APPENDIX 325 



for the proper, safe and best administration of salvarsan 

 and neosalvarsan. They are as follows : 



1. An exact technic. 



2. Observance of the integrity of the hermetically sealed 

 ampoule and the normal physical characteristics of the con- 

 tained drug. 



3. Immediate and fresh preparation of the solution just 

 prior to administration, avoiding improper degree of tem- 

 perature. 



4. Selection of the appropriate dose for the individual 

 case. 



5. Previous examination of the patient to receive the drug, 

 particularly investigation of the renal, cardiovascular and 

 nervous systems. 



6. Assurance that any previous administration of mer- 

 cury has not caused kidney irritation. Wechselmann, who has 

 given over 30,000 doses of salvarsan, cautions against the 

 combined use of salvarsan and heavy mercurial treatment, 

 and protests vigorously against employment of salvarsan 

 after a course of mercurial treatment. 



7. Careful notation after injection of a patient of reac- 

 tionary phenomena, with respect to repeated injections, both 

 as to time and dose ; the most important consideration is ob- 

 viously the possibility of kidney irritation. 



8. Caution as to the resumption of vocational activities 

 by the patient too soon after the administration of salvar- 

 san and neosalvarsan. 



Dosage. — Michaelis has stated the average dose of salvar- 

 san to be 0.01 gramme to every kilogramme of body weight. 

 Salvarsan is marketed in original packages of hermetically 

 sealed ampoules containing 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 1.0, 

 2.0 and 3.0 grammes ; of these the average adult dose is 

 0.6 gramme, which at times may be advantageously dimin- 



