continued 



208 REVIEW — TROPICAL MEDICINE, ETC. 



Trypano- inoculated, and one ox survived, while the check animal died in five days. It appears, 

 somiasis— therefore, that there is some probability of the desired result being attained. 



Goebeli has a paper on the preventive and curative power of human serum on the 

 infection of nagana. He finds that it has no opsonic or cytotropic power in regard to 

 trypanosomes and appears in no way to act by a combination of alexin and sensitising 

 bodies. Its preventive power has been verified for the mouse. 



Amongst the latest suggestions as regards treatment, not mentioned in Nabarro's 

 treatise, is that of Castellani- with reference to the use of quinine cacodylate. He says : — 



1. Quinine cacodylate showa a well-marked trypanocide action in monkeys e.^perimentally inoculated with a 

 strain of trypanosome closely resembling T. evansi. 



2. Mercury perchloride improves the general condition of the inoculated monkeys, and frequently causes the 

 temperature to subside to normal. Given alone, however, its trypanocide action is not very marked. In patients 

 affected with sleeping sickness, it would seem from the experiments made by Low and myself in 1903 that 

 mercury perchloride given by intravenous injection induces a fall in the temperature, but the improvement is 

 only temporary. 



3. I suggest that quinine cacodylate alone, or, better, in combination with intravenous injections of 

 perchloride of mercury, should be tried in sleeping sickness, using large doses. If it should be found that 

 quinine cacodylate has a marked trypanocide action also on T. gamhicnse, the advantage of this drug over other 

 preparations would be its powerful action on the malaria parasites. This would be an appreciable advantage, as 

 in the experience of many observers, among whom are Low and myself, a large number of sleeping sickness 

 patients are suffering also from chronic malaria. 



4. Quinine cacodylate, besides its trypanocide properties and its action on Laveran's parasites, has apparently 

 some action on other protozoa, as, in my experience, its use is beneficial in kala-azar and yaws. 



Laveran and Thiroux^ recommend the administration of atoxyl together with orpiment, 

 and report cures in experimental animals infected with T. gamliense. 



Mesnil and Nicolle* bring their results with atoxyl and the colour Ph. (Afridol- violet), 

 in the case of monkeys inoculated with T. gamhienae, up to date in a paper wherein they 

 affirm that they have definitely cured six of the animals by atoxyl alone, four by alternating 

 atoxyl with Ph., two by Ph. alone, at first, and then associated, at the conclusion of 

 treatment, with one or two doses of atoxyl. 



Browning,'^ a disciple of Ehrlich, reviews the whole question of chemo-therapy in 

 trypanosome infection. The article, which is very erudite, requires careful study. One 

 would only note here that the work seems to show that differences in the immunity-reaction 

 are not a sufficient basis for the classification of difi'erent species of trypanosomes. 



Reference may be made to a special article in the Lancet for January 11th, 1908, on the 

 treatment of trypanosomiasis, which details all the recent work, including the various 

 combinations adopted by Plimmer and Thomson who used the lactate, succinimide and 

 sozoiodol of mercury, and also iodipin along with atoxyl. 



Another important paper for reference is that of Weber,"* who details every kind of 

 treatment which has been tried, dealing with immunity, active and passive, and sero-therapy, 

 the use of extracts of organs and of their secretions, the employment of bacteria and their 

 products, and chemical and physical methods. 



Special references and reviews will be found in the following numbers of the Bulletin 

 de VInstitut Pasteur, July 30th, 1907, September 3Gth, 1907, and January 15th, 1908. 



LcEiHer and Russ,'* working with Nagana, have revived the treatment with arsenious 

 acid, and have been able to cure severely affected animals (guinea pigs, rats and rabbits) in a 

 relatively short time, and to confer on healthy animals the power of resisting repeated 



1 Goebel, 0. (November 25th, 1907), " Pouvoir preveutif et pouvoir curatif du Serum humain dans I'infection 

 due au Trypanosome du Nagana." Ann. dc I'lnstitut Pasteur, Vol. XXI. 



2 Castellani, A. (February 29th, 1908), "Note on the Treatment of Experimental Trypanosomiasis." British 

 Medical Journal, Vol. I. 



' Laveran, A., and Thiroux, A. (February 25th, 1908), " Recherches sur le traitement des Trypanosomiasis." 

 Ann. dc VInstitut Pasteur, Vol. XXII. 



■• Mesnil, P., and Nieolle, M. (December 25th, 1907), "Traitement des infections experimentales k 

 Trypanosoma Gambiense." Ann. de VInstitut Pasteur, Vol. XXII. 



"> Browning, C. H. (January, 1908), " Chemo-Therapy in Trypanosome Infections: an Experimental Study." 

 Jotimal of Patholor/ij and Bacteriology, Vol. XII. 



8 Weber, H. (1907). Zeitsch.fiir Exp. Path, und Ther., Bd. IV. 



' Lceffler, P., and Russ, V. K. (August 22nd, 1907). Deut. Med. Woch. 



• Article not consulted in the original. 



