148 DISEASES DUE TO PROTOZOA 



The chief drugs now reUed upon are antimony oxide, tartar emetic 

 and arsenic. 



Arsenical preparations. 



Liquor arsenicalis has cleared up some cases. It was used before 

 Soamin was known. It should be given well diluted in increasing 

 doses, from 5-15 minims and omitted every fifth week. 



Salvarsan and Xeosalvarsan. These are not more useful than 

 Soamin and much more costly. 



Atoxyl. This is as Soamin, but more toxic, causing optic atrophy, 

 gastro-intestinal inflammation, and peripheral neuritus. It has now 

 been replaced by Soamin. 



Atoxylate of Mercury. Less satisfactory than atoxyl. 



Soamin. The best arsenical preparation to use. 



The methods of giving it are various. By the mouth, by the vein 

 and intramuscular. Examples : — 



3 grains daily per os, omit every tifth week. 



2-3 grains intramuscular every third day for at least two \ears. 

 (Manson.) 



71 grains intramuscularly every fifth day (Broden). 



72 grains intramuscularly two successive days every ten days for 

 ten months (Koch). 



The writer has giv^en 7^ grains (0.50 grm.) of soamin every fifth day 

 for two years without clearing trypanosomes from the lymphatic 

 glands in the majority. The drug was always suspended on mani- 

 festations of arsenical poisoning. Thousands of injections were given 

 following this method, but were abandoned for combined treatment as 

 being unsatisfactory. Soamin will cause the disappearance in some 

 cases of the trypanosomes, but we cannot rest contented with it. 



Orpiment. An organic salt of arsenic used for the lower animals. 



Not any use in human trypanosomiasis. 



Galyl. This has proved useful in some cases with tartar emetic 

 given between doses of galyl. Useful in European cases. 



Antimony preparations. 



The following are new preparations which have not A'et been suffi- 

 ciently tried. They are : Antileutin, antimony and ammonio-potassio- 

 tartras, antimony aniline tartrate, and antimony-sodium tartrate. 



Tartar emetic is the best known and most widelv used. 



All tartar emetic preparations should be preceded by an injection of 

 caffeine; as tartar emetic lowers the blood pressure. I have given 

 thousands of doses of tartar emetic intravenouslv without anv heart 

 symptoms of importance. 



Tartar emetic is too painful for intramuscular use. It was thus 

 first used and abandoned bv Sir Patrick Manson in the earlv davs. 



