Commentary: Dr Choksy's dilemma.

with moribund cases, who were beyond reach of all human help, and with convalescent and semi-convalescent cases being excluded. It was found that the rate of recovery could be doubled in acute and fit cases with the use of serum therapy. In his letter to the Lancet, Choksy contended that there had been no reason for dissatisfaction with Lustig's serum, in the 2 years of its application by him. He held that although the mode of preparation and application at the bedside had to be determined with further research, experiment and clinical observation, serum treatment was the only treatment that could appreciably reduce the high mortality of plague. Choksy maintained that he abided by his experience and called upon critics to withhold their objections and allow those conversant with the subject to continue their work. As for septi-caemia cases, Choksy noted, 3 years later, in his work, Treatment of Plague with Professor Lustig's Serum, 3 that serum therapy did prolong life, but did not always ensure recovery. However, in 1909, in his paper read at the Bombay Medical Congress, entitled, 'The serum therapy of plague in India', 4 he noted that investigations by the Plague Research Commission had shown that recovery was possible with Lustig's serum. In recognition of his work during the plague epidemic , Choksy was given the title of Khan Bahadur (title signifying bravery) by the British. His experience in treating cases of plague, smallpox and cholera was considered unique, and he was associated with the establishment of the Acworth Municipal Leprosy Hospital, Bombay. Choksy was among the initiators of a unique collaborative effort to promote public health in Bombay, in the early 1900s, through semi-official organizations, supported by the municipality , doctors and philanthropists. 5 This resulted in the founding of the Bombay Sanitary Association, in 1903, which aimed at promoting sanitary consciousness through public lectures and the training of personnel. Significantly, the first public lecture at the Bombay Sanitary Association, entitled, 'Some common sense views on plague', was delivered by Choksy. He was also connected with the Bombay Anti-Tuberculosis League, established in 1912, which spread awareness of the disease and provided treatment. In the angry letter he wrote to the Lancet in July 1900, 1 Dr Choksy's irritation obscures the background of the study he describes. That, we thought, might be a good point to start. In the first months of the new century, what …