SALVARSAN AND ITS USE IN TREATMENT OF SYPHILIS 275 



tion of important cell complexes, such as the blindness and ataxia 

 of tabes, the remedy will naturally be without effect. It is to be 

 noted, however, that in very early cases one may occasionally see 

 remarkable improvement even in some of those very symptoms 

 which we are accustomed to refer to the actual destruction of nerve 

 cells, so that the inference suggests itself that some of the symptoms, 

 of tabes, for example, may be due both to toxic influences and to an 

 actual destruction of nerve cells. For this reason the remedy may 

 be given a trial in tabes and paresis at the first sheet lightning, as 

 Ehrlich puts it, while later on it is, of course, useless, and in advanced 

 paresis especially, its employment is even attended by a certain 

 amount of danger. 



As the destruction of spirochetes leads to the production of anti- 

 bodies of a protective character, as is evidenced by the beneficial 

 effect which the milk of salvarsan-treated syphilitic mothers has upon 

 the syphilitic lesions of the child, it has been suggested to extract 

 blood from treated syphilitic patients and to inject the serum into 

 the subarachnoid space of such cases of cerebrospinal syphilis 

 (paresis) in which salvarsan is of no benefit, when given by itself. 

 But as yet no data are available to warrant any conclusions 

 regarding such a mode of procedure. It would seem logical, but 

 it may be questioned whether the injected antibodies would reach 

 the spirochetes in sufficient quantity to do much good. 



However this may be, if we eliminate from our analysis all those 

 cases in which destructive lesions have occurred, and sum up the 

 findings in the remainder, there is overwhelming evidence to show 

 that in salvarsan, either by itself or in combination with mercury, 

 we have a treatment by which we cannot only produce a favorable 

 influence upon the clinical symptoms, but actually effect a cure, 

 in the vast majority of cases. It seems very doubtful in fact whether 

 any cases exist, in which the infection cannot be completely eradicated 

 either by the salvarsan alone, or in combination or alternation with 

 mercury, if the results of the treatment are controlled at frequent 

 intervals by the Wassermann reaction, and if the treatment itself 

 is carried out by experts. A suitable combination of the syphilol- 

 ogist's clinical knowledge and the peculiar training of the immu- 

 nologist will unquestionably yield the best results; either alone is not 

 in a position to give the patient the very best that can be given. 



To enter into a detailed account of case records would lead us 



