SWIFT-ELLIS TREATMENT 57 



inaccessible parts of the body, and these must be caught by con- 

 tinued administration of the drug, or by special methods. The 

 most successful method of treatment is an alternate use of 

 mercury and salvarsan, this apparently being more effective 

 than salvarsan alone. There is now on the market a modified 

 form of salvarsan, known as neosalvarsan, which is milder in 

 its effects on the body but usually considered less powerful in 

 destroying the spirochaetes. Several other more or less valuable 

 substitutes for salvarsan are now prepared. On account of the 

 war, salvarsan itself, a German product, is at present difficult to 

 obtain. 



Salvarsan injected into the veins does not reach the spiro- 

 chaetes in the central nervous system, and since it is too injurious 

 to be injected directly into the spinal fluid, the usual treatment 

 of syphilis is inapplicable to syphilitic infections of the nervous 

 system. An injection of salvarsan into the lymph spaces under 

 the fibrous coverings of the brain is sometimes used, but is not 

 always successful. Swift and Ellis, of the Rockefeller Institute, 

 discovered in 1913 that the blood serum of a syphilitic who had re- 

 cently been given salvarsan was destructive to spirochaetes and 

 could be injected into the spinal fluid without injurious results. 

 Out of this grew the so-called Swift-Ellis treatment of syphilis 

 of the nervous system by the use of " auto-sal varsanized serum," 

 i.e., the serum of the patient himself after having been given 

 salvarsan an hour before. This serum is heated for half an hour 

 to make the salvarsan in it more active, then diluted and injected 

 into the spinal canal. While complete cures in late cases of 

 paralysis and other nervous diseases could hardly be expected 

 from this or any other method, the results which have been ob- 

 tained are very encouraging. It has been suggested that in all 

 cases of syphilis the Swift-Ellis treatment be made routine as a 

 protective measure since, in the majority of cases, the spiro- 

 chaetes invade the nervous system in the early stages of the 

 disease and the consequences of their establishment there are so 

 terrible as to warrant every possible preventive measure. 



The modern methods of diagnosing syphilitic infection have 

 given a definite standard of cure, and the success or failure of 

 treatment can be positively demonstrated. A uniform negative 

 Wassermann reaction given several times during a year, and ab- 

 sence of any symptoms, can be looked upon as an indication of 



