Beneficial effects of chaulmoogra in leprous neuritis

1- Attention should be given to the neural disturbances of leprosy, and they should be treated early because the grave sequelae in advanced cases cannot respond to any antileprosy medication we have at present. 2- The lesion s of moderate neuritis in lepromatous cases generally respond very poorly to sulfone medication, according to the experience of many leprologists, including myself. 3- This type of neuritis, according to my experience, can be arrested and made to regress in a high percentage of cases, even those which have not responded to prolonged sulfone medication, when given chaulmoogra in sufficient dosage (20-30 cc. weekly). 4- The symptoms which are most benefited are, among the subjective ones: numbness, cramps, pains, pruritus, hot sensation, and diminution of strength of the limbs, and among the objective ones: bullae, trophic ulcers, and in some cases mild and recent muscular atrophy. 5- It is suggested that, in similar moderate cases which do not respond to modern leprosy medication, a trial of the old chaulmoogra treatment be made, employing sufficient dosage.

El problema de la transformacion de lepra tuberculoide em lepromatosa

El autor senãla que en sus 25 años de experiencia, en los cuales ha vigilado más de 500 enfermos tuberculoides, no ha visto ningún caso de lepra tuberculoide típica (desde el punto de vista clínico, histológico, bacteriologico y sobre todo de immunología francamente positiva) transformarse en lepromatoso típico. Confirma así lo que ya había sugerido hace 20 años (en 1936), que la lepra tuberculoide y la lepromatosa (que entonces se la denominaba cutánea) debían considerarse como formas o tipos independientes. Los casos de reacctión tuberculoide de immunología francamente positiva tienen en lo que respecta a transformación lepromatosa, el mismo pronóstico benigno que las lesiones tuberculoides figuradas o tórpidas. No interessa por ello la cantidade e intensidad de las lesiones, el factor esencial es el estado de la immunología. Considera que los casos tuberculoides en reacción de immunologia débilmente positiva o negativa son los infaliblemente condenados) a transformarse en lepromatosos, y que en esa transformación influirían varios factores que debilitan al organismo y otros que hoy desconocemos; pero el más importante para el autor sería la insuficiencia y sobre todo la falta de tratamiento antileproso

The use of dilute antigens in lepromin tests

In a study of the value of dilute antigens for the lepromin reactions, a group of 40 tuberculoid leprosy cases has been used. According to earlier lepromin tests with normal antigens (MItsuda-Hayashi integral, 1:20, or the Dharmendra bacillary antigen, 1:1000), 28 of them were classed as strong reactors, and 12 as weak reactors. The dilute antigens used for comparison were: integral, 1:100 and 1:750; bacillary, 1:5000. Both the early and the late reactions were observed, and on the basis of the results seen the followin conclusions are arrived at: 1- Dilute antigens have value or practical use only in strong (2+ and 3+) reactors, in which they give the same percentages of positivity with the dilute antigens as with the normal ones although in lesser intensity. 2- Dilute antigens should not be used with weak (1+) reactors, because the results are virtually always negative and may lead to error. 3- With every individual who is lepromin tested for the first time, or whose capability to respond is not known, a normal antigen should always be used. 4- Dilute antigens should be used only with strong reactors, for the periodical examinations which are usually made to determine thhe immunological curve. In this way we would save antigen material, besides avoiding the residual scars which often occur after strong lepromin reactions.

Estudo comparativo das intradermorreações com a lepromina bacilar comun e a cadavérica em doentes de lepra / Comparative study of intradermorreações with bacillary lepromin comun and cadaverous in leprosy patients

O A. utilizando o antígeno bacilar cadavérico preparado por Campos, realizou um estudo comparativo das intradermorreações provocadas com êsse antígeno em solução a 1:1000 e o antígeno bacilar comum na concentração de 1:2000. Êsse estudo comparativo foi realizado em 170 doentes de lepra, dos quais 120 eram lepromatosos e 50 tuberculoides, constatando uma concordância em 96% dos casos.