Annual report on the Medical Department / Straits Settlements.

  • Straits Settlements. Medical Department.
Date:
[1934]
Catalogue details

Licence: Public Domain Mark

Credit: Annual report on the Medical Department / Straits Settlements. Source: Wellcome Collection.

    55/78 (page 47)
    (c) Iodised Ethyl Esters, prepared by boiling ethyl esters with 0.5 per cent, metallic iodine at a temperature of i5o°C for thirty minutes, are used for the intradermal injections. For this method of treatment the early cases with a limited number of lesions are selected. Intradermal injections undoubtedly hasten the resolution of leprotic lesions, either macular or nodular, but improvement was found to be rapid in the former type. In a macule, complete resolution is effected with one or two injections, whereas in a nodule it may be necessary to inject as many as four or five times before resolution can be caused. The effect is believed to be mainly due to the counter irritation produced in the part of the skin injected. Certain workers prefer ethyl esters combined with creosote for intradermal injection, but experience in this Settlement indicates that the iodine compound is less painful and produces more rapid results. Iodised ethyl esters prepared by the Philippine Health Laboratories is used in this Settlement. Local Treatment.— In the treatment of leprosy, rubbing hydiiocarpus, gingely, and other oils while sitting in the sun has been found to be beneficial, not because any appreciable quantity of the oil is absorbed through the skin, but because of the counter irritation produced by the oil, the friction, and the sun’s rays. Accelerated absorbtion of the leprous lesions may be produced by painting with a solution of trichloracetic acid 1 in 2 for nodules and 1 in 4 for diffuse lesions and macules. Treatment of Lepra Reaction.— The patient is put to complete rest and is given light nourishing diet. (a) Alkalies are used both orally and intravenously. Sodium bicarbonate in saturated solution is given intravenously in doses of 20 to 30 c.c. daily for several days. Another method is to give 200 c.c. of sodium bicarbonate in a 0.5 per cent, solution in normal saline intravenously once a week. In mild reaction, potassium antimony tartarate 0.02 to 0.04 grm. in 2 c.c. saline given intravenously was found to be useful. Sodium salicylate and calcium lactate may also be administered orally. Various dyes were tried in lepra reaction. Mercurochrome has given more consistent and satisfactory results than either flourescin, brilliant green or trypan blue. Mercurochrome in one per cent, solution is administered intravenously in doses of 5 to 10 c.c. once in five days. In nerve reaction 3 minims of adrenalin or 0.02 grm. of ephedrine sulphate in 10 c.c. saline give immediate relief when injected along the course of the nerve. Supplementary Treatment.— Every effort is made to keep the patients cheerful and free from worries and to take their minds off their illness, by keeping them busily occupied in cooking, outdoor work, exercises, gardening etc. Treatment is not compulsory, but patients are encouraged to attend regularly. Early cases and those who improve under treatment are separated from the more advanced cases. The cripples are accommodated in a separate camp. All the children are also accommodated in a separate camp with special facilities that are suited to their age. There are two hospitals for those suffering from lepra reaction and complicating or intercurrent diseases. Control of Discharged Patients.— Supervision and after-treatment of discharged cases are desirable. Owing to the floating nature of the Indian and Chinese population permanent addresses generally are not available. In only a small percentage of the cases therefore has it been possible to arrange for periodical examination and further treatment after discharge. In addition to Pulau Jerejak Settlement the following Settlements for lepers are maintained in the Colony : — Male Settlement, Trafalgar, Singapore ... ... 80 beds Female Settlement, Trafalgar, Singapore ... ... 100 ,, Female Settlement, Penang ... ... ... 86 ,, Treatment is carried out at all these Settlements on the same lines as at Pulau Jerejak. The Male Settlement, Singapore, is used chiefly as a collecting station for lepers from Singapore pending their transfer to Pulau Terejak Settlement.