1 666 



LEPROSY 



Hypodermic injections of ' nastin ' have been tried. _ This is 

 a fatty principle extracted by Deycke from cultures of~a strep- 

 tothrix {Streptothrix lepr aides), which he found in the nodules 

 of leprotic patients. The nastin is combined with benzoyl chloride, 

 and made into ampoules with sterilized olive oil by Kolle and 

 Company, of Biebrich, on the Rhine. Each ampoule contains from 

 0*0005 to o»ooo2 gramme of nastin, which is to be injected once a 

 week, and in the small doses produces no 'local reaction, but in the 

 larger dose causes considerable local inflammation. Deycke' s 

 views as to the method of action are that the nastin attaches itself 

 to the lepra bacillus, and then the benzoyl acts on the bacillus, 

 damaging it by removal of its fat, when the normal fluids of the 

 body complete its destruction. 



Wise and Minett and others have reported unfavourably on this 

 treatment, but recommend benzoyl chloride in petroleum oil as a 

 valuable nasal spray or paint, as it renders the discharge from the 

 nose free from bacilli. 



Castellani and Woolley, and more recently Nicholls, have tried 

 a vaccine prepared by triturating nodules rich in bacilli in salt 

 solution or broth, then filtering through gauze, and finally heating 

 to 60° C. for an hour. 



Pasini has tried Finsen light, and Beurmann radium, with good results, and 

 Duque, Moreno, and Padilla have obtained considerable improvement, and it is 

 said cures, by treatment with decoctions of 20 to 60 grammes or 2 to 5 grammes 

 of the powdered mangrove Rhizophora mangle, which, given in small doses 

 at first, and gradually increased, are well stood, and produce a gradual 

 improvement in the symptoms; and in the course of a year, it is said, cases 

 may be cured. A. Bertarelli has obtained temporary good results by treating 

 a patient with hypodermic injections of a solution of carbolic acid. Wellman 

 and Rocamara have tried salvarsan, and claim good results. Maxwell has tried 

 Williams' leprolin and Malegin Sprengler's I.K. Lepra with good results. 

 Sugai recommends intravenous injections of a solution of potassium cu pro- 

 cyanide. 



Surgical treatment on the ordinary lines is required for ulcers, 

 whitlows, etc. Eye lesions should be treated as though the disease 

 was non-leprous, and should not be neglected. Grossmann thinks 

 that leprous infiltration might be arrested by the production of 

 cicatricial tissue, by a corneal or pericorneal incision. 



With regard to other measures, lepers should be provided with 

 plenty of fresh air and good food, and their quarters should be 

 kept strictly clean. Care should also be taken that they are 

 supplied with some form of light work and amusement, and the 

 institution of rural colonies, provided they are well supervised, is 

 to be recommended. 



Prophylaxis. — Beyond isolation and antiseptic precautions after 

 handling leprous people, nothing more can be done, as so little is 

 known about the causation of the disease. The financial burden of 

 isolating large numbers of lepers is very heavy. Hence the diffi- 

 culty of carrying out this very necessary method of protection 

 completely and efficiently. 



