Page:Tropical Diseases.djvu/696

650 violent a character as to be dangerous to life imposed limitations upon the general use of the remedy.

Finding that benzoyl-chloride (..), by removing their fatty protective contents, rapidly deprived tubercle bacilli of their "acid-fastness," he concluded that this substance might act similarly on the lepra bacillus; and also finding that benzoyl-chloride was innocuous, he concluded that by combining it with nastin the therapeutic efficiency of the latter might be so reinforced that it could be used in doses so small that violent reaction would be avoided. Experiment justified the conjecture, and although benzoyl-chloride administered alone has no therapeutic action in leprosy, given in appropriate combination with nastin, in a large proportion of instances, although not in all, the results are highly satisfactory, the lepra bacilli and lepra lesions slowly or more rapidly disappearing.

Prof. Deycke's hypothesis as to the mode of action of the combination is to the effect that the nastin element, having affinities with the fat of the lepra bacillus, acts merely as the introducer of the benzoyl-chloride, which is the actual bactericide.

As the result of much experience Prof. Deycke considers that what he calls "Nastin B1," in which one part of nastin is dissolved in forty parts of benzoyl-chloride, and this again in sterile olive oil, is the best combination, rarely, if properly administered, giving rise to reaction. A weaker solution, "Nastin B0," he uses in cases of ophthalmic and nerve leprosy, as a special precaution against dangerous reaction. After the weaker preparations have been used for some time a stronger nastin, B2, may be employed.

There are certain points in the nastin treatment of leprosy on which Prof. Deycke lays stress: (1) Reaction from excessive doses is unnecessary and should be avoided. (2) Not too frequent injections; once a week suffices. (3) Perseverance for months and years, intermitting the injections for a month or two occasionally.

Reports from British Guiana, where systematic