Report on experiments with Nastin B in Leprosy / by Major S. Anderson and Major L. Rogers ; with notes by Colonel G.F.A. Harris, inspector-general of Civil Hospitals, Bengal.

  • Anderson, S.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Report on experiments with Nastin B in Leprosy / by Major S. Anderson and Major L. Rogers ; with notes by Colonel G.F.A. Harris, inspector-general of Civil Hospitals, Bengal. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    20/124 (page 14)
    DIEECTIONS EEGAEDING THE TREATMENT OF LEPROSY WITH NASTIN-B. Pure Nastin is a bacterial fatly substance, viz., a crystallisable and neutral iat (ester of glycerine). Detailed information as to its manufacture, its theoretical importance and its practical application, is contained in our essay, published in the Deutsche medizinische Wochenschrift (1907, No. 3, Deycke Pasha and Reschad Bey). Nastin-B is a coml)ination of Nastin with Benzoylchloride (Gg Hj—• C 0 CI), a well-known chemically very active substance, which in vivo and in vitro displays a fat-removing action on so-cfiUed acid-proof bacilli, a process which directly prepares these bacilli for further disintegration (bacterio- lysis). This substance is effective in the living organism only when combined with the Nastin, whereas in vitro it deprives, for instance, tubercle bacilli directly and at once of fat and, as a consequence, of their acid-proofness which depends on the presence of fatty substances. In full accord with this view, Nastin-B has been found to greatly excel pure Nastin in respect of reliability and constancy of therapeutic results on the one hand, and with regard to elimination of the dangers arising from Nastin reactions, on th& other hand. Hence it is only Nastin-B whish, on the strength of our experi- ence, is to be recommended for general practical use in the specific treatment of leprosy. For therapeutical purposes Nastin-B is employed by way nf injections of oily solutions of Nastin-B in definite concentrations, as follows: — The injections are made hypodermically (the arm, the thigh, the infracla- vicular fossae, etc.), and only into the subcutaneous fatty tissue, but not into the muscular system. For the injections the customaiy glass syringes, with glass-, metal-, or asbestos-pistons, may be used ; syringes made from hard- rubber are to be avoided, as they do not stand keeping for a long time under ether. As very recommendable we name the so-called Luer -syrmges with a platinum canula suitable for annealing. The syringe and canula must be absolutely dry (anhydrous). Unless one prefers dry sterilisation in the hot air chamber, one had best clean the syringe, before and after using it, with anhydrous ether only and to keep it always in a hermetically sealed specimen glass under anhydrous ether, so that it is ready for use at any time. The presence of but minute quantities of water gives rise to the formation of hydrochloric acid, and, as a consequence, to abscesses and necrosis at the places of injection. An injection of Nastin-B, when properly applied, causes a transitory, burning pain, but does not give rise to indurations, abscesses, necrosis, etc., in a word, it does not bring about any local reaction of any kind whatever. Nastin-B is supplied by the firm of Kalle & Co, Aktiengesellschaft at Biebrich-on the-Rhine (chemical works) until further notice—put up in hermeti- cally sealed glass tubes of I c. c.—in three concentrarions ditfering as to the amount of Nastin, but not so as regards the amount of Benzoyichloride which is the same in all solutions. The standard solution for use in the treatment of leprosy is Nastin-Bi. One begins the treatment by injecting a whole syringeful ^1 c. c.); only in severe cases one applies O o c. c. at the outset. At fii'st one injection is given per week, subsequently every fifth day, or if required, one may go so far as to apply 2 c c. once a week. But it is always better to proceed by degrees, because doing so is less risky. Nastin reactions (local and general] should not ensue at all if the Nastin-B^ solution is employed ; and they can only occur when injections are given frequently. The Nasfcin-B^ solution, however, in which Nastin is present in excess, is-of more or less pronounced reactivity (more especially so if applied frequently), it may give rise to local iuflammatory symptoms of the leprous tissue ^consisting in simple softening of pulpy consistency, inflammatory edematous swelling and infiltration, the forming of serous and hsemorrhagic vesicles.- suppuration, necrosis, etc.)—as well as fco general reactions (subjective feelings of discomfort, fever, rheumatoid and neuralgiform pains, and such like pheno- mena) whose extent and intensity naturally are subject to far-re ictiing fluctua- tions individually. The use of this solution is restricted, thtrefore, to cases with few and particularly persistent leprous formations.