Some observations on the treatement of leprosy
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Abstract
From personal experience the writer
comes to the following conclusions :-
I. In almost all cases the progress of the disease can be arrested.
2. In many early cases the infection is apparently overcome and no bacilli can be found.
3. In more advanced cases the progress of the disease is arrested, the existing lesions become less, the nasal discharge can be rendered free from organisms, thus much diminishing the infectivity and after prolonged treatment the disease apparently becomes inactive, though some acid fast bacilli can be found in the skin.
4. That every effort should be made to eradicate intercurrent and concurrent affections so that the resistance of the patient may be raised. Such conditions as syphilis, malaria, worm infestations, should receive early and energetic treatment.
5. That the Kahn test is not to be relied on in the diagnosis of syphilis in the leper. Neither is it to be relied on as a test of cure in the syphilitic leper.
6. If possible all early cases should be treated as out -patients. This would only be possible if treatment centres were established near their homes.
7. Compulsory segregation defeats its own ends in that early cases hide themselves away for fear of being incarcerated. Settlements and Leper Homes should be voluntary.
8. Treatment by Alepol injections is certainly beneficial and compares favourably with treatment by other hydnocarpus preparations. (table No.I0)
9. Early nerve (AI) and early skin (BI) cases can be cured and should be given every hope for cure.
I0. Late skin cases (B3) should receive energetic treatment, which must be very carefully watched. Considerable improvement has been observed in these cases under appropriate treatment, and possibly, if the case be not too far advanced, arrest of progress of thE disease should take place.
II. That in A2 cases with considerable deformity treatment should be carried out, for it most certainly aids the natural arrest or burning out of these cases. Those cases with commencing deformities should be energetically treated in the hope that an early arrest will take place.
I2. In mixed leprosy treatment should be arranged as if the case were a pure skin one. Here again results depend on the stage of the skin condition.
I3. Trichloracetic acid applied locally is of considerable value and a most useful adjuvant to treatment.
From a study of the literature the following conclusions are arrived at :-
I4. Treatment by intradermal injections is of considerable value especially in B2 and B3 canes and is specially useful in B3 cases with hard and fibrosed nodules.
I5. Mercurochrome soluble 220 appears to be of great value in clearing up septic skin conditions, eye infections, and is a very powerful agent in stopping severe lepra reactions. Furthermore it appears to be of value in the treatment of leprosy when it is used intraderinally or into the nodules.
I6. That Gold preparations, the so called specific for leprotic eye affections, have not been unequivocally proved of value in these conditions. In view of the conflicting reports great caution should be exercised in the use of these remedies.
I7. From personal observations and from a study of the literature the greatest caution is necessary in using potassium iodide in treatment. It should in any case be used only in specially selected cases.
I. In almost all cases the progress of the disease can be arrested.
2. In many early cases the infection is apparently overcome and no bacilli can be found.
3. In more advanced cases the progress of the disease is arrested, the existing lesions become less, the nasal discharge can be rendered free from organisms, thus much diminishing the infectivity and after prolonged treatment the disease apparently becomes inactive, though some acid fast bacilli can be found in the skin.
4. That every effort should be made to eradicate intercurrent and concurrent affections so that the resistance of the patient may be raised. Such conditions as syphilis, malaria, worm infestations, should receive early and energetic treatment.
5. That the Kahn test is not to be relied on in the diagnosis of syphilis in the leper. Neither is it to be relied on as a test of cure in the syphilitic leper.
6. If possible all early cases should be treated as out -patients. This would only be possible if treatment centres were established near their homes.
7. Compulsory segregation defeats its own ends in that early cases hide themselves away for fear of being incarcerated. Settlements and Leper Homes should be voluntary.
8. Treatment by Alepol injections is certainly beneficial and compares favourably with treatment by other hydnocarpus preparations. (table No.I0)
9. Early nerve (AI) and early skin (BI) cases can be cured and should be given every hope for cure.
I0. Late skin cases (B3) should receive energetic treatment, which must be very carefully watched. Considerable improvement has been observed in these cases under appropriate treatment, and possibly, if the case be not too far advanced, arrest of progress of thE disease should take place.
II. That in A2 cases with considerable deformity treatment should be carried out, for it most certainly aids the natural arrest or burning out of these cases. Those cases with commencing deformities should be energetically treated in the hope that an early arrest will take place.
I2. In mixed leprosy treatment should be arranged as if the case were a pure skin one. Here again results depend on the stage of the skin condition.
I3. Trichloracetic acid applied locally is of considerable value and a most useful adjuvant to treatment.
From a study of the literature the following conclusions are arrived at :-
I4. Treatment by intradermal injections is of considerable value especially in B2 and B3 canes and is specially useful in B3 cases with hard and fibrosed nodules.
I5. Mercurochrome soluble 220 appears to be of great value in clearing up septic skin conditions, eye infections, and is a very powerful agent in stopping severe lepra reactions. Furthermore it appears to be of value in the treatment of leprosy when it is used intraderinally or into the nodules.
I6. That Gold preparations, the so called specific for leprotic eye affections, have not been unequivocally proved of value in these conditions. In view of the conflicting reports great caution should be exercised in the use of these remedies.
I7. From personal observations and from a study of the literature the greatest caution is necessary in using potassium iodide in treatment. It should in any case be used only in specially selected cases.
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