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67

H.—Bl.

PARI V—MISCELLANEOUS. Report on Nabtin Treatment op Leprosy. Sir,— hyttelton, 9th January, 1911. I have the honour to report on the various treatments of leprosy that I have tried at Quail Island. Altogether four cases of leprosy have been under treatment—viz., two Maoris with old anaesthetic leprosy; two Europeans with mixed leprosy—one case (W.V.) of seven years' standing, the second case (A.L.) of recent date. Tin.' Maori (G.W.) had the usual mutilations, and was treated with Chaulmoogra oil. After a year's treatment, as he gave no manifestation of active leprosy, and the baccilus lepra' was absent from the nasal mucus (after iodisrn had been induced), he was discharged. * The other Maori (J.W.) had been much neglected at home: feet and hands were reduced to stumps, and there was so much neuritis present that his only means of progression was by shuffling on the floor in a squatting attitude. He took Chaulmoogra oil, but it soon developed such dyspepsia that it had to be omitted. In May, 1908, I started treatment with Nastin on W.Y., and on 28th November on J.W. I have found this treatment fulfil the claims of Deycke Pasha. At first I ventured tc use Nastin B 2 on W.V. when I ran short of Nastin B t . Far from being inert, the reaction that ensued gave me a week's anxiety. I administered Ketyn witli benefit. In September, 1908, W.V. developed a leproma at the edge of the cornea —first in the right eye and later in the left. All the skin lepromata had vanished, but I had to stop the Nastin, as Deycke Pasha states that this affection of the eye is a contra-indication. During the administration I had frequently to omit the Nastin treatment on account of joint-pains, and once for an abdominal disturbance resembling appendicitis. W.V. is the subject of syphilis, to which his joint-pains may be attributable; but I am convinced that during the treatment with Xastin lepromata on the face and hands vanished, and on its omission gradually reappeared. Personally I attributed the frequent joint-pains to reaction to Nastin. In the case of J.W., treatment had been so successful (whether due to Nastin or to generally improved conditions) that he has recovered the use of his legs, and can walk without a limp and can climb hills. He can close his eyes and mouth, which previously remained open from facial paralysis, and has such command over his tumeated fingers that he can attend to W.V.'s diseased eye and write his own letters. A.L. has been under treatment since the end of August of last year (1910). He is a robust Australian, and can take Chaulmoogra oil without nausea — three fluid drachms a day. He receives an injection of Nastin B t every week, and lives an active healthy life. He is most anxious to get well and free. He gets not bad reactive effects from Nastin B x . Within five months he has manifestly improved. The lepromata on his face have flattened, the scaliness over the right brow has disappeared, the large anaesthetic coppery patches on the inner flexor aspects of both arms have diminished in area, prominence, and discoloration. It is very disappointing that the worst of all leprous lesions —viz., the leproma of the conjunctiva, that invades and destroys the cornea and eyeball —should develop during Nastin treatment; but I am convinced that in many cases Nastin treatment is effectual on the ordinary crusting nodules of the skin. During its administration the efflorescences becomes less frequent, and abort finally, until the rash temporarily disappears. In the case of W.V., in forced discontinuance of the Nastin, the lepromata have reappeared on the nose, and caused great disfigurement. I have given W.V. a course of Soamin without apparent benefit to the leprosy. The Chief Health Officer. Charles Hazlett Upham. Table showing Number of Vessels inspected by the various Port Health Officers. Kawaka .. I New Plymouth .. 3 Timaru .. .. 8 Helensvillc .. -t Wanganui .. 12 Oamaru.. .. 1 Dargavillc .. 13 Wellington .. 135 Lyttelton .. 28 Hokianga 11 Napier .. . . 3 Port Chalmers . . 16 Auckland .. 278 Picton .. .. 2 Dunedin .. 11 Thames .. .. 2 Nelson Bluff .. 44 Whitianga .. 1 Westport .. 15 — Gisborne .. 10 Greymouth .. I Total .. 599

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