\ 



1912.] Trypanosomiasis and Yaws with Metallic Antimony. 213 



Occasionally a trypanosome comes rapidly to a standstill and dissolves away 

 so that only a haze of protoplasm can be seen left behind. 



After 5 minutes. — The exaggerated motility is not so frequently observed, 

 but the trypanosomes are more often anchored and may be seen lashing about 

 in an extreme state of activity. They appear to be somewhat reduced in 

 number. 



After 7 minutes. — Trypanosomes are more scanty. Exaggerated motility is 

 not a feature of these preparations, but all the other changes occur as in the 

 earlier preparations. 



After 10 and 15 minutes. — In all preparations taken at these times a 

 considerable search was required to find a trypanosome, but in the majority 

 of cases one could be found in a search of 10 to 20 minutes. 



After 20 minutes. — Very many preparations have been examined and have 

 invariably proved negative. 



An intravenous injection of antimony therefore kills the trypanosomes in 

 the circulating blood in 20 minutes. 



On the Treatment of Yaws by the same Method. 



Some cases of yaws have been met with in the course of this work. 



In view of the successful results published by Strong, Castellani, and 

 Alston, the first three cases were treated with salvarsan. One was given 

 an intramuscular injection of - 6 grm. in olive oil ; the lesions — plantar 

 ulcers — were healed in three weeks. The two others had an intravenous 

 injection of 0"45 grm., they showed several small patches on the face and 

 trunk and responded much more rapidly to intravenous treatment. 



I had been much impressed with the rapid trypanocidal action of this 

 metallic antimony, and decided to treat a case of yaws with this drug. At 

 first doses of 1 gr. Avere given and the condition improved, but not very 

 rapidly. With a larger dose the effect was much more striking ; 1| gr. 

 seems to be quite efficient, but 2 gr. have been given to the last four 

 cases. None of the 10 cases manifested the hyper-susceptibility to antimony 

 that has been seen in sleeping sickness, and there have been no after effects. 



In an adult of fair condition 1 sr. should be given as a first dose, and 

 doses of 1\ gr. or 2 gr. repeated twice with intervals of four days. I have 

 sometimes shortened the interval by one day. Three doses, I believe, is a 

 quite sufficient course of treatment, but in the majority of our cases a 

 fourth dose has been given to ensure, as far as possible, a permanent result, 

 as most of these cases have been collected from different villages and pass 

 out of observation when they are discharged from hospital. The antimony 

 is administered as described above (p. 204) for trypanosomiasis. 



