MEDICINAL TREATMENT.- Ice may be applied to buboes, and it has been recommended that bichloride of mercury be injected into them. Apart from these local measures, the chief reliance of orthodox medicine is on prophylactic vaccines (Haffkine’s principally). The therapeutic principle is that outlined in the chapter on vaccines, and considerable success has been claimed for this particular vaccine. The mortality of plague varies very much at different places and seasons, and in different epidemics, and consequently it is far from easy to establish the comparative values of remedies Homoeopathically chosen drugs have not had an extensive trial. From the symptoms, Arsenicum album, with Baptisia should be useful at first, and Lachesis, Crot., Naja, and Elaps later. Lieut.- Colonel Deane, a homoeopathic physician who has treated many cases of plague, thinks the serpent poisons the most hopeful remedies. A vaccine might be tried in potencies.
260. Malta Fever.
DEFINITION.-A specific disease, characterised by irregular pyrexia, sweats, arthritis, general pains and enlarged spleen. The cause is an organism-Micro-coccus melitensis. The disease prevails in Malta and countries bordering on the Mediterranean. It occurs also in India, China, Porto Rico, and Manilla.
SYMPTOMS.-There is an incubation period of from six to ten days. The fever is of a remittent type, the temperature chart showing waves of pyrexia lasting from one to three weeks, with intermissions of two or more days. This condition may last six months or more. Obstinate constipation, progressive anaemia and debility set in, and the spleen becomes enlarged. Neuralgic and joint pains are common, and arthritis and inflammation of fibrous tissue occur. The direct mortality is not high, but patients are very liable to relapses, and may remain more or less ill for years, although having intervals of comparative health.
TREATMENT.- Prophylactic.-There is good evidence that the germ is largely conveyed in goat’s milk, and avoidance of this is the best prophylaxis.
Medicinal.-There is no record as far as we know of cases treated homoeopathically. In the early stages Baptisia and Arsenicum should be useful. Later Arsenicum, particularly the Iodide of Arsenic, Mercurius, Natrum Mur., Ceanothus, Ferrum phos., Phosphorus, Lycopodium and Sepia would have to be considered. If the fever is high, cold sponging may be used, and in chronic cases a change of climate is desirable.
261. Leprosy.
DEFINITION.- A chronic infectious disease, caused by a specific bacillus, characterised by tubercular nodules in the skin and mucous membranes, or by changes in the nerves. The forms may be separate at first, but are combined in the course of time.
The disease is a very ancient one, and has been known for thousands of years, although various skin diseases were no doubt confounded with it sometimes. It was once widely spread over Europe, but has declined since the sixteenth century. To-day it is found in Iceland, Norway, Sweden, Russia and parts of Spain. There are a few small foci of the disease in Canada and U.S.A. It occurs in the West Indies and Mexico, and the Sandwich Islands, and in South Africa, Australia and New Zealand. It is wide-spread in China and India.
The cause of the disease is a bacillus which has certain resemblances to the tubercle bacillus. It is very difficult to cultivate, but genuine cultures appear to have been made. The bacilli are found in the open sores, and in the secretions of nose and throat, and probably enter the body through mucous membranes or skin. Probably infected clothes play a large part in spreading it, and in any tropical country the laundry arrangements need the most careful supervision.
SYMPTOMS.-In Tubercular Leprosy the first symptom is that of areas (maculae) of erythema in the skin, which are highly sensitive. Pigment often develops in them and on these places the characteristic tubercules develop. They may grow into nodules of some size with intervening areas of ulceration and partial cicatrization. Deep ulcers may form, leading to loss of fingers or toes. Sometimes tubercules do not develop, but the maculae become insensitive and lose all pigment, so that the skin there becomes perfectly white. Eyelashes and eyebrows fall out in later stages, the mucous membranes of nose, throat and often conjunctiva become inflamed, and death often results from pneumonia or laryngeal inflammation, In Anaesthetic Leprosy the first symptoms are usually pains in the limbs and areas of numbness, Maculae or bullae (large blisters) may form and leave areas of anaesthesia when they disappear. The nerve trunks where they are palpable are found to be large and nodular. Later large bullae develop; they break and leave destructive ulcers, with
loss of substances. This form is very chronic.
