880 CHEMOTHERAPY 



fection. In the treatment of any case of syphilis the best results are not 

 secured from following any course of treatment according to a rule of 

 thumb; they are obtained only by a suitable combination of expert 

 clinical knowledge and training in serologic technic. All possible aid 

 should be enlisted in the treatment of the disease. 



It is beyond the scope of this book to present either case reports or a 

 lengthy discussion of salvarsan in the treatment of the various stages of 

 syphilis; suffice it to say that, in the absence of contraindications, the 

 drug may be administered whenever living spirochetes are present in a 

 patient's tissues, as evidenced either by clinical symptoms or a positive 

 Wassermann reaction. The method of administration selected should 

 be that which will best bring the drug into contact with the diseased 

 tissues. 



In the studies of Schamberg, Raiziss, and I 1 upon the chemotherapy 

 of mercurial compounds as compared with salvarsan, salvarsan has 

 shown itself to be by far the most powerful trypanocide known in both 

 the living animal and in the test-tube. In my in vitro-vivo method 2 it 

 destroys trypanosomes in dilution as high as 1 : 40,000. Bichlorid of 

 mercury shows markedly inferior values in this respect. The superiority 

 of the influence of salvarsan over mercury in experimental trypanoso- 

 miasis is incontestable. In the test-tube salvarsan exhibits a greater 

 destructive influence on animal parasites, and mercury a greater de- 

 structive influence on vegetable parasites. Salvarsan is a powerful 

 trypanocide and a feeble bactericide; mercury is a powerful bactericide 

 and a relatively feeble trypanocide. 



SALVARSAN IN THE TREATMENT OF NON-SYPHILITIC DISEASES 



While salvarsan therapy has achieved its greatest success in the 

 treatment of syphilis, its influence on certain non-syphilitic diseases has 

 been so pronounced that it is being used in an ever-increasing number of 

 diseases, the aim being to thus enlarge its sphere of usefulness. A re- 

 cent systematic study of the subject has been made by Best. 3 Good re- 

 sults have been reported by various observers in the following diseases : 



Frambesia (Yaws). The results achieved in this disease from the 

 use of salvarsan have equaled those obtained in syphilis. Two thousand 

 four hundred and thirty cases have been reported, a cure having been 

 effected in all but a few instances. Since the use of salvarsan has come 

 into favor hospitals for the treatment of frambesia have been closed. 



1 Amer. Jour. Syphilis, 1917, 1, 3. 2 Jour. Infect. Dis., 1917, 20, 10. 



3 Jour. Amer. Med. Assoc., 1914, Ixiii, 375. 



