1298 



THE KALA'AZARS AND PSEUDO-KALA-AZARS 



cent, carbolic, which in practice renders unnecessary a sterihzation 

 by heating. 



Intramuscularly . — Intramuscular injections are painful and often become 

 inflamed. The following solution may be used: — 

 Tartrate of antimony 

 Carbolic acid 

 Glycerine . . 

 Bicarbonate of sodium 

 Distilled water 



The dose is J-i cubic centimetre every other day injected intramuscularly 

 into the gluteal region, 



Martindale's formula may also be used: — • 



Antimonii oxidi . . . . . . . . gr. gV. 



Glycerin.) 



Aq. dest./ "l^v. 

 One ampoule. 



Combined. — Oral administration may be combined with intravenous or 

 intramuscular injections. The following mixture may be given:- — • 

 Tartrate of antimony . . . . • • 5 grains. 



Q grains, 

 lo minims. 

 3 drachms. 

 1 grain. 

 I ounce. 



Bicarbonate of sodium 

 Glycerine . . 

 Chloroform water , . 

 Water 



30 grains. 

 I ounce. 

 I ounce, 

 to 3 ounces. 



The dose is one to two teaspoonfuls in water three times a day. 



Rogers regards sodium antimonyl tartrate, given intravenously, as being 

 more efficacious than tartar emetic. Colloidal antimonial preparations have 

 been recommended. 



Symptomatic Treatment.— ^/^sworrA^i^zc symptoms may be treated 

 by calcium lactate in lo-grain doses twice or three times a day. 

 Diarrhoea may be combated by bismuth subnitrate in 10-12 grain 

 doses, with or without 5-10 grains of salol, every four to six hours, 

 as may be required. Intestinal parasites should be looked for and 

 treated as prescribed in the chapters pertaining to the different 

 forms. The heart must be watched and cardiac tonics or saline 

 injections given if required {vide Treatment of Malaria, p. 1188). 



General Treatment. — ^The patient should be kept in bed and well 

 nursed during this treatment. 



Diet. — The diet should be good and nourishing, but if there is much 

 diarrhoea it is necessary to restrict it to milk, Benger's food and the 

 like, soups, etc. 



Prophylaxis. — ^As the method of infection is unknown, all that 

 can be done is firstly to segregate the sick and carefully disinfect 

 his motions, as well as protect him against blood-sucking arthropods. 

 Secondly, to remove the healthy from the infected area, and to 

 disinfect or destroy the clothing, furniture, and houses, while a 

 complete change of the drinking-water supply is essential. If this 

 latter cannot be done and the water-supply is a well, it may be 

 sterilized by blowing in steam, as in the case of prophylaxis against 

 the guinea-worm (p. 1971) ; or if this cannot be done, the simple boil- 

 ing of all drinking-water should be carried out. It does not appear 

 probable that infection comes about via unbroken skin. 



