23.5 Samson and Limkako: Creosote in Leprosy 519 



INCIDENTAL EFFECTS DURING TREATMENT 



In the course of the treatment various incidental conditions 

 have arisen, resulting' directly or indirectly from the treatment, 

 that probably have more or less bearing on the results obtained. 



LOCAL EFFECTS 



The local effects of intramuscular injections of chaulmoogra 

 ethyl esters are local inflammation and, infrequently, abscess 

 formation at or near the site of injection. Local inflammation 

 of moderate degree is a natural and constant reaction to this 

 drug; however, usually it causes but little discomfort, lasts but 

 a short time, and more or less completely subsides within a 

 week. However, because of increase of dose, increased suscep- 

 tibility or, perhaps, delayed absorption, more-severe reactions 

 frequently occur which cause greater discomfort and last 

 longer. 



The number of such more-severe local reactions occurring in 

 each group is shown in Table 3. 



Table 3. — Frequency of local reactions. 



Z 



: 0- |»«. 



«— J»-Br 



.« \-z 



"* 



In Group I, 4.3 per cent of the injections caused acute cellu- 

 litis. In the total of 1,200 injections given Group II, local re- 

 actions were caused 101 times, or 8.4 per cent. Of these 33, 

 or 32.6 per cent of the total number, occurred in three patients. 

 These were abnormally susceptible to the ethyl esters, for they 

 had very frequently exhibited this phenomenon while under the 

 previous routine treatment. Excluding these unusual cases, the 

 reaction percentage in this group is 5.9 per cent. Why there 

 should have been more reactions in this group than in Group I 

 is not apparent. The highest incidence occurred in Group IV, 

 8.4 per cent of all injections causing inflammation; in Group 

 HI, with twice as much creosote but with camphor added, the 

 rate was considerably less. 



