260 CHEMOTHERAPY 



in tabes and paresis at the first sheet lightning, as Ehrlich puts it, 

 while later on it is, of course, useless, and in advanced paresis 

 especially, its employment is even attended by a certain amount 

 of danger. 



If now we eliminate from our analysis all those cases in which 

 destructive lesions have occurred, and sum up the findings in the 

 remainder, there is overwhelming evidence to show that in salvarsan, 

 either by itself or in combination with mercury, we have a treatment 

 by which we cannot only produce a favorable influence upon the 

 clinical symptoms, but actually effect a cure, in the vast majority 

 of cases. It seems very doubtful in fact whether any cases exist, 

 in which the infection cannot be completely eradicated either by the 

 salvarsan alone, or in combination or alternation with mercury, if 

 the results of the treatment are controlled at frequent intervals by 

 the Wassermann reaction, and if the treatment itself is carried out 

 by experts. A suitable combination of the syphilologist's clinical 

 knowledge and the peculiar training of the immunologist will 

 unquestionably yield the best results; either alone is not in a position 

 to give the patient the very best that can be given. 



To enter into a detailed account of case records would lead us 

 too far afield, however, and I would refer those who are interested to 

 the special literature upon the subject; suffice it to say at this place 

 that barring those cases in which the treatment is cleary contra- 

 indicated, it should be followed whenever there is reason to believe 

 that living spirochetes are present in a patient's body, as evidenced 

 either by the character of the clinical symptoms or the presence of 

 a positive Wassermann reaction. 



SALVARSAN AND ITS USE IN NON-SYPHILITIC MALADIES 



While salvarsan has gained its greatest fame in the treatment of 

 syphilis, there is evidence to show that the remedy is of value also 

 in combating other infections that are due to protozoan parasites. 

 It has thus been found to be quite effective in the treatment of 

 tertian malaria and notably in those cases which are refractory to 

 quinine. In this connection, the interesting observation has been 

 made that in some cases of this order the administration of salvarsan 

 in very small doses, may cause the refractory behavior to quinine 

 to disappear. 



