On pharmaco-therapy and preventive inoculation applied to pneumonia in the African native : with a discourse on the logical methods which ought to be employed in the evaluation of therapeutic agents / by Sir Almroth E. Wright.

  • Wright, Almroth E. (Almroth Edward), Sir, 1861-1947.
Date:
1914
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Licence: In copyright

Credit: On pharmaco-therapy and preventive inoculation applied to pneumonia in the African native : with a discourse on the logical methods which ought to be employed in the evaluation of therapeutic agents / by Sir Almroth E. Wright. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    another important limitation. It is impracticable, in the case where the evaluations of different observers diverge, to bring these together into a single judgment. For there is no method for finding the resultant of a number of non-numerical evaluations. The difficulties in connexion with the application of the statistical method are not less serious than those encountered in the application of the experiential method. But they are of a different order. They lie in the fact that it is the exception to find in connexion with clinical material either a really critical feature by reference to which the cases can be sorted out into successes and failures; or a significant feature which is universally present and which lends itself to arithmetical evaluation. The difficulty of finding a critical feature which would subserve the purposes of a statistical evaluation can be illustrated by taking the case of the treatment of phthisis. It matters not whether we take as our criterion of success, the disappearance of the tubercle bacilli from the sputum, or the disappearance of the pyrexia, or a gain in body-weight, or the return of the patient to full work, or simply the survival of the patient for a certain fixed period : no matter what criterion we elect, there will inevitably be found among those who benefit by the treatment many in whom that particular condition is not realised, and also many in whom the fulfilment of that condition will not be of critical value. It might be suggested that these difficulties should be circumvented by allotting a certain arbitrary number of marks to each significant clinical phenomenon, and then evaluating in accordance with such convention. In reality, such a scheme resolves itself into a proposal to make a number of separate statistical tables, and to combine the results in such a way as to make of the statistical method a method of unrestricted outlook. This proposal would make shipwreck upon the fact