TWO-AND-A-HALF YEARS' EXPERIMENTAL WORK ON THE SULPHONE GROUP OF DRUGS

Abstract

This long paper records brief notes on 54 cases of leprosy treated by sulphones in South India in the course of two and a half years. Most of them were given diasone or sulphetrone orally with very similar results to those recorded previously by a number of leprologists. Of greater interest are six cases given injections of sulphetrone with very similar results to those obtained after its oral administration, but obtained with a total average dosage of 81 grammes in place of an average of over 3, 000 grammes by oral use; a very material saving in cost per case. A discussion of the whole series with a comparison with hydnocarpus oil treatment brings out the following points, including the effects of injections of the much less expensive sulphone, diamino-diphenylsulphone, in eleven cases. Good photographs of six cases before and after treatment are given, but unfortunately the table relating to them does not give the number of pages referred in the text in the case of two, and in two others such data do not appear to correspond with those in the text. The first part of the paper concludes that for oral use sulphetrone is superior to diasone; a conclusion others had previously reached. About 30 per cent. of those treated with diasone showed reactions, but they later subsided in spite of the drug being continued without rest and they did not recur in any cases after 1000 tablets had been given. Furthermore, under this drug the only cases that became negative were in boys who received relatively large doses, so maximum dosage is indicated, but the high cost rarely allowed more than 4 tablets a day to be given. With oral sulphetrone only one patient had a very severe reaction and foot drop followed. Four of the nine became negative within two years. Owing to the high cost of diasone and sulphetrone given orally, which prohibits its use on a large scale, and the necessity of giving daily intravenous doses of promin, the author has tried injection of sulphetrone with interesting Tesults. The active principle of all three, namely, sulphone or diaminodiphenyl-sulphone has also been tested by injection, but the case notes and comments show that the latter gave rise to more severe reactions. Treatment by sulphones in general is also compared with that by the injection of hydnocarpus oil. The best results were obtained by subcutaneous injections of 7 cc. of 50 per cent. sulphetrone in water twice a week. On the other hand sulphone in doses of 1 to 1.5 gramme a week in a strength of 25 per cent. suspension in groundnut oil is probably the most potent remedy, but one which produces severe reactions in the form of anaemia, giddiness and sickness, and peripheral neuritis, sometimes of an alarming degree; this prohibits its use on a large scale until a safe dosage is found. In early lepromatous cases, hydnocarpus treatment is the best. This paper should be studied by all interested in leprosy treatment. L. Rogers.