Annual report on the Medical Research Institute / 1909-.

  • Nigeria. Medical Research Institute.
Date:
[1923]
Catalogue details

Licence: Public Domain Mark

Credit: Annual report on the Medical Research Institute / 1909-. Source: Wellcome Collection.

    15/34 (page 13)
    superior to Heiser’s, as regards the rate of improvement, and there was not the same objection by the patients to its continued use. In the following year, Roger’s method was adhered to, combined with the use of Nastin B.I. This latter preparation did not appear to hasten or aid the healing process. By the end of 1919 the disease was, to all appearance definitely arrested in five cases, greatly ameliorated in six, and without any restraining effect in one. This last was a recent and very acute case. During 1920, Potassium Cupro cyanide, in view of a very favourable report in the Tropical Diseases Bulletin, was given a trial in the last-named case and in two others which had shown improvement with Gynocardate. At the end of three months there was now evidence whatsoever, of benefit, and it was given up. For the greater part of this year, therefore, no special treatment was given. The only drug used was the crude Chaulmoogra oil and the patients were allowed to please themselves as to how much they took and when they took it. Moogrol was then adopted, in the latter half of 1921, at which time, the five patients in which the disease appeared to have been arrested at the end of 1919, still showed no sign of relapse. However there was a severe exacerbation of the disease in two of the six cases which had improved and in the acute case, the condition was still an active one. These three patients and four others recently admitted were given Moogrol intravenously. The result of four and a half months’ administration was a distinct improvement in all, particularly in the acute case. During the early part of 1922 Oscol Stibium was substituted in three of the new cases and Moogrol was continued in the remaining four. In April however, all the cases were put on Harper’s treatment (Moogrol Ether and Iodine). This was given at first intravenously, then intramuscularly, and finally, omitting the ether, the Moogrol and Iodine were given in a chalk mixture, by the mouth. The improvement was more or less maintained during the six months of this regime, but in 1923 it was decided to resort again to Moogrol by the intravenous route, with seven patients, five of them old inmates and two new admissions. All showed improvement, in such ways as healing of ulcers, decrease in size and number of tubercles, disappearance of maculae and improvement in sensation. The object aimed at is not a rapid cure which appears to be unattainable, but to keep the patients contented and optimistic so that they may be willing to continue the treatment over many months, even years, inasmuch as the disease itself being of a slowly progressive nature the process of cure must of necessity be a protracted one. The advant¬ ages of the Moogrol treatment are, besides its specific action on the lepra bacillus, (a) that the amount of the drug necessary to obtain good results is small (2 to 4 c.c.), and therefore it is easily administered with a small syringe and a fine needle, (b) that administration once or at most twice a week is adequate, (c) that no cumbersome preliminary preparation is involved, the boiling of the syringe and needle, and the application of iodine to the skin over the site of puncture being all that need be done, and (d) provided the vein be entered there is no local disturbance and the patient is satisfied. This last is an important practical point, for the Nigerian leper will not long submit to hypodermic or intramuscular medication, and he takes quite a keen interest in the successful puncture of a vein with no swelling left behind. The following extracts from reports by Medical Officers who have been using Moogrol in outstations, are given. Dr. W. 0. Cobb, n.s.o., reports from Bauchi, 9/1/24. Case (1) Male, aged twenty-seven years. States four years a leper. Only one lesion, a roughly oval-shaped macule on back, about »five inches long, definitely anaesthetic in parts, with edges slightly raised, and much lighter in colour than