Prophylaxis. — The fact that French skins, since Pasteurian inoculation has been employed in French flocks, have been found to rarely cause anthrax speaks in favor of that method. Disin fection, even by formol, is uncertain.
Skins of French animals are never in fectious, the result, it is believed, of an thrax being almost stamped out among the French flocks by the practice of Pasteurian inoculation. Formol-vapo• does not penetrate them sufficiently to disinfect thoroughly. The only safe guard against anthrax infection is the Pasteurian inoculation. M. le Roy des Barres (Brit. Med. Jour., Sept. 25, '97).
The present laboratory-method of pro ducing immunity to anthrax gives rise to a very transient immunity, and in order permanently to protect animals that are spontaneously exposed it is necessary to modify the method so as to deprive the immunity of its transitory character. By combining passive im munization (by means of serum) with active immunization a marked success observed. Sheep received mixtures of anthrax serum and attenuated anthrax cultures, and were still immune to viru lent cultures one and one-half months afterward. A. G. Sobernheim (Berliner klin. Woch., Mar. 27, '99).
Treatment. — In man the disease re mains localized a longer time than in animals. Hence it is possible to remove it more thoroughly. Complete extirpa tion of the affected part, by means of the Paqueliu thermocautery, and subse quent cauterization with nitric acid are to be practiced.
Complete excision of the pustule is the best treatment, except when vital structures are involved, in which case injection of strong solutions of the most energetic antiseptics may he used. II. L. Burrell (Annals of Surg., p. 621, '93).
According to Koch, bichloride of mer cury is the most effective poison for the anthrax bacilli, being capable of killing them when used as diluted as 1 part to 300,000 of water. Consequently it is a good plan to use, in and around the af fected part, injections of 1 to 100 bichlo ride or 2- to 5-per-cent. carbolic acid. General treatment has been very unsatis factory, although Russian authors have met with success by the energetic use of carbolic acid locally and internally.
Theoretical considerations should never deter one from operating, not only during the early stages, but at whatever period of the disease the cases present them selves. There are a number of instances where success has followed excision even in the later stages. It seems that we have in the pustule a manufactory which supplies bacilli, in unlimited quantities, and, when this is removed, the phago cytes are well able to cope successfully with the organisms which have escaped in the blood-stream. Lowe (London Lancet, Jan 23, '92).
Case of anthrax of the nose in a tanner successfully treated with injections of carbolic acid and hot compresses (122° to 131° F., changed every ten minutes, day and night). In the course of eighteen days more than 400 Pravaz syringefuls of 3-per-cent. solution of carbolic acid were given without signs of intoxication appearing. Alexander Strube]] (Mtin chener med. Woch., Nov. 20, 'OS).
The fact that experiments have shown that ipecacuanha added to tubes contain ing 5 cubic centimetres of broth invaria bly destroy the vitality of all the anthrax bacilli present, and no growth ensued (provided that they contained no spores) has suggested the use of this drug as a remedy.
Ipecacuanha, locally, in form of pow der and internally in doses of 5 grains every four hours advocated. Fifty cases so treated without a death. Maskett (Med. Chronicle, Aug., '91).
Nucleinic acid has also given promis ing results in the hands of Vaughan.
Case of grave anthrax successfully treated with Marmorek's serum. In cision and curetting had been of no use. A. L. Dupraz (Archives Prov. de Chir., Mar. 1, 1900).
In anthrax and other septic conditions general infection must be prevented, yet no operation is indicated. Applications to the carbuncle, with fixation and in ternal treatment, suffice. Operative in terference may cause general infection; yet, when abscess forms, it should be thoroughly evacuated. A dry dressing is advised; in some cases iodoform gauze and pure carbolic acid are good. In all but very slight conditions moist dress ings are contra-indicated. E. Lexer (Die Therapie der Gegenwart, Jan., 1903).