JOHN A. KOLMER 1125 



Ethylhydrocuprein in i per cent solution has also proved efficacious in the treat- 

 ment of pneumococcus conjunctivitis, and I believe it possesses some curative activ- 

 ity in the local treatment of pneumococcus sinusitis, mastoiditis, and otitis media as 

 well as in pneumococcus meningitis, pleuritis, and for the disinfection of the mouth 

 in carriers. 



COMPOUNDS OF MERCURY, ARSENIC, AND OTHER SUBSTANCES IN THE 

 CHEMOTHERAPY OF BACTERIAL DISEASES 



Without doubt the soluble salts of mercury are among the most potent known 

 bacteriostatic and bactericidal agents in vitro in a menstruum of distilled water or 

 simple saline solution. Even in a menstruum of blood, serum, pus, or muscle extract, 

 the majority of mercurial compounds maintain fairly high bactericidal values so that 

 they have long held the attention of chemotherapeutists in relation to the possibility 

 of synthesizing useful compounds for the treatment of local and systemic bacterial in- 

 fections, y 



It is hardly necessary, however, to discuss in much detail the bactericidal effects 

 in vitro in water or saline solution of the salts of the heavy metals because these effects 

 are only of value in relation to the sterilization of instruments and other objects. In 

 relation to the chemotherapy of localized and superficial infections of the skin, mucous 

 membranes and wounds by topical application or of systemic infections by subcu- 

 taneous or intravenous injection, as well as the disinfection of sputum, feces, urine, 

 pus, etc., only the effects produced in vitro in the presence of blood, serum, or tissue 

 extractives possess interest and practical importance. Possibly an exception may be 

 made to this general statement in dealing with chemical agents primarily designed 

 for treatment of localized infections of the urinary system in which useful tests in 

 vitro may be conducted with a menstruum of sterile urine as employed by Young, 

 White, and Swartz in their studies with mercurochrome. 



I have selected a few compounds of the heavy metals for purposes of illustration 

 in the present discussion because of their wide clinical use in the treatment of localized 

 infections of mucous membranes and because in a general manner they serve as 

 examples of the comparative bactericidal activities of the heavy metals represented 

 by them. Working with a blood serum-muscle extract medium seeded with staphy- 

 lococci and conducting duplicate tests in exactly the same manner and at the same 

 time except that sterile distilled water was substituted for their special medium, I 

 have found that the final concentrations proving completely germicidal at the end of 

 twenty-four hours at 30° C. were approximately as shown in Table II. 



The matter of rapidity of disinfection by compounds of the metals is deserving of 

 mention and especially when they are employed for the treatment of localized bac- 

 terial infections. For example, in the treatment of urethritis, conjunctivitis, gingivi- 

 tis, etc., the disinfectant agent is in contact with the tissue for probably only a matter 

 of a few seconds, and only those agents known to act quickly are likely to prove bac- 

 tericidal under these conditions; rapidity of sterilization bears a relation to concentra- 

 tion of the chemical agent and its absorption or fixation by cells. 



The subject of acquired resistance of bacteria to compounds of mercury and other 

 metals has not commanded much attention since they have not been administered 

 over long periods of time in the treatment of bacterial infections. But the subject is 



