203 



A Preliminary Report on the Treatment of Human Trypano- 

 somiasis and Yaivs with Metallic Antimony. 



By H. S. Ranken, M.B. Glasg., M.R.C.P. Lond., Captain R.A.M.C., Member 

 Sudan Sleeping Sickness Commission. 



(Communicated by H. G. Plimmer, F.R.S. Received December 23, 1912, — 

 Read February 6, 1913.) 



(From the Yei Camp, Sudan Sleeping Sickness Commission.) 



The use of precipitated metallic antimony, in a state of finest division, was 

 devised by Plimmer for the treatment of trypanosomiasis, and the results of 

 his and other experiments with this substance have been published.* After 

 a long series of experiments on subcutaneous and intramuscular injections of 

 this form of antimony suspended in water, oily media, egg yolk, etc., all of 

 which caused great irritation, he found that it was possible to inject it 

 intravenously with safety, and without causing any irritation of the tissues. 

 A large number of animals were cured of trypanosomiasis by this means, and 

 in May, 1910, Major W. B. Fry gave a dose intravenously to a late case of 

 Kala Azar, thus demonstrating that it could also be used safely in this 

 manner on human beings. 



Captain R. J. C. Thompson, R.A.M.C., gave this preparation by intravenous 

 injection to the cases first admitted to the Yei Sleeping Sickness Camp 

 between January and March, 1911. Eighty-one injections were given to 

 38 cases, but pressure of administrative work prevented these cases being 

 fully treated and investigated, and they were all transferred to atoxyl 

 treatment. Captain Thompson states that from a clinical standpoint some 

 of these cases showed great improvement. 



Later 1 had the honour of being appointed to the Sudan Sleepiug Sickness 

 Commission for work at Yei in the Lado Enclave, and since October, 1911, 

 I have collected a series of cases treated by metallic antimony alone and in 

 conjunction with other drugs. This report is consequently only preliminary ; 

 but it demonstrates that antimony in this form is a safe drug to employ in 

 the treatment of sleeping sickness, if used with reasonable precautions, and 

 that the results obtained so far certainly call for extended use and further 

 investigation. 



During the past year 76 newly admitted cases have been treated with 

 antimony, alone and combined with salvarsan and atoxyl, and shorter courses 

 of antimony have been given to 143 old cases previously treated with atoxyl, 



* ' Boy. Soc. Proc.,' B, vol. 80, p. 483 ; B, vol. 81, p. 354 ; and B, vol. 83, p. 140. 

 VOL. LXXXVT. — B. Q 



