The mortality is usually given as about 95% although Rogers states that he has reduced this to 75% by large doses of quinine. The action of antimony is that of a specific. Patients often succumb to complicating septic conditions or pneumonia.
Prophylaxis and Treatment
Prophylaxis.—The best results in India have been obtained by abandoning infected houses and establishing new ones for the non-infected villagers, which need not be more than 300 yards from the old ones, thus showing that mosquitoes and flies are probably not concerned in transmission. Measures directed against the bedbug seem to offer the best chance of success. Often, however, the bugs are so deeply located in cracks of thick-walled houses that they may not be reached by sulphur fumigation. Flaming of such crevices with a plumber’s lamp has been recommended.
Treatment.—Rogers has recommended quinine in doses of 60 to 70 grains daily, claiming thereby to have reduced the mortality of the disease to 75%.
Castellani recommends a combination of quinine and atoxyl, while Manson has reported success with atoxyl in 2 cases, giving 3 grains intramuscularly every other day.
Salvarsan has been tried, but without much success, as is also true of X-rays.
Some have tried cinnamate of soda with the idea of increasing the leucocytes.
With the purpose of increasing leucocytes Rogers has tried hypodermic injections of sodium nucleate and killed staphylococcus vaccines as well as splenic substance tablets. The sodium nucleate injections were most painful and did not increase the leucocytes. He had some success with tabloids of spleen substance.
If the blood serum shows a lessened alkalinity the intravenous injection of solutions of bicarbonate of soda should be tried.