^{page 65 note 1} Vide Wright, A. E. and Surgeon-Captain, D. Bruce, “On Haffkine's method of vaccination against Asiatic Cholera”, British Medical Journal, 4th 02, 1893, pp. 227–231CrossRefGoogle Scholar; and Haffkine, W. M., “Injections against cholera”, The Lancet, 11th February, 1893, pp. 316–318CrossRefGoogle Scholar. The latter paper was read by Dr Ruffer at a meeting in the Conjoint Research Laboratories of the Royal Colleges of Physicians of London and Surgeons of England, where, in co-operation with him and with Prof. Sims Woodhead and Dr Cartwright Wood, I had demonstrated the principal experiments connected with the subject. The operations performed with Prof. Wright and his then assistant, Surgeon-Captain, now Surgeon-General Sir David Bruce and the Surgeons on probation at the Army Medical School in Netley were, however, of a more elaborate and detailed character, as may be seen from the first of the publications just mentioned.

^{page 65 note 2} Wright, A. E. and Surgeon-Major, (now Colonel Sir David) Semple, “On vaccination against typhoid fever”, British Medical Journal, 30th 01, 1897, pp. 256–259.CrossRefGoogle Scholar

^{page 67 note 1} Vide the Commission's Report, vol. v, p. 197, table summarising the events in the Byculla House of Correction. The dates corresponding to what is referred to in that table as “Mr Haffkine's figures” are, as explained by me in a letter to the Commission, those of the first appearance in the patients of morbid symptoms; the dates corresponding to what is mentioned as the “Official figures” are those on which the patients were ultimately transferred from the observation ward to the plague hospital, and were reported officially as plague occurrences in the jail.

^{page 69 note 1} Half the members of each family had been inoculated.

^{page 70 note 1} Should be “developed.”

^{page 70 note 2} For summing up my reason (as quoted above) the last words should have been: “had elapsed prior to the time of inoculation.”

^{page 70 note 3} In pursuance of the procedure adopted by me, only those who were attacked within 24 hours after the date of inoculation were to be “omitted.” (See Section 47, quoted on p. 68.)

^{page 71 note 1} The operations in the Byculla House of Correction and in Undhera were performed at one sitting. The particulars enumerated by the Commission formed part of the description of the experiments in question.

^{page 71 note 2} Not employed by me in any of my studies.

^{page 73 note 1} In January, 1897.Google Scholar

^{page 74 note 1} Vide supra the statement as to the effect of large doses of pneumonia vaccine.—In carrying out the work of anti-typhoid inoculation, the operators introduced, amongst others, a certain formula for determining the volume of the dose, which the Plague Commission defined as “the quantity of broth culture which is lethal for 100 grammes of guinea-pig.” (Vol. V of their Report, page 183, section 395.) My criticism of this procedure was made in a Report to Government, No. 1269 of 9th August 1900, “On the present condition of manufacture of the plague prophylactic in the Plague Research Laboratory”, Government Central Press, Bombay, 1900; pages 14–17Google Scholar. It was seen shortly afterwards that the dose as above defined was apt to cause to the inoculated increased incidence of typhoid, or, in the terms of the statement quoted above, to produce “a negative phase.” Subsequently, a special “Anti-Typhoid Committee,” appointed at the War Office, and of which Sir Almroth E. Wright at first formed part, rectified the procedure as regarded the dose and some other particulars, and the inoculations, which had been suspended by the orders of the War Office, were resumed. (Cf. Sir Leishman, W. B., “Anti-Typhoid Inoculation”, Journ. of the Royal Inst. of Public Health, July, August and September, 1910Google Scholar; and Report of the Anti-Typhoid Committee, 1912, His Majesty's Stationery Office, London.)Google Scholar

^{page 74 note 2} Cf. the paragraph before the last and the second conclusion in the last.

^{page 76 note 1} The Lancet, 10th January, 1914, p. 92, quoted on p. 78 infra, and Wright, A. E., “Notes on the treatment of Furunculosis, Sycosis and Acne”, The Lancet, 29th March, 1902.Google Scholar

^{page 76 note 2} Vide Part II of this memoir.

^{page 78 note 1} Reproduced on p. 72; vide also p. 75.

