332 APPLIED IMMUNOLOGY 



the secondary, latent, tertiary, nervous and hereditary forms 

 of the disease, mercury or mixed treatment must supplement 

 the administration of arseno-benzol. We seldom administer 

 less than three intravenous injections, usually at intervals of 

 a week. Then, after a respite of three weeks, the blood is 

 tested by the Wassermann reaction. If the result still be 

 positive, three more injections are given and so on until in 

 a few cases a dozen or more doses have been administered. 

 As soon as a negative Wassermann is obtained the patient is 

 subjected to a vigorous course of mercurial or mixed treat- 

 ment for three months to a year. Treatment is then sus- 

 pended and the further conduct of the case may depend upon 

 Wassermann reactions of the blood taken at three-month 

 intervals, associated in certain cases with the Wassermann 

 reaction and cytological examination of the spinal fluid. 

 Although no absolute law may be promulgated, no case 

 should be pronounced cured until consecutive negative Was- 

 sermann tests are obtained for a period of at least two years 

 after the suspension of all treatment. (See technic de- 

 scribed in Chapter XII.) 



Preparation of Patient. — After determining the organic 

 fitness of the candidate, the patient to receive an intravenous 

 injection of salvarsan or neosalvarsan should receive a 

 cathartic the night before the injection of the drug. He 

 should take no food at the meal immediately preceding the 

 introduction of the remedy, but may be allowed limited quan- 

 tities of liquid. He should be placed in the supine position 

 on a table, the arm (preferably the left in right-handed in- 

 dividuals) slightly abducted, the forearm supinated and 

 resting on a support, the elbow very slightly flexed, as 

 shown in Fig. 60. While an assistant sterilizes the region 

 of the elbow, with soap and water, alcohol and a solution of 

 bichloride, the operator, always with the strictest observance 



