of treatment now coming into vogue for tuberculosis are equally applicable to leprosy.
Many drugs have been regarded, from time to time, as being more or less in the nature of specifics in the treatment of this disease. But, though some of these drugs appear for a time to do good, and in consequence acquire a certain degree of popularity, hitherto all of them, one after another, have sooner or later fallen into disfavour. One is very apt to be deceived in estimating the value of a drug in leprosy. The leper applies for treatment generally during, or soon after, one of the periodical exacerbations of the disease, and when the nodules and other eruptions are active and well pronounced In the natural course of events, and without treatment of any description, especially if the patient be placed under favourable hygienic conditions, these acute manifestations tend to become quiescent, and the disease temporarily to ameliorate. Observers are too apt to attribute this natural and temporary amelioration to whatever drug the patient may happen to be given at the time. Moreover, in judging of the value of any drug in leprosy, it must be remembered that the disease may be arrested spontaneously, or even be recovered from, without the use of any drug whatever.
Chaulmoogra oil (Oleum gynocardium), in doses of from 2 to 10 up to 40 drops or more, according to tolerance, three times a day, together with inunction of the same drug mixed with some oil, is a favourite remedy with English practitioners. Such lepers as can assimilate large doses of this drug appear to derive benefit. Sandwith has reported a case in which marked benefit followed persistent hypodermic administration of chaulmoogra. I have had lepers under my care who, in addition to large doses of chaulmoogra by the mouth, received hypodermic injections daily up to one drachm of the drug. The improvement for a time was marked. The bacilli, however, were just as abundant in the nodules during and after as before treatment, and there was no alteration in their appearance.
