Therapeutics of syphilis : including preliminary observations with the Ehrlich-Hata preparation, dioxydiamidoarsenobenzol or salvarsan / by Victor C. Pedersen.

  • Pedersen, Victor Cox, 1867-1958.
Date:
1911
Catalogue details

Licence: In copyright

Credit: Therapeutics of syphilis : including preliminary observations with the Ehrlich-Hata preparation, dioxydiamidoarsenobenzol or salvarsan / by Victor C. Pedersen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    referred the patient for 606. The serum test was weak to positive. The blood pressure varied from 119 to 142, 0.5 gramme 606 was given November 77th. Patient remained in bed until November 21st, and was subsequently ob- served at short intervals. No effect on the limb was ob- served. The lesion later proved to be an osteomyelitis. CONCLUSIONS. Syphilis has been historically known for many hundred years and its well established characteris- tics have been studied during this time, as to chron- icity and tendency to relapses. Many cases have been cured permanently by mercury and potassium iodide. Hence, it would be premature and imma- ture to think that these drugs may be supplanted as if by magic. Since the observation of the cases reported in this paper in January. 1911, the writer has administered salvarsan to about thirty other patients in all of whom immediate benefit occurred. This leaves the main question open: How perma- nent and enduring are the results of salvarsan? If permanent, then a wonderful discovery for the re- lief of syphilis has been made. But this question remains for the next twenty years to decide. Another question still unanswered is: What is the best dose ? Originally 0.3 gramme was pro- claimed as correct. Now it is 0.6 gramme; indeed, some of the German observers have given more. Here, again, only patient study and long continued observation will answer the question. If the results of salvarsan shall be shown to be temporary rather than permanent, by relapses which have already been appearing in the hands of many careful observers, then the question arises: How frequently may the medicine be repeated in the cor- rection of such relapses ? Here, again, only many careful observations, distributed of necessity wide- ly the world over and persisting through the next twenty years, can in human experience furnish the solution of this problem. Again, only time reck- oned in many years can answer the question, through the study and record of many cases : Given a relapse, will a repetition of salvarsan be better than a resumption of mercury and iodide? Such a question is of far reaching importance! Finally, in closing, the words of Marshall (Lan- cet, February 25, 1911) cannot be improved: “The two main questions to be decided are: First, is arsenobenzol capable of replacing mercury and iodides in the treatment of syphilis? Secondly, if it is incapable of doing this, is it of value as a third weapon against syphilis? Before any drug can re- place mercury and iodides it must be proved capa- ble of producing one or more of the following ef- fects: (1) The realization of an abortive cure of syphilis; (2) the prevention of tertiary or para- syphilis manifestations; and (3) the healing of syphilitic lesions with greater rapidity, greater con- stancy, and, at the same time, with less liability to l'elapse and recurrence than is the case with mer- cury and iodides. It must compare favorably with the latter as regards dangerous toxic effects.” In the main, it is rational and conseiwative to leave all these points for settlement by many years of time and by a larger and larger record of care- fully studied cases. 45 West Ninth Street.