TREATMENT.-Since the bacillus (or more properly speaking, streptothrix, for it probably not a true bacillus) has been cultivated, it is possible to make a vaccine and encouraging results are reported from its use (Rost). Chaulmoogra oil has a certain reputation with orthodox physicians.
HOMOEOPATHIC TREATMENT.- Apart from vaccines (which are in principle homoeopathic), homoeopathic treatment holds out some hopes of relief or cure, but homoeopathy has not had much opportunity to try its methods hitherto. The following should be useful remedies:-
Sulphur.-(Occasional doses of high potencies) will almost certainly be needed as an intercurrent remedy in the course of this disease.
Sepia is more likely to be needed in later stages when ulceration and tubercles are well developed.
Silicea.-Later stages, with ulceration.
Anacardium.-Anaesthetic patches with weakness and prostration.
Arsenicum.-Hyperaesthesia and anaesthesia; involvement of nerve trunks.
Comocladia.-Skin white.
Lachesis.-Deep ulcerations.
Phosphorus and Graphites are other drugs that should be borne in mind, and Hydrocotyle has been much praised.
All discharges from wounds and mucous surfaces should be carefully disinfected and great care exercised by any who come in contact with the cases to avoid contagion. Lepers, wherever possible, are isolated in definite communities.
262. Pellagra.
This is disease which may be treated of for convenience here, but it is not properly speaking a tropical disease., It occurs chiefly in Italy, South of France, and Spain, and it has now penetrated to the United States. It is now considered to rank with Scurvy to rank with Scurvy and Beri-Beri as one of the deficiency diseases, i.e. diseases due to the absence or diminution of an essential protein from the diet. Undoubted cases have been observed in England, and it is probable that the disease is more widespread than has hitherto been recognised. It frequently ends in paralysis and mental disorders, so that the English cases have so far been recognised in asylums Poverty is a marked predisposing cause.
SYMPTOMS.-These at first are indefinite, being debility, pains in the spine, insomnia, dyspepsia, rarely diarrhoea. The characteristic sign is the development (almost always in the spring) of the skin lesion. This begins with erythematous patches, followed by desiccation; the skin becomes harsh, dry and pigmented. Crusts may form with suppuration underneath. With this occur much more marked dyspepsia salivation, and diarrhoea. Milder cases slowly recover, but relapse. More grave cases go on to marked symptoms, headache, backache, spasms; finally paralysis and melancholia or mania and death.
TREATMENT.-For drug treatment, homoeopathic experience as yet is small, but from the symptoms given there is no doubt that Sulphur, Sepia, Nat-Mur., Lachesis, Arsenicum, Phosphorus, Argent-Nit. and other drugs should have great value. In Paralytic cases Lathyrus should be remembered. In early stages remarkable improvement follows a diet rich in proteins (eggs and meat), though in later stages this is ineffective.
263. Sprue.
DEFINITION.-A chronic disease characterized by catarrh of the alimentary canal from mouth to anus, tenderness of tongue, and pharynx, aphthae of tongue and gums, diarrhoea, gradual atrophy of the liver. It fluctuates much with periods of improvement, but leads to gradual exhaustion, anaemia, and in severe cases to death.
The disease is endemic in India, Ceylon, Malay, Annam, Tonquin parts of China and Japan.
It is due to an infiltration of the mucous membrane of the tongue and alimentary tract by the yeast fungus Existing intestinal disease and other debilitating conditions no doubt predispose. It affects women more than men, Europeans more than natives, and seldom comes on till after long residence in the tropics (ten to fifteen years).
SYMPTOMS.- The earlier are attacks of sore tongue and tender gums, and white patches (aphthae), and small ulcers appear. With this there is dyspepsia and perhaps diarrhoea. Recurrences occur becoming more and more severe, but the characteristic diarrhoea sets in; this consists of frequent stools in the early part of the day, at first watery and pale yellow, but later of a dirty white colour, and the consistence of mud, at times frothy and fermenting. The stool is acid; bile is absent and the liver gradually diminishes in size. The mouth and throat symptoms continue; the tongue becomes red and denuded, and is very sensitive. Taste and smell are often lost. Fever is not common, but anaemia and sweating occur in later stages, and death from exhaustion. The disease may last for years.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."