Fig. 28.—Malignant Pustule, third day after infection with Anthrax, showing great œdema of upper extremity and pectoral region (cf. [Fig. 29]).
Fig. 29.—Malignant Pustule, fourteen days after infection, showing black eschar in process of separation. The œdema has largely disappeared. Treated by Sclavo's serum (cf. [Fig. 28]).
Prophylaxis.—Any wound suspected of being infected with anthrax should at once be cauterised with caustic potash, the actual cautery, or pure carbolic acid.
Treatment.—The best results hitherto obtained have followed the use of the anti-anthrax serum introduced by Sclavo. The initial dose is 40 c.c., and if the serum is given early in the disease, the beneficial effects are manifest in a few hours. Favourable results have also followed the use of pyocyanase, a vaccine prepared from the bacillus pyocyaneus.
By some it is recommended that the local lesion should be freely excised; others advocate cauterisation of the affected part with solid caustic potash till all the indurated area is softened. Gräf has had excellent results by the latter method in a large series of cases, the œdema subsiding in about twenty-four hours and the constitutional symptoms rapidly improving. Wolff and Wiewiorowski, on the other hand, have had equally good results by simply protecting the local lesion with a mild antiseptic dressing, and relying upon general treatment.
The general treatment consists in feeding and stimulating the patient as freely as possible. Quinine, in 5 to 10 grain doses every four hours, and powdered ipecacuanha, in 40 to 60 grain doses every four hours, have also been employed with apparent benefit.