^{page 79 note 1} My own analysis pointed approximately to a proportion of 9·6 and 3·8, as against the Commission's 12½ and 19. Subsequent consideration has shown me that the figure relating to general causes (3·8) required to be further reduced, and that relating to plague (9·6), correspondingly increased.

^{page 79 note 2} Vide foot-note (2) on p. 80.

^{page 80 note 1} Vide next quotation.

^{page 80 note 2} This view, and not the one quoted on p. 79, had originally been held by Surgeon-General Harvey, I.M.S. On 7th August, 1898, after first perusing my Khoja Inoculation Report, he wrote to me from Simla, in conjunction with the late Lieutenant-Colonel J. T. W. Leslie, I.M.S. (subsequently Sanitary Commissioner with the Government of India), as follows: “There must be a fallacy somewhere unless you have unconsciously hit upon the Elixir vitae. It seems to me that your figures make the uninoculated accountable not only for their own proper deaths, but for those among the difference between the total ultimately inoculated and the mean daily average of such.” In the March following, upon my suggestion, he came to Bombay, made a detailed enquiry, which lasted several days, in the Khoja quarters of the town and ascertained that the view in question was not tenable. His statement to the Commission after this investigation was as follows (“Minutes of Evidence,” vol. III, p. 347, section 26, 435): “I think that the records of the community are kept in a much more full and proper way than those of any average people. Several points have come out in addition to the fact that the records are correct. …We know, I should think, with practical accuracy from the Jamaat books those who have been inoculated and those who have not, so that we can get a very fair index as to the mortality among the two classes.” “I find that the original investigation of Prof. Haffkine was one which involved an enormous amount of energy and thought. Although it is a very short report (see App. No. IV in vol. I of these Proceedings), the amount of work involved in it was enormous.”—Surgeon-General Harvey's statement concerning the Jamaat records referred, as he mentioned, to the assignment of deaths among the inoculated and the non-inoculated, and not to the diagnosis of the causes of deaths.

^{page 86 note 1} Proceedings of the Royal Soc. of Med., January, 1908.Google Scholar

^{page 93 note 1} Vide, however, on p. 98 infra the authors' reference to the “popular verdict on statistics.”

^{page 94 note 1} As may be seen from the brief summaries given on pp. 88–93, the plan of study described here as “the statistical method” embraces the whole of the “raw material of experience,” the selection of one feature as a criterion, to the exclusion of others, not being necessary. In acute diseases, however, often one particular “feature,” such as the recovery rate, may, indeed, be taken as an essential criterion of success. As already stated, I limited my enquiries to such a criterion in the first days of the plague epidemic in Bombay.

^{page 95 note 1} Vide preceding foot-note.

^{page 95 note 2} Vide foot-note (1) on p. 93 and remarks on pp. 88 and 90 concerning symptoms and particulars not universally present.

^{page 95 note 3} Vide remarks on p. 90 on the idiosyncrasies of observers and on the question of recurrences of morbid symptoms.

^{page 96 note 1} Vide foot-note (1) on p. 93.

^{page 96 note 2} Vide, with reference to the four points mentioned, Section II. pp. 88–93 supra.

^{page 97 note 1} Vide foot-note (1) on p. 94.

^{page 98 note 1} Vide Section IV, p. 99.

^{page 98 note 2} Vide the view quoted on p. 100 concerning the capacities of the human intellect for carrying in mind and weighing one against the other processions of substantive and control cases.

^{page 99 note 1} Vide Freeman, J. M.D., Assistant in the Department of Therapeutic Inoculation at St Mary's Hospital, in the Proceedings of the Royal Society of Medicine, 1910, vol. IIIGoogle Scholar; or in Nachbar's, J.“Vaccine therapy: its Administration, Value and Limitations,” 1910 (Longmans, Green and Co.), pp. 99 and 100.Google Scholar

^{page 99 note 2} Vide Sir A. E. Wright's address in the Proceedings of the Royal Society of Medicine. 1910, or in Nachbar's work just quoted, pp. 13 and 32.

^{page 100 note 1} Cf. Section II, pp. 88–93 supra, and the results of the Witwatersrand evaluation.