At first sight these figures may not appear striking, but when plotted against the standard figures they do show that the move to the left which is indicative of improved results.
LONDON HOMOEOPATHIC HOSPITAL STATISTICS.
I have extracted from the hospital records the notes of 87 cases of lobar pneumonia between the years of 1920-29. I cannot claim that these are all the cases of pneumonia treated during that period, but they include all the cases under the direct care of three physicians and as many single cases as could be traced in the records of the various assistant physicians.
Unfortunately the records are not yet fully indexed, and so one had to go through all the records for that period.
Excluding moribund cases there were seventeen deaths 19.5 per cent mortality, a very average figure.
1 case had crisis on the second day of the disease.
1 case had crisis on the third day of the disease.
4 cases had crisis on the fourth day of the disease.
7 cases had crisis on the fifth day of the disease.
13 cases had crisis on the sixth day of the disease.
15 cases had crisis on the seventh day of the disease.
8 cases had crisis on the eighth day of the disease.
5 cases had crisis on the ninth day of the disease.
16 cases had crisis on the tenth onward.
Calculated on a percentage of cases by a certain day the figures are as follows. For a comparison and as a basis for the curve, the figures of other large series of cases are shown as well as those of Rorke previously noted (11).
Day…………. 2 3 4 5 6 7 8 9
L.H.H……….. 1.1 1.1 4.6 8.0 15.0 17.2 9.2 –
Rorke……….. 0 5.0 10.0 5.0 35.0 25.0 15.0 –
266…………. 0 1.5 4.7 14.2 12.4 16.9 11.6 –
829…………. 0.5 3.0 5.9 11.3 10.3 18.2 12.9 -.
It will be seen that the hospital figures are only average and there is no move to the left so apparent in those of Rorke. It is to be noted that the majority of cases were not admitted earlier than the third day, and it is the opinion of some that this is more common in our hospital than in others.
From a consideration of the hospital records I would urge:.
1. That an accurate account of the onset be obtained and that the date rather than the day of the week be noted for the convenience of those who may in later years be studying the records.
Particular attention should be paid to the onset by chill, or pain, or cough, as denoting different and chronological stages of the disease.
2. That as far as possible pneumonias be treated as “star” cases and the opinion of the physician be sought on the day of the admission.
3. That reasons for the administration of the particular remedy be given.
4. That the case be typed according to modern bacteriological methods.
It might be possible to verify the opinion that, e.g., Bryonia is a remedy for illness of slow onset and therefore for Types III and IV rather than for Type I.
5. That blood-cultures be made and the severity of the disease compared with the number of colonies noted.
In conclusion, might I say that there are those who think we claim too much. One orthodox colleague has asked me to get you to publish your results in pneumonia, if they are as good as you claim them to be. I know that we can abort the disease, but the orthodox school are not interested in opinions. They will have figures. I have tried to show that adopting their own criteria of success Rorkes figures are good but, knowing how important it is to get the cases early, I feel that there must be a large number of cases in private practice unrecorded which would be overwhelmingly convincing if collected.
Please let us have them for publication.
