23,6 Rodriguez and Eubanas: Leprosy with Antimony 577 



In the preliminary examination, cutaneous sensibility to light 

 touch, deep touch, heat and cold, and pain was determined and 

 charted. Nodules, contractures, eye lesions, and other features 

 of interest were described and in many cases photographed. 

 The ulcers were counted and the more prominent ones measured. 

 Bacteriological examinations were made from the cutaneous 

 lesions or, in the absence of such, from the nasal septum. The 

 acuteness of vision in those presenting involvement of the 

 eyes was also tested. The urine of each was examined at least 

 four times during the period; before starting treatment, after 

 two months, after four months, and at the completion of the 

 experiment. 



TREATMENT 



During this period no other treatment was given that could 

 obscure the results. Ulcers were washed with weak potassium 

 permanganate solutions and dressed daily, as were those of 

 others in the wards. The patients were maintained under 

 exactly the same general conditions as were the others, who 

 therefore served in a way as controls. 



The doses of the drug tolerated by our cases were much lower 

 than those used in other tropical diseases such as kala-azar, 

 sleeping sickness, etc., in which as much as 10 milliliters of the 

 1 per cent solution is injected daily for ten or more days. To 

 avoid irritation of the kidneys, since chronic nephritis is common 

 among Culion lepers, the first dose was fixed at 0.5 milliliter, 

 or 0.005 gram of tartar emetic. This was increased by 0.5 

 milliliter at each weekly injection, up to 2.5 milliliters, or 0.025 

 gram. With this dose most of the patients became weak, com- 

 plained of various ill effects, and urine examination revealed 

 evidence of kidney injury in the majority of cases. The amount 

 of the dose was then reduced to 1.5 milliliters, or 0.015 gram, 

 with which dose most of the objectionable side effects were no 

 longer noticed. In three cases the urine cleared up under this 

 dose. 



As the larger dose was clearly harmful, an attempt was made 

 to give the drug more frequently in smaller amounts. This was 

 tried on two patients who were already showing signs of im- 

 provement; the results proved disastrous as shown by the follow- 

 ing notes : 



Case 10.— N. T. Ulcers improving up to the ninth injection of 2.5 

 milliliters. Patient began to cough, and ulcers to return, so dose was 

 reduced to 2 milliliters and, finally, to 1.5 milliliters, when improvement 

 began again. After four injections at this dose the interval was reduced 



