Prevention is the most important consideration and this will include all
that has been stated above with regard to the restriction of the disease
in flocks and herds, the drainage and improvement of anthrax lands, the
seclusion, destruction, deep burial or cremation of carcasses without
autopsy or incision, the disinfection of stalls, secretions and all
contaminated products, and the suppression of all traffic in anthrax
products—meat, milk, blood, guts, bones, horns, hoofs, hair, wool,
bristles, etc., or the thorough disinfection of the same. Above all, is
the adoption of personal precautions. No one should handle anthrax
animals, nor suspected products who has any sore or abrasion on hands or
face, or such sore may be temporarily covered with a film of albuminate
of silver, or the hands may be washed with a solution of mercuric
chloride (1:500), or chloride of lime (1:200). If persons must work in
wool or textile products which are open to suspicion a respirator is an
obvious precaution, and this may be disinfected by live steam at
intervals.
_Treatment of malignant pustule_ is mainly surgical. At the outset the
thorough destruction of the dark central point or nodule with a red hot
needle or powerful caustic will be sufficient. Even when the pustule is
fully formed, its free excision with as much of the surrounding
infiltrated tissue as can be safely accomplished and the free
application of caustics will usually succeed. Potassa fusa, or zinc
chloride (1:3), or mercuric chloride or iodide in powder with or without
calomel, or pyoktanin, or formaline, or iodized phenol may be named as
especially applicable. Injections of carbolic acid (5 or 10:100) into
the indurated centre and infiltrated periphery have proved very
successful. In the case of Kaloff, when the excision of the nodule
followed by the local use of carbolic acid solution, failed to prevent
implication of the inguinal and pectoral glands, violent fever,
prostration, and diarrhœa; the excision of the affected glands and the
free use of phenic acid solution (5:100) in the adjacent tissues led to
speedy improvement. Some surgeons make a crucial incision of the pustule
and apply caustics freely. Muskett has been successful in excising the
nodule, filling the wound with ipecacuan powder and giving the same
agent internally. Many mild cases, or those that occur in refractory
systems will however recover spontaneously or under a less drastic
treatment. In the anthrax districts of Russia mercurial ointment is
rubbed on the sore, and the application of tincture of iodine or iodized
phenol to the raw sore or incised nodule and surrounding infiltration is
often successful.
Camescasse has claimed great success by incising the swelling, applying
tincture of iodine freely, and then wrapping in cloths kept wet with a
solution of 5 drachms of bicarbonate of soda in a quart of tepid water.
When systemic reaction has set in it is desirable to have resort to
general medication as for internal anthrax.
_Treatment of Anthrax Œdema_ must follow the same rule. Free incisions
into the œdematous tissues with the application of antiseptics, solution
of mercuric chloride or biniodide (1:1000), or the injection of the
whole infiltrated area and around it with the same agents, with phenic
acid (5 or 10:100), or with pyoktanin (1:1000) will prove useful, and as
in the malignant pustule the surface should be kept disinfected by a
compress wet in solution of the mercuric chloride or biniodide, carbolic
acid, iodized phenol, formalin or pyoktanin. If the pain of these
applications is very acute cocaine will be demanded or even ether. If
ether is applied to the surface its evaporation will cool the parts and
retard the proliferation of the bacillus. Under other conditions cold
water, pounded ice or snow may be applied.
_Treatment of Intestinal Anthrax._ When anthrax flesh has been eaten, or
when there are symptoms of incipient intestinal anthrax, the first
resort is an emetic of ipecacuan, followed by an active oleaginous
purgative to clear the _prima viæ_ of bacilli and their toxins. To these
may be added potassium iodide, pyoktanin, sodium salicylate, quinine or
tincture of muriate of iron, by way of keeping in check the
multiplication of bacilli. To counteract depression and heart failure
digitalis, strophanthus or strychnia with alcoholic stimulants may be
resorted to.
In _Pulmonary Anthrax_ the same principles are applicable. The patient
may be made to cautiously inhale gaseous chlorine, iodine or bromine or
a solution of iodide of potassium in an atomized condition. The vapor of
carbolic acid, eucalyptol, or oil of cinnamon may be tried.
The irritable stomach may be soothed by oxide of bismuth, with milk,
beef tea and other bland nutritive or stimulating draughts.
The grave character of internal anthrax, however, is such that resort
may be had to one of the various antitoxins, antidotal cultures, serums,
and immunizing agents that have proved useful in different hands.
Unfortunately such agents do not seem to act in the same manner on all
genera, and what has been effective in one of the lower animals may fail
in the human being. Thus Roger found that sterilized cultures of
bacillus prodigiosus retarded or obviated anthrax in rabbits, but
hastened its progress in the Guinea pig.
The sterilized cultures of the pneumococcus of Friedländer (Buchner) of
the bacillus pyocyaneus, or of the staphylococcus pyogems aureus,
(Pawlowsky) when injected subcutem have proved antidotal to anthrax.
Emmerich has successfully used erysipelas serum subcutem in the
treatment of anthrax. (Münch. Med. Woch. 1894). The sterilized cultures
of the streptococcus erysipelatos therefore offer themselves as
promising curative agents. The same is true of the sterilized cultures
of the bacillus pyocyaneus (Woodhead and Cartwright-Wood).
The blood serum of animals that are naturally immune (frog, white rat,
pigeon, dog,) is bactericidal and to a certain extent antidotal to the
bacillus anthracis, but that of an animal which is naturally susceptible
but which has been artificially immunized has proved much more potent.
In the experience of the writer this potency attaches no less to the
blood of an animal in the advanced stages of the disease. In adult
cattle he has found the symptoms of anthrax subside under two successive
daily doses (4cc.) subcutem of the sterilized blood serum of one of the
herd which had just died. Relapses were observed several days after the
serum treatment was abandoned. In experiments on rabbits two check
animals with anthrax inoculations died at the end of 3½ and 4 days. Of
six inoculated with anthrax and injected from one to three times with
sterilized (anthrax) blood serum one recovered, and the others died, one
at the end of the 7th, two of the 6th and two of the 5th day. In this
connection it may be stated that successful treatment by leucocytes is
claimed, (Pawlowsky) and that one of the effects of serum treatment is
the destruction in part of the globules and the release of nuclei, and
in this we may have an explanation in part at least of the therapeutic
action of the serum from the infecting and immunized animal.
Protective serums may be utilized by hypodermic injections daily or
every second day for a week, giving time for the disposal of the bacilli
present in the system. In the intestinal anthrax they may be given by
the mouth and injected into the peritoneal cavity. In pulmonary anthrax
they may be introduced into the trachea, bronchi and pleural cavity.