Koch’s tuberculin was administered to five anæsthetic, three tuberous, and three mixed cases, as a rule, daily, from January 8th to May 8th. The dose at the commencement was 1 milligramme, and in several cases as much as 320 milligrammes were finally injected. The injections were made, sometimes daily, sometimes at intervals of a few days, according to the degree of reaction which followed the injections. In some cases the injections had to be stopped very soon, because they produced fresh leprous eruptions; and in one case bacilli were found in the blood. It seemed as if the tuberculin had set the bacilli afloat. We came to the following general conclusions:—(1) Tuberculin administered to lepers produces a general and local reaction, usually forty-six hours after the injection, seldom after twelve hours, and very seldom after two to three days. The local reaction becomes evident later. (2) These reactions do not beneficially influence the leprosy, they rather aggravate the disease by causing fresh eruptions just as iodide does. (3) Tuberculin does not kill the lepra bacillus. (4) Immunity against tuberculin can be attained, but this immunity does not influence the progress of leprosy.
Dr. Carreau, in Guadaloupe, treated a leper with chlorate of potassium, he believed with great benefit; he gave the remedy in enormous doses. Dr. Hjort had, already, in 1838-39 tried this remedy without effect. Dr. Beaven-Rake has also tried the remedy according to Dr. Carreau’s directions, but also without result. Dr. Danielssen, too, tried it, but without any benefit.
During the last few years the following remedies have been tried in the Lungegaard’s hospital: Hydroxylamin, Europhen, Naphthol, Salol, Methylene blue, Aristol.
Hydroxylamin forms colourless crystals, easily soluble in alcohol and glycerine. It is decidedly poisonous, and is, according to some authors, a more powerful reducing agent than chrysarobin or pyrogallic acid; 2 to 5 hydroxylamin to 20 glycerine and 80 alcohol, was painted on the patches of four maculo-anæsthetic lepers. In two of them there developed, after the painting, an erythema, during the persistence of which the painting was discontinued. The painting was continued for two months, and then a 2 per cent. hydroxylamin ointment was applied, but as no amelioration could be noted after four or five months, the remedy was laid aside. In four tuberous patients the painting could only be continued for two or three days, because the spots re-acted severely, grew red and painful, and vesicles formed. The tubers somewhat diminished, but otherwise the condition remained unaltered.
Europhen has some resemblance to iodoform, but gives up its iodine less readily. It is a fine yellow powder, insoluble in water, but soluble in alcohol, ether, chloroform, and oil. A solution in oil was used for hypodermic injections: at first 0.015 europhen was injected, and after a month 0.025. At the end of another month an eruption developed in one of the patients; in the others no effects were evident, and thereupon 0.030 was injected. After three weeks an iodine eczema developed in three of the patients, and a leprous eruption in another, and consequently no further trials were made. Dr. Julius Goldschmidt of Madeira, has also used this remedy, and considers one of his patients as almost cured, while four others remain unchanged.
Aristol was tried by three patients, partly internally, dissolved in ether, and partly externally, in the form of ointment; the effect was the same as after the use of iodide of potassium, and it was stopped after three weeks’ trial.
Naphthol and Salol were tried for a long time, but the effect was almost nil. Salol has also been used by Dr. Lütz in the Sandwich Islands, and by Surgeon Major Cook in Madras, but though some amelioration in the condition of the patients has been noted, no case has been cured.
Methylene Blue was given to one tuberous patient, both internally and hypodermically. The skin, especially the tubers, became deeply blue, but a microscopical examination showed the bacilli unaltered. The treatment was continued from May 20, 1891 till January 30, 1892. Some tubers diminished a little, but most of them became larger, so that the disease as a whole grew worse.
Nerve stretching was first tried by Dr. Gerald Bamfert, who stated that he had done the operation with success on an anæsthetic patient, in whom both hands were atrophic and sensibility much diminished. The ulnar nerve was stretched and incised longitudinally. The sensibility in the right hand re-appeared immediately after the operation; and after some days the muscular power was almost completely restored. In three anæsthetic patients in the Lungegaard’s hospital the operation was performed; the ulnar nerve was stretched and incised along a length of three to four inches. All went well, only the anæsthesia remained unchanged; neither sensibility nor muscular power was restored. Dr. Beaven-Rake, who has done numerous nerve-stretchings in Trinidad, says, “on the whole the results of nerve-stretching for anæsthesia cannot be considered satisfactory.”
Dr. Beaven-Rake has also done the operation for pains in the limbs, for which hypodermic injections of morphine have been successfully used in the Lungegaard’s hospital.