368 LEUKEMIA 



]^ Solutio kalii arsenicosi 10.0 



Aq. cinnamomi 30.0 



M., D., S. : Gtt. xv-xxx, three times daily. 



We begin with 15 gtt. t.i.d. (taken after meals), and increase gradually, 

 i. e., after one week 20 gtt. t.i.d., after the second week 25 gtt. t.i.d., and after 

 the third week 30 gtt. t.i.d. ; this dose we maintain for some time. I am not 

 enthusiastic regarding the subcutaneous use of arsenic. The injection of 

 arsenic into the circulating blood could only be desirable if the results obtained 

 by this method were incomparably more brilliant than after the administration 

 of arsenic by the mouth, and this is decidedly not the case. 



Another remedy producing apparently favorable results is quinin. Its 

 action is asserted to be remarkable, especially if it be combined with arsenic 

 or iron. In this respect, the mineral waters containing arsenic and iron, as 

 Levico and Eoncegno water, and the Levico water used in the form of baths, 

 deserve consideration. 



In the majority of cases the erythrocytes decrease to one-half their number 

 or less with the increase of white corpuscles (at least in the latter course of both 

 leukocytic and lymphocytic leukemia), and here the administration of arsenic, 

 iron and quinin, whose favorable influence on the red corpuscles cannot be 

 denied, is warranted from a theoretical standpoint, as well as empirically. 



lodin preparations, formerly prescribed to some extent, have recently been 

 less used; no appreciable results of their use have been noticed. The same 

 is true of phosphorus in doses of 0.001 to 0.005, which has been praised, espe- 

 cially by English physicians. 



Two therapeutical measures which were recently hailed with enthusiasm, 

 oxygen inhalations and organotherapy (preparations made from lymph-glands 

 and bone-marrow), have produced no striking results, although amelioration 

 and a slower progress of the disease have been supposed to follow their admin- 

 istration. In general, what has been said of the administration of arsenic, 

 iron, and quinin is true also of this method of treatment. We may use these 

 remedies, indeed, we must use them, but we can only hope for a partial suc- 

 cess; the disease up to this time has been invariably fatal, but, as a rule, 

 lasts a year or longer, and calls for a display of humanity on the part of the 

 physician which is not shown by quietly folding his hands and rejecting any 

 method of treatment which offers the patient the slightest hope of recovery or 

 even improvement. 



Although I strongly recommend the trial of the above-mentioned thera- 

 peutic measures in the treatment of leukemia, just as strongly must I con- 

 demn local procedures. Fot only does the lack of results militate against their 

 use, but we are thoroughly convinced that the nature of leukemia is not to 

 be found in the affection of the spleen or of any individual lymph-gland, nor 

 in any other organ accessible to local treatment. I believe that the time has 

 come to discontinue all efforts to cure the disease by injections of arsenic, 

 ergotm, etc., into the spleen, by faradization or galvanopuncture of the organ, 

 or even by extirpation of the glands, or by splenectomy which, without an 

 exception, has been rapidly followed by death. 



