OBSERVATIONS ON A PALLIATIVE TREATMENT OF 

 ELEPHANTIASIS.' 



By Aldo Castellani. 2 



Elephantiasis is considered to be an incurable infection except in 

 those cases where the scrotum is affected or where there are localized, 

 mdulous tumors which may be treated surgically. For some time 

 past I have been experimenting with a view to devising a palliative 

 treatment for this disease, which is extremely common in some parts of 

 the tropics. At first, following the example of my predecessors, I tried 

 injections of various antiseptics with the idea of destroying the organism 

 which causes the disease. 



The chemicals experimented with were the following: 



1. Methylene blue, given by the mouth as well as by subcutaneous injections. 



2. Solutions of bichloride of mercury, carbolic acid, cyllin, and other antiseptics 

 given hypodermically. 



3. Various arsenical compounds: cacodylate of sodium, of quinine, etc., given by 

 the mouth and by subcutaneous injections. 



The result of the investigations was negative and not the slightest 

 improvement was ever noticed in any case. It then occurred to me that 

 since one of the anatomical features of elephantiasis is the enormous 

 increase of the fibrous tissue, thiosinamin might be useful in the treat- 

 ment of the disease, especially in case of long standing. It is well 

 known that thiosinamin, according to Hebra, Van Hoorn, Lengemann, 

 etc., has the power of softening various kinds of fibrous tissue, facilitating 

 its absorption, although the mechanism of this action is not known. 



Thiosinamin was discovered in 1828 by Berzelius; it is obtained by 

 treating two parts of mustard essence with one part of absolute alcohol 

 and seven parts of ammonia, heating at 40° for several hours, and then 



>>NH 2 

 slowly cooling. The chemical formula of thiosinamin is, C =S 



.XHCVH, 



The crystals of thiosinamin have a bitter taste, a garlic-like odor and 

 are easily soluble in alcohol and ether, but not in water. Thiosinamin, 



1 Read at the Fifth Annual Meeting of the Philippine Islands Medical Associa- 

 tion, February 29, 1908. 



2 Director of the clinic for tropical diseases, Colombo, Ceylon. 



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