APPENDIX 343 



Ellis demonstrated that the splrochaeticidal properties of the 

 serum were markedly increased by heating. 



" Salvarsanized serum prepared according to the method 

 of Ogilvie must be used fresh, that is, within three hours of 

 the time that it is made up." 



Although a few investigators have added as much as 

 12 mg. of neosalvarsan to the serum in vitro prior to intra- 

 spinal injection, with salvarsan an initial dose of 0.1 to 

 0.25 mg., increased perhaps to 0.5 mg., should not be exceeded. 

 Pordyce regards the limit of safety to lie within 0.5 mg. 



After-care of the Patient. — Following a full intravenous 

 injection of salvarsan or neosalvarsan, particularly the 

 former, the patient should lie still for one-half hour. Indeed, 

 it were better for him to be confined to bed over night, and 

 longer if reactions make it desirable. The practice of per- 

 mitting patients to go home alone immediately after an in- 

 travenous injection of the drug is reprehensible, although 

 in many clinics and offices it is commonly done, especially 

 after neosalvarsan. It is our practice both in the hospital 

 and in the office to detain the patient for four to six hours, 

 when if he exhibits no reaction, or any toxic effects of the 

 drug have disappeared, he is allowed to go home. If the 

 reaction is persistent in any way, the patient is advised to 

 remain over night. 



After an injection of arseno-benzol, the patient is not 

 allowed to have anything by mouth, even water, for two 

 hours. If, then, he is not nauseated he may be given all the 

 water he cares to drink. Food is usually not craved, but 

 should the patient become hungry during the afternoon or 

 evening a glass of milk, broth or consomme with a slice of 

 bread or a cracker is all-sufficient. As a routine practice, it 

 is unnecessary to treat headache, nausea, vomiting, fever, 

 diarrhoea, etc., which occasionally supervene. Rarely 



