196 The Philippine Journal of Science wis 



patients do not seem to object to this treatment; on the contrary, 

 they willingly submit themselves after they are convinced of 

 its gratifying results. 



Our results confirm the conclusion of Castellani that the 

 diverse manifestations of framboesia heal under the influence 

 of his treatment. The cure of recent infections by this prepara- 

 tion is nearly as marvelous as that by salvarsan and neosal- 

 varsan. We cannot assert as yet whether or not the cure is 

 permanent, since only a limited number of cases remained under 

 our observation for a long time. We believe, however, that the 

 continuation of the treatment after the lesions have healed 

 (from five to ten days' treatment with intermissions of from 

 ten to fifteen days) will insure a permanent cure. 



The tendency of the mixture to cause emesis and iodism is 

 not a serious objection to its routine employment, because these 

 untoward effects are slight and may be easily corrected. If 

 emesis, gastralgia, and diarrhoea are troublesome, they can be 

 prevented by merely increasing the sodium bicarbonate or by 

 giving, fifteen minutes before each dose, 4 cubic centimeters of 

 paregoric or 1 centigram of codeine. Other untoward effects, 

 which are apparently due to vasomotor disturbances, such as 

 oedema, lachrymation, coryza, congestion of the conjunctiva, 

 etc., are readily overcome by epinephrine. According to Milian, 

 (3, 4) this drug also gives excellent results in iodism and cerebral 

 symptoms associated with the use of arsenobenzol. He strongly 

 advocates the administration of massive doses of the drug, for 

 example, 3 milligrams per orem twice daily, and if this fails, 1 

 or 2 milligrams injected subcutaneously or intramuscularly. 



In the administration of Castellani's mixture it is always im- 

 portant to bear in mind the possible presence of the larval form 

 of hyperthyroidism and also the greater susceptibility of chil- 

 dren to iodides, for large doses may give rise to alarming and 

 very unpleasant side effects. 



Framboesia, though not a grave malady quod vitam, has a 

 tendency to relapse, running a highly chronic course extending 

 for years, and gives rise to rheumatoid pains, osseous deform- 

 ities, extensive ulceration (which may serve as a portal of sec- 

 ondary infection), and deforming cicatrices, which not only are 

 disfiguring but often more or less seriously incapacitate the 

 patients, school children and adults alike. Admitting that it 

 is not a source of high mortality, it is, however, decidedly a 

 cause of high morbidity, entailing material loss to the individual 

 and to the community. 



