but crippling of the extremities and blindness often resulted. The
following is a summary of the commondeformities in the 112 patients:
Hands:
Severe crippling (contractures and/or tssue loss)
13
Moderate crippling (contractures and/or tissue loss)
Mild crippling (contractures and/or tissue loss)
No crippling (contractures and/or tssue loss)
Feet:
Foot drop (some bilateral)
Plantar ulcers : including those with osteomyelitis)
Osteomyelitis (secondary to ulcers)
:
Eyes:
Total blindness. both eyes (leprous)
Total blindness. one eye (leprous)
Leprous eye involvement (not serious)
L
.
Osteolysis (leprous bone reabsorption)
7
.
25
67
12
34
12
:
12
:
.
.
Serious eye involvement, not leprous (traumatic or congenital)
Nase:
Septal perforation...
.
vince
Mucous membrane ulceration without perforation
.
o.
:
:
vee
:
eae
..
foe
I
I
13
4
8
31
The 20 nontuberculosis wards remained filled most of the time with
patients hospitalized chiefly for: (1) severe plantar ulcers, some with
osteomyelitis; (2) lepra reactions: systemic, cutaneous, and/or neural;
(3) intercurrent nonrelated illnesses. Small burns were common due
to the anesthesia. Four of the five deaths which occurred at the
leprosarium between September 1948 and July 1951 were due to
tuberculosis rather than leprosy.
Treatment routines at Tinian were patterned after those used at
the National Leprosarium, U. S. Marine Hospital, Carville, Louisiana.
Lieutenant (j. g.) G. C. McNeilly, MC, USNR, who succeeded Dr.
Millar as medical officer in charge in 1950, has written of the treatment
and prognosis:
To date the treatment of choice in leprosy is the sulfone series of drugs.
Over 40 of our patients receive intravenous promine daily, omitting Sundays
and every fourth week. Over 60are given oral diason on the same schedule.
An experiment was conducted on the use of streptomycin in the treatment
of leprosy, [t was the clinical impression that the value of streptomycin is
definitely less than that of the sulfones. Complications are treated separately. For hand paralysis and contractures we have inaugurated a small
physiotherapy program. Subsequently tendon transplants are anticipated
by several patients. Only one has been done to date, with a gratifying result.
For foot ulcers treatment has consisted of supportive and conservative experimental measures with results thus far being rather disappointing. Simple
special shoes for 2 patients. and external metatarsal bars for 2 others have
recently been ordered locally. Lepra reactions are treated symptomatically
and by giving intravenous procaline, antihistaminics. occasionally discon-
907
S00b04 1.