MALIGNANT PUSTULE AND WOOLSORTER'S DISEASE.
The first name is a synonym for Charbon, or Cutaneous Anthrax, whilst Woolsorter's Disease is the title given to the pulmonary type of anthrax.
The treatment of the pustule should be prompt and radical; excision, cutting wide of the infected tissue, is advisable, after which the wounded surfaces should be thoroughly disinfected by Perchloride of Mercury solution, Carbolic Acid or the cautery. The injection of a few minims of a I in 13 solution of Carbolic Acid or 2 per cent. Iodine at several spots around the basis of the swelling should be performed whether excision be done or not. Some surgeons recommend powerful caustics as Chloride of Zinc, Nitric Acid, Caustic Lime or Potash; but Braem discards all surgical procedures, and treats the local lesion by applying a i in so solution of Acetate of Aluminium on lint, whilst the part is elevated and the patient ordered to bed. It is claimed by several authorities that excision is liable to lead to the introduction of the spores or bacilli into the blood; hence when operative measures are resorted to strong antiseptics should always be freely used locally.
Owing to the danger of the bacillus entering the blood, serum therapy should always be resorted to. The extent of the local lesion and the mildness of the constitutional symptoms give no indications of the gravity of the case. Sclavo's Serum is prepared by immunising asses by injections of attenuated virus gradually increased in quantity and virulence. 3o c.c. should be injected intravenously or hypodermically in all cases and repeated several times during the three weeks necessary for recovery. Carbolic Acid in full doses is advocated by the mouth.
It is worth remembering as an important point in prophylaxis and local treatment that though the anthrax bacillus is speedily destroyed by most antiseptics, when the organisms are allowed to dry up by the evaporation of the blood or serum containing them, spores form in the presence of atmospheric oxygen, and these are practically indestructible.
Woolsorter's Disease occurs in operatives employed in woollen factories, the dried spores finding their way into the lungs from the dried fleeces which are employed in the manufacture of mohair, alpaca, &c.; hence prophylaxis should consist in the thorough disinfection of the hair or wool coming from all foreign countries where splenic fever is endemic. Once the symptoms have shown themselves the only hope lies in the intravenous injection of 3o c.c. Sclavo's Serum. This preparation preserves its efficacy unimpaired for 2 years when kept in sealed tubes in the dark.
The cardiac failure, high fever and dyspncea will also require the prompt use of such agents as Strychnine hypodermically, Ammonia and Whiskey along with Oxygen inhalations. Pleuritis and oedema of the glottis must be met by appropriate agents.
The rare intestinal type of anthrax is to be treated on the same lines, the poison in these cases reaching the alimentary canal through contami nated milk or food or by swallowing the saliva which has become infected by the accumulation of the spores in the naso-pharynx. Muskett strongly recommends large doses of Ipecacuanha as in the treatment of tropical dysentery, and he employs this drug as a dressing for malignant pustule. A paste made with Quinine and Turpentine appears to possess the same antibacterial properties.