THE SPECIFIC CURE OF YAWS. 439 



edging my thanks to him for the opportunity to try the effect of this very 

 valuable preparation. Because of the favorable results which were being 

 obtained with it in the treatment of syphilis, the idea naturally suggested 

 itself to try the remedy in yaws on account of the morphological and 

 biological relationship which exists between the spirochastae giving rise 

 to these two diseases. Twenty-five cases in all have been studied and 

 treated. A report of the cure of three of the most striking of these was 

 made before the Manila Medical Society on September 5, where photo- 

 graphs and one of the patients were exhibited. The discussion of all 

 of the work has been withheld until the present time, in order to ascertain 

 if relapses would occur. So far there has been no evidence of a relapse, 

 and the cases have all remained cured, although the great majority of 

 them were treated over four months ago. 



The preparation was received in hermetically sealed capsules. These 

 were opened, and the solution always prepared immediately before being 

 inoculated. Dioxy-diamido-arsenobenzol, as Ehrlich has stated, is not 

 readily soluble, and to obtain a satisfactory solution for inoculation, 

 his suggestion as to the most satisfactory means for the solution of the 

 monochlorhydrate was followed. From 0.3 to 0.4 gram of the preparation 

 was placed in a glass vessel, moistened with a few drops of methyl alcohol, 

 and thoroughly rubbed up with a glass rod. From 20 to 30 cubic centi- 

 meters of distilled water were then added, the stirring ' with the glass 

 rod being continued. When the solution was apparently complete, 5.5 



N 

 cubic centimeters (for 0.3 gram of the preparation) of an — — sodium 



hydroxide solution were slowly added, stirring with the glass rod being 

 continued. The precipitate, which forms on this addition, was then 

 slowly redissolved. 



The injections were given deep into the gluteal muscles, from 15 

 to- 20 cubic centimeters of fluid usually being injected in one place. On 

 the following day and the day after there was usually some reddening, 

 swelling and induration of the skin and underlying tissues in the vicinity 

 of the point of the inoculation. In no instance did suppuration result, 

 nor any unfavorable symptoms develop. Occasionally a transitory rise of 

 temperature was noted a few days after the injection. In some of the 

 cases, pain was complained of after the injection, sometimes lasting for 

 from 10 to 24 hours, or sometimes even longer, but as a rule no great com- 

 plaint was made. A number of the inoculated cases have been among 

 young children who did not cry, either during the inoculation or after 

 it ; usually they did not care to play about for the first 24 hours following 

 the injection. One European suffering with syphilis who was given a 

 large injection into the buttock, suffered severe pain, lasting for nearly 

 24 hours. This case was given a second injection intravenously twenty 

 days later. No pain whatever followed. 



