CHEMOTHERAPY IN BACTERIAL DISEASES 881 



Relapsing Fever. In the treatment of this disease the drug has 

 likewise had a remarkable effect. Of 195 cases reported, in most of them 

 the microorganisms could not be found in the blood after an injection, 

 and in none of the cases were relapses observed to occur. 



Filariasis. Salvarsan has been found effective in killing the Filaria 

 sanguinis hominis and in ridding the blood of these parasites. Of 

 course, in elephantiasis it is impossible to restore the affected parts to 

 their normal appearance. 



Vincent's Angina. An immediate improvement and rapid healing 

 have been reported as following either an intravenous injection or the 

 local application of the drug in the form of a dusting-powder or in sus- 

 pension in glycerin. 



Duhring's Disease (Dermatitis Herpetiformis), Scurvy, Chorea, Ma- 

 laria, Acanthosis Nigricans, Ulcus Tropicum, Variola, and Verruca Plana. 

 In all these affections salvarsan has been found to exert a beneficial 

 and curative effect, either by direct action upon the microorganisms 

 present or as the result of the alterative and stimulating effect of the 

 arsenic. 



In Aleppo boil, leprosy, lupus vulgaris, tuberculosis, anemia, kera- 

 tosis follicularis, lichen planus, mycosis fungoides, pellagra, and pity- 

 riasis rubra, good or indifferent results have been reported. In 

 many conditions it would appear that salvarsan exerts a direct germi- 

 cidal effect, and in others the beneficial results appear to be dependent 

 upon a certain tonic, stimulating, and alterative effect of the arsenic. 

 In chancroid, scarlet fever, Hodgkin's disease, psoriasis, trichinosis, and 

 trypanosomiasis the drug does not appear to exercise any influence, 

 which is due probably, in the last-mentioned disease, to the fact that 

 trypanosomes are much more likely to become arsenic-fast than are the 

 spirochetes. 



CHEMOTHERAPY IN BACTERIAL DISEASES 



Principles. The ultimate aim in bactericidal chemotherapy is the 

 discovery or the rational and systematic development by synthesis of 

 a substance that is strictly monotropic; that is, one possessing a selective 

 affinity for the protoplasm of a particular microparasite and exerting 

 a specific killing effect on that organism. Thus far this desideratum has 

 not been achieved ; as even arsenobenzol (salvarsan) is not strictly para- 

 sitotropic for Treponema pallidum, but possesses also a marked para- 

 sitropism for other spirochetes and other protozoa, notably various 

 trypanosomes. While the development or discovery of substances which 

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