as the uninoculated the inoculated should have had 332 deaths instead of 36, which represents a difference in mor tality of 89.2 per cent.
In a careful analysis of the results of the inoculation it is shown that the effi cacy of the prophylactic depends on the virulency of the microbe from which the lymph is prepared, and on the dose and its powers of producing a well-marked febrile reaction, and that it is more effective in preventing deaths than at tacks. M. W. M. Haffkine and Lyons (Brit. Med. Jour., Jan. 8, '98).
In Hubli, India, from May I lth to August 23d, 33,330 persons were inocu lated (24,133 twice, 9742 once). In all, 58,013 inoculations were performed in fifteen weeks. Actual plague deaths have averaged 85 per cent. in favor of the inoculated. Haffkine's inoculation method and sanitation and hygiene should be utilized together. The general health of the inoculated persons seems to be improved, as shown by the lower death-rate from "other causes." Leu mann (Lancet, 10, '99).
Bubonic plague can be easily controlled by careful isolation and sanitation, one of the best disinfectants for rooms being formaldehyde-gas. All evacuations, spu tum, clothing, bedding, etc., should be disinfected, and the patient kept isolated for one month after apparent recovery. Among those attendant on the sick, 1 cubic centimetre of the Haffkine prophy lactic should he injected once a month.
The only curative is the antipest serum of Yersin and Roux, 30 to 50 cubic centi metres of which should be injected at the earliest possible moment. This may also be used as a prophylactic in dose of 10 cubic centimetres repeated every ten days. Walter Wyman (Document 2165, Treasury Department, Washington, 1900; Med. News, May 12, 1900).
The treatment of plague by means of antitoxin serum has proved most suc cessful in the hands of Calmette and some other observers. Thus, at Oporto, during September, October, and Novem ber of last year, 142 patients were treated with serum, and only 22 died. The mortality among those treated with antiplague serum was therefore only 15 per cent. as compared with 63 per cent. among those not so treated. Calmette insists on the necessity of injecting the serum directly into the circulation; 20 cubic centimetres of antiplague serum are injected into a superficial vein of the patient's hand, forearm, or leg as soon as a case of plague is suspected without waiting for the results of bac teriological examination. If the fever does not subside completely in twenty: four hours, and if the diagnosis is con fumed, another injection of 20 cubic centimetres of serum must be given into a vein. These injections are absolutely harmless, and if care is taken to warm the serum to body-temperature before injection the patient experiences no dis comfort from the injection. Serum in jection is equally efficacious for the prophylaxis of plague in localities al ready infected, but the protection af forded is not a very lasting one and the injection must be renewed at the end of a week. Prophylactic injections need not, however, be given intravenously; a simple injection of 10 cubic centimetres under the skin of the abdomen is quite efficacious. The serum presents the im mense advantage of conferring immu nity in a few hours. J. L. Bunch (Lan cet, Feb. 23, 1901).