S28 APPLIED IMMUNOLOGY 



1909, was the first to try salvarsan on the human subject. The 

 preparation used was an alkaline solution of the disodium 

 salt. Shortly afterward Michaelis, Wechselmann and Lange 

 devised the method of neutral suspension injections and prac- 

 ticed the same subcutaneously and intravenously in thou- 

 sands of cases. Other notable methods that have been ad- 

 vised are Junkemann's and Lesser's modification of Alt and 

 Hoppe's alkaline method and Kromayer's suspension of sal- 

 varsan in paraffin. About this time Schreiber, associated 

 with Hoppe, described the method by intravenous administra- 

 tion. Wechselmann appears to be the first to have employed 

 salvarsan by intraspinal injection. Subsequently, Marie and 

 Levaditi likewise injected neosalvarsan directly into the 

 spinal canal. While the technic of direct intraspinal injec- 

 tions of salvarsan and neosalvarsan was being perfected, even 

 before the use of hypertonic solutions of neosalvarsan as 

 practiced by Ravaut and Wile, Swift and Ellis recommended 

 the intraspinous injection of auto-salvarsanized serum. This 

 method is less irritating to the nervous system and less 

 dangerous and consequently is the most popular form of sub- 

 dural arsenic medication. Recently Fordyce has recom- 

 mended adding minute quantities of salvarsan or neosalvar- 

 san to the auto-salvarsanized serum prior to intraspinal 

 injection. 



Subcutaneous Administration. — The subcutaneous admin- 

 istration of salvarsan or neosalvarsan, either the injection 

 of the full therapeutic dose at once or repeated injections of 

 fractional doses over a period of time, is practically an 

 obsolete method. This has been due to great and long per- 

 sistence of pain, induration, non-absorption of the chemical 

 and necrosis of the skin. 



Intramuscular Administration. — The intramuscular in- 

 jection is superior to the subcutaneous inasmuch as the above 



