23,6 Rodriguez and Eubanas: Leprosy with Antimony 581 



The most serious reaction was diarrhoea with abdominal pain. 

 These symptoms were complained of by three patients, two of 

 whom died. Treatment was stopped in the third case and ap- 

 parently a fatal termination was averted; the diarrhoea disap- 

 peared without further treatment. When, in the course of a 

 series of injections with tartar emetic, these symptoms appear, 

 the drug should be discontinued at once. On the other hand, 

 transient abdominal pain need not be taken seriously. 



The greatest drawback to the use of this drug in our cases 

 was its effect on the kidneys. Examination of the urine as a 

 routine measure at stated intervals brought to light evidence of 

 kidney damage in a large proportion of the cases treated, in 

 spite of the small doses used. 



Twelve of those with negative urine at the start became posi- 

 tive for albumin within two months, though in most only traces 

 were found. Casts appeared in four of these cases, and in one of 

 them blood casts were observed, indicating the degree of irri- 

 tation to which the kidneys had been subjected. Six had albumin 

 at the outset ; two of these died, one was dropped from treatment, 

 in one the kidney condition cleared up, and in the other two it 

 was aggravated. The nonleper showed no evidence of kidney 

 injury. 



TUBERCULOSIS 



Eight patients showed evidence of pulmonary tuberculosis at 

 the outset. One had haemoptysis after receiving 8 milliliters in 

 six injections. This case, together with three others who showed 

 marked injurious effects, had been dropped within five weeks 

 after starting; one of them died after having developed what was 

 evidently a psoas abscess. 



Only one of the eight tuberculous patients finished the six 

 months course. The tuberculous process was accelerated in 

 several cases, and in one markedly so, as confirmed by autopsy. 

 Another died from persistent diarrhoea, apparently caused by the 

 drug, not from the effects of the lung lesion. 



SUBSEQUENT OBSERVATIONS 



Six months after the conclusion of the experiment the sur- 

 viving patients were reexamined. Three had continued to im- 

 prove, so far as the ulcerations were concerned; all of these had 

 been taking chaulmogra oil by mouth since the end of the ex- 

 periment. Three had become worse, and the rest remained 

 stationary. 



