2 BULLETIN" 1057, U. S. DEPARTMENT OF AGRICULTURE. 



investigators employed, by intramuscular injection, the ethyl esters 

 derived from its peculiar fatty acids. 



In 1918 the Kalihi receiving station 2 invited Dr. A. L. Dean, 

 professor of chemistry and president of the University of Hawaii, 

 to cooperate in determining which of the constituents of chaul- 

 moogra oil possessed specific value in the treatment of leprosy. 

 Basing his work upon the exhaustive researches of Dr. Frederick 

 B. Power and his collaborators in London (1, 17, 18, 19, 20, 21), 

 who first isolated and described the optically active chaulmoogric 

 and hydnocarpic acids and prepared their esters, Dr. Dean (6), in 

 collaboration with Dr. Richard Wrenshall, undertook the fractiona- 

 tion of chaulmoogra oil in order to ascertain the best method of 

 preparing the acids and their respective ethyl esters in quantities 

 sufficient for clinical use. By means of a high vacuum the acids were 

 obtained in a satisfactory degree of purity. 



The standard treatment consisted at first of weekly intramuscular 

 injections of the mixed ethyl esters with 2 per cent of iodin in chemi- 

 cal combination. These injections wece supplemented by the oral 

 administration of the fatty acids with 2.5 per cent of iodin, this 

 preparation being given in capsules three times a day. 



The method of treatment was later changed by omitting the iodin 

 and also the oral administration of the acids, as it was found that 

 this procedure was not necessary and that the injection of the ethyl 

 esters was vastly more important. It was furthermore observed 

 that the mildest forms of the disease showed the slowest improve-, 

 ment. One of the difficulties encountered in treating patients is said 

 by Drs. McDonald and Dean to be that something like 10 per cent 

 of them are unable to take the injections continuously, as they tend 

 to break out with swellings, which may be a form of toxemia or an 

 anaphylactic reaction. 



While it is a fact that it will require a period of several years to 

 demonstrate that persons treated with the ethyl esters of the acids 

 obtained from chaulmoogra oil are absolutely cured of leprosy, the 

 indications of their curative action after nearly two years of use 

 have. been so promising as to make a thorough study of the trees 

 which furnish this oil and some closely related products extremely 

 advisable. That the above-mentioned preparations have been of 

 immense help in the treatment of the disease is beyond question. 

 McDonald and Dean (16, p. 1473) have, indeed, considered it to be 

 established "that the fatty acids of the chaulmoogric series are 

 specific in leprosy." 



a This institution is located in the suburbs of Honolulu,, where for many years those 

 suspected of having leprosy were received for examination and whence those affected 

 were sent to the leper settlement of Molokai. 



