Quarterly report on the progress of segregation campus and medical treatment of sleeping sickness in Uganda ; For the quarter December 1st , 1907-February 29th, 1908 / by Captain A.C.H Gray, R.A.M.C.

Gray, Arthur Claypon H.

Date:: 1908

Credit: Quarterly report on the progress of segregation campus and medical treatment of sleeping sickness in Uganda ; For the quarter December 1st , 1907-February 29th, 1908 / by Captain A.C.H Gray, R.A.M.C. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$2. Fine crystalline powder fairly soluble in cold, more so in hot saturation appearing to be approximately a 40 per cent, solution. Solution is perfectly colourless and remains so for three or four days, when it acquires a slight yellow tinge as with Atoxyl, though not to such a great extent. In a coloured bottle the solution keeps much longer colourless. Dose.—At first I tried small doses of 1 grain hypodermically, but this had no effect on the trypanosomes, so I gradually raised it to 5 grains which dose completely banished the parasites from the glands. Later, finding its effects similar to Atoxyl, and thinking it might be the same chemical in a purer form only, I tried 1 gm. as an initial dose followed by •5 gm. doses, with no toxic effects. Toxicity.—As stated above, I have given it in repeated gramme doses with, up to the present, no signs of poisoning. However, bearing in mind our experience with Atoxyl, one will be better able to judge after the lapse of another month or so. Therapeutic Action.—Trypanosomes disappear from the glands after the first adequate injection and do not seem to reappear subsequently either in the gland or blood, using the very useful method of examination recommended by Prof. Koch*; and the diminution of the glands and general improvement in the patients have been satisfactory, and in the special case reported its action was very marked and interesting. Conclusions.—As far as my experience goes the action of this drug is similar in many respects to that of Atoxyl without the toxic effects of the latter. I do not know that it will prove any more lasting in its effects than Atoxyl, as the time which has elapsed has been too short for one to judge accurately, taking into consideration the fact that with Atoxyl tire first improvement shown is not maintained in a great number of cases. It still remains to be seen whether with this drug that will also be the case, therefore a report on the same cases in three months’ time will be of the greatest value and allow us to better judge of its permanency or no. However, I think we shall be 'perfectly safe in substituting this drug for Atoxyl as a routine in these camps, especially in view of the fact that there has been so much uncertainty in the quality of Atoxyl supplied, and the alarming number of untoward symptoms which have been resulting, specially the ocular trouble, which so often proves refractory; my reasons for the suggested substitution I give belowr:— 1. Action is at least quite equal to that of Atoxyl, without apparently its toxicity. 2. The quality of the drug seems to be of a high standard, and all samples have been similar and pure, and show the careful manu- facture that we are accustomed to in all Messrs. Burroughs Wellcome and Company’s products. 3. It is a British manufactured article from a firm of high reputation. 4. Its price is less than a third that of Atoxyl, which seldom seems twice the same in its quality and purity. This last is seen in the great difference in the rapidity of decomposition and the degree of yellow which different samples of Atoxyl have. * Dr. vnn Someren looted for trypanosomes in thick fresh films; Prof. Koch in thick stained films. [Ed.]$