146
The figures of treatments and cases at Karachi are of interest.
P. A. Room Karachi . . .
1935.
1936.
1937.
1938.
1939.
Cases treated . . .
456
246
434
747
604
Total infections . . .
5
2
10
28
3
The outstanding feature of these diseases is of course the complete change
established in the treatment of gonorrhoea by the Sulphapyridine group of
drugs and, in particular, M. & B. 693. Gone are the days of 2 months stay in
hospital for gonorrhoea. The average length of stay is now reduced to 18
and even 14 or 12 days and must be reduced still further. Gonococci dis
-appear in 2—3 days and the discharge dries in 3 to 8 days. The absence of
complications and relapses is a notable feature. The following examples are
typical :—
At Karachi . . . Previous average stay in hospital . . . 65 days.
11 cases treated with Sulphanilamide . . . 40. 9 "
58 cases treated with M. & B. 693. . . 14.4 „
At Rawalpindi . . .
Average number of days in hospital.
1935.
1936.
1937.
1938.
1939.
Fresh gonorrhoea . . .
50
43
34
31
*17
Relapse gonorrhoea. . .
37
40
27
25
One case of minimum time in hospital is worth mentioning.
While serving a sentence of detention he developed gonorrhoea, was
admitted and put on treatment with M. & B. 693. Owing to difficulties in
finding a guard owing to war activities, he was discharged next day and con
- t i n u e d h i s d e t e n t i o n a n d h i s t r e a t m e n t f r o m t h e M . I .R
o o m
o n o r d i n a r y d i e t .
He made a perfect recovery.
Routine methods of treatment have now been adopted, the principle
being to develop a high concentration of the drug in the body as soon as possible
and discontinue before toxic results can develop. 28 grammes (56 tablets)
over 4 days is one routine method. This may be repeated. No local treat
- m e n t i s g i v e n a n d t h e m e t h o d o f a l l o w i n g i m m u n i t y t o d e v e l o p b y w i t h h o l d i n g
treatment for a week is being discarded. In many cases now ordinary diet is
allowed to patients under treatment.
The case of a patient who required 71 days in hospital because he sun
-bathed is referred to in paragraph 66.
With the prevalence of these drugs in the bazaar and the widespread
knowledge of the ease with which treatment can be carried out it is quite
certain that men are resorting to bazaar treatment. Cases of Urethritis
without any organisms present are becoming common. In addition there is
the danger that patients may receive gross over dosing because illicit treat
- m e n t f r o m b a z a a r p r a c t i t i o n e r s i s n o t a c k n o w l e d g e d w h e n t h e y a r e a d m i t t e d
finally for treatment at the military hospital. Cases of toxic results and even
a death have been reported.
For syphilis standard methods of diagnosis and of treatment are laid
down and give satisfactory results.
A case is recorded of Tabes dorsalis in an Assistant Surgeon which showed.
remarkable improvement even at that late stage under treatment with Tryp
- a r s a m i d e , a n d h i s c e r e b r o s p i n a l f l u i d s h o w e d a r e v e r s a l o f r e a c t i o n .
One case of syphilis while under arsenical therapy developed haemorrha
-gic enephalitis and died.
* Includes 4 very resistant cases who averaged 71 days.