The Effect of Roentgen Rays on Lepromatous Leprosy

Abstract

Various attempts have been made in the past to treat certain manifestations of leprosy with ionizing rays. Superficial roentgen irradiation has been employed for the local treatment of skin lesions and for the eye. Deep roentgen therapy was given in cases of neuritis. Radium has been used for the local treatment of nodules of the skin and nasal and oral cavities. Historical Some reference to radiation therapy in leprosy has been made in various textbooks on tropical diseases. A comprehensive survey was given by Klingmueller in 1930 in his chapter on local treatment of the disease, but unfortunately he omitted from his bibliography all titles of published papers. Strong, in Stitt's textbook, stated that cutaneous lesions, nodular infiltrations, and ulcers often respond favorably to roentgen rays, and that radium may be employed for lesions about the eyes as well as in the mouth. As opposed to this, Rogers and Muir wrote in 1946 that x-rays had their vogue but were of little benefit and were apt to cause blisters and ulcerations in nerve cases. A. Roentgen Radiation for Superficial Lesions: According to Belot, it was Sequeira who first reported on the use of roentgen rays in leprosy in 1901, when he described partial regression of nodes and softening in a case of nodular leprosy. Oudin treated two cases in 1903, produced a good reaction with roentgen rays, and also observed regression of lesions of the face and hands. Lie, the famous Norwegian leprologist, stated in 1904 that roentgen rays have a certain influence on leprosy. He noted marked diminution of nodes after irradiation. During the same year, Pernet, of Britain, said that he had observed good local results with the rays, adding that they were, of course, not curative, the disease being a general infection, but by this means improvement of the face could be obtained in advanced cases. At the Lepra Conference in Bergen in 1909, Pernet again emphasized that x-rays cause regression and/or disappearance of the local nodules, though to talk of x-rays as curing leprosy, as was done in some quarters, he designated as “to say the least, curious.” Wilkinson published an interesting report on leprosy in the Philippines, with an account of its treatment by x-rays, in 1906. He had irradiated 13 patients and listed his results as showing 3 cured, 7 improved, and 3 unimproved. He observed that irradiation of one leprous spot produced improvement in untreated spots elsewhere in the body and stated it as his belief that leprosy bacilli are killed by the treatment and that their bodies are reabsorbed into the blood, producing immunizing and curative factors, as in plague immunization. A similar study was made during the same year (1906) by Lassar, Siegfried, and Urbanowicz at the Lepraheim in Memel, Germany. Nine patients received roentgen therapy, and regression of local lesions was observed. However, further studies for evaluation of results were recommended.