ADMINISTRATION OF SALVARSAN AND NEOSALVARSAN 797 



tion which Hata used in his original experiments, and it was the form 

 recommended by Ehrlich. I shall, therefore, describe this method in 

 detail a little further on. 



ADMINISTRATION OF SALVARSAN AND NEOSALVARSAN 

 INTRAVENOUS INJECTION 



Dosage of Salvarsan. Males receive in general about 0.3 to 0.6 gm. ; 

 female patients are usually given from 0.25 to 0.5 gm. In the case of 

 weak and poorly nourished adult patients it in inadvisable to give more 

 than 0.3 or 0.4 gm. Since it has been generally impossible to cure a 

 patient with a single larger dose, the practice among syphilologists at 

 present is to give smaller doses frequently repeated. 



For infants suffering from congenital syphilis the dose is from 0.006 

 to 0.01 gm. of salvarsan for every two pounds of body weight, so that a 

 child of eight pounds would receive from 0.024 to 0.04 gm. of salvarsan. 

 To older children, weighing from 40 to 60 pounds, 0.2 to 0.3 gm. may be 

 given. 



Dosage of Neosalvarsan. This preparation is less toxic than sal- 

 varsan, and may be administered in larger doses, as from 0.6 to 1 gm. 

 The same general rule as to the physical condition of the patient should 

 apply here in deciding the dosage. At the present time the tendency 

 is to give adult patients about 0.6 gm. for three, four, and more injec- 

 tions at intervals of a week or so. 



Frequency of Injections; Intensive Treatment. As was just stated, 

 there is a distinct tendency among those of large experience to regard 

 salvarsan as a more potent spirocheticid than neosalvarsan. As pre- 

 viously mentioned, the original idea of sterilizing the patient with one 

 large dose of the drug has been largely abandoned, especially in the 

 treatment of syphilis in any but the earliest stages. A large number of 

 smaller doses are being given, and the results are controlled by the 

 Wassermann reaction with blood and cerebrospinal fluid, in addition to 

 the cytologic changes in the latter. Thus from 0.3 to 0.5 gm. of sal- 

 varsan or neosalvarsan is given every week or twice a week for three, 

 four, or ten doses and more, depending upon the clinical results and the 

 serologic findings. In this connection it must be remembered that a 

 negative Wassermann reaction is of little value if blood has been with- 

 drawn within two weeks of the last treatment. (See Chapter XXIII.) 

 While it is the common practice to administer a number of doses of sal- 

 varsan or neosalvarsan, and to follow this with mercury and then with 



