TREATMENT OP FUNGUS INFECTIONS 137 



Allergists have made extensive surveys of the mold spore content 

 of the air in different geographical areas and at different times of 

 year. It is routine practice to skin-test allergic patients with stock 

 fungus extracts or with extracts of fungi isolated from the particular 

 patient's environment. The role of fungi in allergy has been re- 

 viewed by many allergists, including Sulzberger/^ Peck,'*^ and 

 Brown.^ 



Treatment of Fungus Infections. The treatment of mycoses is 

 frequently unsatisfactory, the infections persisting for long periods 

 of time in spite of treatment. In actinomycosis, blastomycosis, and 

 histoplasmosis the prognosis is grave and the mortality high. In 

 superficial infections, as the dermatophytoses and thrush, local appli- 

 cations of strong antiseptics may sometimes lead to a rapid cure.^'^ 

 Many of these, however, are also stubborn and persistent. 



In sporotrichosis the internal administration of iodides causes 

 the rapid disappearance of the lesions. Similar, though less marked, 

 beneficial results are obtained in localized actinomycosis and blasto- 

 mycosis, so that it has come to be generally considered that the iodides 

 are a specific for fungus infections comparable with the arsenicals in 

 protozoan infections. However, Davis ^^ showed for Sporotrichum 

 (as did Reynolds and Henrici ** for an actinomycete) that the iodides 

 have no effect upon the fungi themselves either in vivo or in vitro; 

 growth occurred in media containing as much as 10 per cent of po- 

 tassium iodide. Such therapeutic results as are obtained therefore 

 must be due to an action on the tissues rather than on the parasite. 

 The iodides probably stimulate the formation of fibrous tissue which 

 tends to wall off the organisms. On the other hand Martin and 

 Smith point out that in systemic blastomycosis administration of 

 iodides may cause a rapid extension of the lesions unless the patient 

 is first desensitized. They suggest that the reason for this is that 

 the iodides cause the death of many fungi, and that a toxin is there- 

 upon liberated from the dead fungus cells. 



Many attempts have been made to find other specific drugs for 

 the treatment of fungus infections, but without much success. Prob- 

 ably because they have been extensively used as fungicides in the 

 treatment of fungus diseases of plants, copper salts and colloidal 

 copper have been used. Neither copper nor sulphur is as useful 

 against the fungus pathogens of man as against those of plants. 

 Tartar emetic and preparations of arsenic and mercury are also used. 

 Although apparent cures and improvements under such treatments 

 have been reported, the results in general are not sufficiently striking 

 to indicate that any specific chemotherapeutic agent has been found. 



