258 CHEMO THERA P Y 



but few organisms are present as contrasted with their tiny size 

 when the number is large. He accordingly advises that such cases 

 be reinjected with the salvarsan, and there are already a number of 

 reports to show that such treatment is indeed frequently followed 

 by a most favorable result, while it is well known that a nerve that 

 has actually been damaged by arsenic itself (atoxyl for example) 

 is hopelessly doomed, if a second injection is given. 



Results. While there is evidence to show that the therapia magna 

 sterilisans, i. e., the complete destruction of all the parasites during 

 a single course of treatment is no mere dream, but an actual possi- 

 bility, this point is not reached so readily in syphilis of the human 

 being, at least, as in the spirillosis of chickens, in relapsing fever, and 

 frambesia, where a single injection is usually sufficient. That it 

 can be done, however, in a relatively short time has already been 

 shown by a number of observers. 



Here as elsewhere in the treatment of disease the best results will 

 be obtained if this is instituted early. Gennerich thus reports, that 

 of 58 cases of primary disease that had been treated with calomel, 

 followed by salvarsan, not a single one developed secondaries, nor 

 did the Wassermann reaction become positive again, and that of 

 these, 20 had already been followed for from nine to sixteen months, 

 at the time of writing. Tanzer, who used the salvarsan by itself, 

 similarly reports that of 21 cases which could be followed for from 

 three to thirteen months, none had a relapse, while the Wassermann 

 reaction remained negative. Arning states the same of 67 cases 

 which had been treated with salvarsan and mercury, etc. The ques- 

 tion, of course, might rightfully be asked, whether these people could 

 actually be regarded as cured, and whether the disease had not merely 

 become latent. Opposed to such a conclusion, is the fact that some 

 cases of syphilis which had been treated with salvarsan, and in whom 

 no further symptoms developed, later came back with a new infection, 

 i. e., with a new chancre, which would prove that the patient must 

 actually have been cured, since reinfection in the active syphilitic 

 is not possible. To this it might be objected that the new chancre 

 was in reality not a new infection, but a relapse, analogous to the 

 neurorelapses referred to above. But as Ehrlich remarks, the neuro- 

 relapses occur after a period of from two to five months, so that 

 if no symptoms develop within that period of time, one would hardly 

 be justified in looking upon the cases referred to above as being latent. 



