Notes on the prognosis and treatment of pellagra / by C.H. Lavinder.

  • Lavinder, C. H. (Claude Hervey), 1872-1950.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Notes on the prognosis and treatment of pellagra / by C.H. Lavinder. 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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    Symptomatic remedies must be used as needed. For insomnia some of the well-known hypnotics; for the erythema, if dry, oily applications or possibly tincture of iodine; if moist, a dressing of 1 per cent aqueous solution of picric acid is valuable at times, or other similar applications may be tried. Diarrhea must be met with the usual remedies; salicylate of bismuth has been highly recommended, and opium may prove of value. Pain, which is fortunately not very common or severe, may at times require morphine. Complications, such as malaria, syphilis, and intestinal parasites, should receive prompt attention with appropriate remedies. If much anemia be present, many good observers think a bland preparation of iron is indicated. Mercury, except in cases complicated by syph- ilis, seems valueless. Following Wright’s work on the succinamide of mercury in tuberculosis, Babcock and I tried this remedy in several cases, but achieved no results except in syphilitic cases. The drug proved quite irritating locally. Use of the newer arsenical compounds.—The more or less recent in- troduction of certain new arsenical compounds seemed, in the light of Lombroso’s work, to offer a better therapy for pellagra. Atoxyl, first used, I think, by Babes, has been given a trial by several and with very discordant reports as to results. Of these preparations atoxyl and soamin are the only ones which have been used, so far as I am aware. Arsacetin is another important member of this group. A few words on these drugs and their method of use may not be inappropriate. Atoxyl and soamin are both trade names and are forms of sodium arsanilate, containing, respectively, about 26 per cent and 22 per cent of arsenic. They are sold in the form of the salt itself and in the form of hypodermic tablets. Sodium arsanilate is prepared by condensing aniline and arsenic acid, eliminating water and isolating the arsanilic acids. The sodium salt is prepared by the usual methods. It occurs as white, odorless cr}7stals soluble in 5 or 6 parts of water and more soluble in warm water. Action.—The arsenic of the arsanilic acid is liberated very slowly in the system, thus producing the ordinary therapeutic effects of arsenic with the advantage of a more continuous and less toxic action and less irritation. Toxic effects from excessive doses have been frequently noted although the toxicity is stated to be about ^ one-fortieth of that of arsenic trioxide. The use in large doses has occasionally resulted in blindness from degeneration of the optic nerve. Dose.—0.02 to 0.2 grams (£ to 3 grains) hypodermically, every other day, gradually increasing if necessary until the single dose reaches 0.65 grams (10 grains) and until a total of 6.5 grams (100 grains) have been