ATOXYL IN THE TREATMENT OF MALARIA. 6 



Part I. 

 TREATMENT BY ATOXYL ALONE. 



We are able to report upon seven cases, of which four were of malig- 

 nant, tertian malaria and three of single, tertian fever. These were 

 numbers 2, 6, 8, 12, 15, 16, and 17. 



No gi'eat weight must be attached to the observations on case number 12, as 

 the treatment was interrupted by the abrupt departure of the subject. Three 

 inoculations were made diiring six days, the two first consisted of 0.25 gram and 

 the other of 0.50 gram. They were well supported. 



On the other hand, the observations on case number 2 are complete. 



The patient was a young Annamese 23 years of age and was suffering with 

 malarial cachexia, with hypertrophy of the spleen, oedema of the extremities and 

 pulmonary congestion. The treatment in hospital lasted eighty- five days. He 

 was given only 1.50 grams of atoxyl in three injections during a period of nine 

 days. All other medication was avoided. The fever remained above normal for 

 sixteen days although there were some remissions. Therefore, the parasitic action 

 of the drug seems nil, but the general state of health improved, and the spleen 

 diminished in an appreciable manner. 



Number 8 was a case of double tertian, malarial fever in a native of 

 22 years of age. 



The first injection of atoxyl, 0.50 gram, was made during an exacerbation of 

 the fever and when the blood showed an intense multiplication of the parasite. 

 Three injections were made within six days in doses of 0.50 gram each. The 

 patient was lost sight of at this period, but it was not long before lie returned 

 in a still worse condition, with advanced cachexia. The extremities were swollen 

 and albumin was present in the urine. It was only too evident that the first 

 injections had no effect. On his return he was given two more grams of atoxyl 

 in four days (0.50 gram per day). An analysis of the blood left no doubt as to 

 the failure of the specific treatment. The further increase of the young forms 

 of the parasite continued regularly, there being at the previous examination from 

 three to four parasites in a field and at the later examination, from ten to twelve; 

 neither were the gametes in any way influenced by the drug. The effect on the 

 general condition seemed favorable, but it is difficult to give a decided opinion 

 on this point, as the patient was lost sight of again before his cure was terminated. 



Number 6 was a typical case of tertian fever. Atoxyl was again 

 employed; in nine days three injections were given consisting of 2.50 

 grams. 



The chart of the temperature and the analysis of the blood proved that the 

 infection followed its course without any modification whatever by the drug. The 

 experiment was pushed as far as the resistance of the patient would permit. 

 Sponging and antipyretics were necessary to keep the fever witliin bounds. The 

 specific action compared to that of quinine was certainly nil. After some slight 

 relapses, convalescence set in with a surprising rapidity. The patient left the 

 hospital after a month having increased three kilograms in weight. He had 

 received altogether 5.50 grams of atoxyl. 



