II20 CHEMOTHERAPY OF BACTERIAL DISEASES 



Gentian violet, brilliant green, acriflavin, etc., have also been employed for the 

 disinfection of the throat and nose of diphtheria bacilli and meningococci, but with 

 indifferent success, largely due to the difficulty of removing the mucoid secretions 

 sufficiently well to permit the penetration of the dyes into crypts where the organisms 

 are especially likely to persist. 



Acriflavin, proflavin, and other dyes have also been employed in the treatment of 

 infections of such mucous membranes as those of the mouth (in gingivitis), the eye, 

 the urethra, and vagina. Success is claimed by some and denied by others, but many 

 of the reports are of a favorable character. 



Gentian violet and acriflavin have also been employed for the treatment of 

 pleuritis and infections of the larger joints, and the results have been mainly good 

 when the pus was first removed and the infected tissues cleansed before the injection 

 of the dyes. Morgenroth and others have also reported the successful treatment of 

 furuncles, carbuncles, buboes, suppurative mastitis, pelvic abscesses, etc., with acridin 

 dyes and especially rivanol. 



Gentian violet, acriflavin, rivanol, and other dyes have been used with apparent 

 success in the treatment of staphylococcus and streptococcus bacteremias; indeed, 

 these would appear as special diseases calling for chemotherapeutic measures alone 

 or as adjuvants to serum therapy, and some notably successful results have been re- 

 corded. 



CINCHONA DERIVATIVES IN THE CHEMOTHERAPY OF BACTERIAL DISEASES 



While the anilin dyes were among the first substances to be used for selective 

 bacteriostasis and bactericidal activity and especially in vitro in relation to the isola- 

 tion of organisms, yet to cinchona derivatives belongs the distinction of being first 

 employed for systematic efforts in the development of an efficient chemical disinfection 

 of animals with an experimentally produced generalized bacterial (pneumococcus) 

 infection. 



BACTERIOSTATIC AND BACTERICmAL ACTIVITY OF THE CINCHONA 

 DERIVATIVES IN RELATION TO CHEMOTHERAPY 



Morgenroth and Levy found that ethylhydrocuprein possessed a high and selec- 

 tive degree of pneumococcidal activity in vitro, and this observation has been amply 

 confirmed, although, as would be expected, the pneumococcidal dilutions published 

 by different investigators have varied greatly according to the technique employed. 

 Ethylhydrocuprein hydrochlorid and other quinin compounds, however, act some- 

 what slowly on organisms, including pneumococci, and demonstrate more clearly their 

 specificity for the pneumococcus in bacteriostatic than in bactericidal tests. In my 

 experiments, when solutions of the drugs were prepared in broth and seeded with 

 pneumococci followed by incubation for eight days, it was found that ethylhydro- 

 cuprein hydrochlorid inhibited the multiplication of pneumococci belonging to the 

 first three serological types in dilutions varying from i : 1,000,000 to i : 2,000,000, while 

 with the ordinary quinin salts the inhibiting dilutions ranged from i : 5000 to i : 200,- 

 000. For other organisms like B. typhosus and Staphylococcus aureus, the inhibiting 

 dilutions with all of the quinin compounds varied from i : 500 to i : 2500, demonstrat- 

 ing their special and selective effects upon pneumococci. 



