130 An Introduction to Medical Mycology 



results of the work of Gould and Carter, Schamberg and Kolmer, Scham- 

 berg, Brown and Harkins, Kingery and Adkisson, and Emmons indicate 

 that the fungicides to be discussed are active in the approximate concen- 

 trations named. Since these and other investigators based their results on 

 the use of varied technics and different species of fungi, there are many 

 discrepancies in the reports of the concentrations of drugs necessary to ob- 

 tain the desired effect. There are, however, few actual differences of opinion. 



1. Salicylic and benzoic acids were found to be only feebly fungistatic 

 when tested separately by Schamberg and Kolmer, but Gould and Carter 

 found that by combining and adding to culture mediums salicylic acid in 

 the strength of 1:10,000 and benzoic acid 1:5,000, no growth resulted when 

 the culture mediums were inoculated with six strains of common patho- 

 genic fungi. 



2. Iodine is strongly fungistatic (1:10,000) but not as strongly fungicidal 

 (1:500). Schamberg, Brown and Harkins found iodine to be a powerful 

 fungicide. Emmons, too, found it the most efficient fungicide, on the basis 

 of its phenol coefficient. Others have confirmed these results. 



3. Gentian violet, crystal violet and brilliant green restrained growth of 

 fungi but were found to be less active as fungicides than as bactericides. 

 Loos found brilliant green to be a most effective substance. 



4. Mercurial products were effective both as fungistatic and as fungicidal 

 agents. 



5. Thymol, oil of cinnamon and oil of cloves were active in vitro. 



6. Chlorine ( sodium hypochlorite ) was found by Emmons to be almost as 

 effective a fungicide as iodine. 



That complete reliance cannot be placed on laboratory tests is indicated 

 by the poor results recorded for sulfur and chrysarobin. It is well known 

 from clinical experience that both these drugs are valuable fungicides. So- 

 dium hydroxide proved to be a poor fungicide in vitro. 



When the various drugs just enumerated ( and many others ) are applied 

 to skin it is at once apparent that there is marked variance in cutaneous 

 tolerance to them. Thus, thymol must be used in high dilutions, and while 

 its performance is excellent in vitro it is not quite so effective in clinical trial. 



The prescriptions which we shall present may be found useful. It must 

 be reiterated that the patient should be treated as an individual, the 

 strength of the drug and the choice of vehicle depending greatly on the 

 personal requirements. 



It is customary to apply the medicament to the affected parts before 

 retiring for the night. While this is usually the most convenient time, in 

 many cases morning may be better. It is essential that the product be 

 applied with pressure or massage, to insure the optimal effect. A smear or 



