Conquering Leprosy

What Nauru is Doing Steady Decline In Cases

SOON after the administration of the phosphate island of Nauru was taken over by Britain, Aus tralia and New Zealand, under the League of Nations mandate, in 1920, it discovered that leprosy was making extraordinary and highly al arming inroads upon the native popu lation.

The official figures published in the last annual report show that cases of the disease were reported as follows: 1920 .. 4 1926 .. 167 1921 .. 10 1927 .. 174 1922 .. 139 1928 .. 132 1923 .. 151 1929 .. 132 1924 .. 193 1930 .. 95 1925 .. 189 The Nauru administration, during the past ten years, has made deter mined efforts to cope with the disease and has created an organisation equip ped with the most modern methods. As a result, medical science, as is indi cated by the above figures, is slowly but surely winning the stubborn battle.

Each month the whole native popula tion is inspected by a medical officer with a view to discovering the first signs of leprosy. Suspicious cases are dealt with immediately and this early treatment is undoubtedly proving ef fective in combating the disease.

The Administrator, Mr. W. A. New man, gives the following details relat ing to the treatment of leprosy, and we publish same for the information of other Pacific administrations interested in this subject: Treatment of Leprosy.—The majority of the patients are treated with intra muscular in jections of Esters of Oleum (Hydnocarpus Wightiana), and in certain selected cases with Potassium lodide orally. The treatment with Potassium lodide is however discontinued if reaction proves severe or prolonged, or if corresponding improvement in condition is not readily forthcoming.

Early and obstinate cases have been treated with subcutaneous injections of a 3 per cent, aqueous solution of Alepol, containing .5 per cent, of phenol. Alepol is a derivative of Hydnocarpus oil and is described technically as the “sodium salt of the lower melting point fatty acids of Oleum (Hydnocarpus Wightiana), with the irritant properties re moved.” Alepol has an advantage over other anti-leprotic drugs in that it is exported in powder form and is ready for use after the necessary quantity has been dissolved in dis tilled water. It was thought, because of the ease of export and its simplicity in prepara tion and use, that Alepol might eventually supersede Oleum (Hydnocarpus Wightiana).

Whilst in certain cases Alepol has proved of distinct advantage, experience in a period of carefully observed usage has shown that uni formly good results follow the general appli cation of Oleum (Hydnocarpus Wightiana).

Intradermal Leprolin Test. —The Adminis tration has been in communication with the Director of the Leprosy Research Laboratory of the School of Tropical Medxine and Hygiene at Calcutta, and has also had the advice and assistance of Sir Leonard Rogers—an eminent authority in Leprosy Research. Realising that the solution of the leprosy problem depends to a great extent on early diagnosis, the intra dermal leprolin test (P. Bargehr) for the detection of early and latent leprosy is, on the advice of Sir Leonard Rogers, being ap plied on this island under carefully recorded conditions, and it is believed that the result ant data will prove of practical value not only in Nauru, but elsewhere. Particulars with regard to the result of this test will be available for inclusion in the next annual report.

As Nauru is an almost completely isolated place, the medical officers have had a unique opportunity of making very thorough tests of leprosy treat ments. Consequently, the Nauru re ports on the anti-leprosy campaign are awaited with keen interest by other experts interested in this class of in vestigation.