592 The Philippine Journal of Science 1923 



protracted periods of febrile lepra reaction, is added the burden 

 caused by the multiple, usually infected, lepromatous ulcers, that 

 in many cases persist for years; the constipation so prevalent 

 in our cases; and the numerous drugs usually received by 

 these patients, by injection or otherwise. In the majority of 

 advanced cases the vital function of the skin is doubtless more 

 or less handicapped by extensive cutaneous lesions, and by 

 nervous changes and the atrophy so often prominent in this 

 stage of the disease. The diminution or absence of sweat over 

 the affected parts is a classical manifestation of the disease. 

 Furthermore, in a surprising number of cases, the limited ef- 

 fective portions of the skin are affected by yet other, incidental 

 skin diseases. It is therefore not to be wondered at that the 

 kidneys of advanced lepers are usually damaged. We are made 

 more and more to realize that, in the therapy of this disease, 

 the influence of the drug used on the kidneys must be carefully 

 observed. 



According to Levy and Dimmitt 7 tartar emetic should always 

 be cautiously used. These authors have found that the total 

 non-protein nitrogen in the blood is increased by the administra- 

 tion of even a small amount of tartar emetic for a comparatively 

 short period of time. Underhill, Pearce, Ringer, and Salant 8 

 have observed injury to the kidneys of experimental animals 

 produced by small doses of tartrates. 



Pulmonary tuberculous lesions in certain of our cases showed 

 rapid progress under the influence of the treatment. We are 

 inclined to believe that it is an indirect effect through lowering 

 of the resistance of an already run-down patient, thus enabling 

 the disease to progress rapidly, rather than a direct influence on 

 the tuberculous process. 



The patients who were under the Castellani mixture received 

 only 2 grams of potassium iodide daily. Wayson 9 used as 

 much as from 6.5 to 13 grams of potassium iodide per day in 

 Hawaiian lepers, and observed breaking down of the leprotic 

 nodules into ulcers which healed, leaving little scars, with res- 

 toration of sensation. Salivation, nausea, and vomiting took 

 place at one time or another in the majority of our patients. 



•£l!S ¥' ?*' Snd Dim . mitt > P - S - Am - J ourn. Trop. Med. 2 (1922) 569. 



