276 CHEMOTHERAPY 



too far afield, however, and I would refer those who are interested to 

 the special literature upon the subject; suffice it to say at this place 

 that barring those cases in which the treatment is clearly contra- 

 indicated, it should be followed whenever there is reason to believe 

 that living spirochetes are present in a patient's body, as evidenced 

 either by the character of the clinical symptoms or the presence of 

 a positive Wassermann reaction. 



SALVARSAN AND ITS USE IN NON-SYPHILITIC MALADIES 



While salvarsan has gained its greatest fame in the treatment of 

 syphilis, there is evidence to show that the remedy is even more 

 effective in combating other infections that are due to protozoan 

 parasites. It has thus been found of signal value in the treatment of 

 those cases of tertian malaria which are refractory to quinine. In 

 this connection the interesting observation has been made that in 

 some cases of this order the administration of salvarsan in very 

 small doses may cause the refractory behavior to quinine to 

 disappear. 



Brilliant results have been reported by many observers in the 

 treatment of relapsing fever, where a single injection suffices to cause 

 the parasites to disappear and to effect a lasting cure. Equally 

 favorable results have been obtained in frambesia, which plays a 

 more important role among the plantation workers of Surinam than 

 even syphilis. Koch and Flu report that of 900 cases which had thus 

 been treated only three developed a relapse. As a rule a single 

 injection is sufficient, or at most two injections. Quite important, 

 further, is the observation of Joannides that bilharziasis can be 

 cured with a single injection. The same is reported concerning 

 the effect of the treatment on aleppo boil, while it seems to be of 

 no avail in kala-azar. Whether or not the remedy is of use in the 

 treatment of typhm fever is not yet certain; some writers report 

 favorable results, while others are less enthusiastic. In amebiasis 

 and Vincent's angina, however, it seems to have a definitely favor- 

 able effect. Wonderful results have been reported in yaws. In 

 the treatment of sleeping sickness the results have been inconstant. 

 As the tendency to the development of arsenic-fast strains is much 

 greater in the case of the trypanosomes than in the spirochetes, 



