Mitchell of Chicago reported on the comparison between salvarsan and arsenobenzol. I was one of the first who through Dr. Schamberg's kindness was able to give this drug an extensive trial, and according to his statement have at the present time had perhaps the largest experience with it. Inasmuch as the Philadelphia product is about to be issued to the medical profession at large, it seems proper to supplement the Ormsby-Mitchell report in order to apprise the profession that the remedy may be

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... used with perfect safety. The cases reported herein have been studied with two main considerations in view : first, the possible toxicity of the new drug, and second, its relative therapeutic value as compared with old salvarsan. During the past six months, 243 cases of syphilis have been treated at the University Hospital with arsenobenzol. These patients have received in all 612 injections. The accompanying table classifies the types of cases treated. TYPES OF CASES TREATED Type No. Cases of primary and secondary syphilis. 98 Cases of gummous syphilis. 18 Cases of latent syphilis . 85 Cases of hereditary syphilis . 14 Cases of tabes dorsahs . 14 Cases of acute cerebrospinal syphilis . 11 Cases of general paresis . 3 In addition, I have given about sixty intraspinal injections, using the arsenobenzol in a dosage of from 0.00033 + to 0.0005 gm. Patients thus treated were for the most part tabetics and persons with cerebrospinal syphilis. With regard to the efficiency of the drug, it was noted that the immediate lesions disappeared as promptly as though they had been treated with the older salvarsan preparation. In 116 cases in which there were manifest cutaneous syphilids, there have been but four recurrences. One of these was a malignant pustular syphilid which returned after three injections in four months with a large gumma of the fore¬ arm. The other three were in the nature of neurorecidives. At the outset, in order to test out the product, and not being familiar with its properties, I gave the drug in somewhat smaller doses than is my custom with the older preparation. Thus whereas I customarily give 0.3 mg. as an initial dose at the outset, I gave but 0.2 mg., and the succeeding doses were correspondingly smaller. I am inclined to regard the four cases of recurrence, therefore, as due to underdosage, and it is noteworthy in this connection that the four cases occurred among the first ones which I treated. At the present writing I am using the arsenobenzol in repeated doses equivalent to the dosage employed in the use of old salvarsan. In the 612 injections given we can attest to the fact that only three cases showed any reaction. These were in the nature of allergic reactions, dyspnea, slight cyanosis and slight cardiac depression occurring during the third injection. In a few other cases in which many lesions were present, a rather sharp Herxheimer reaction occurred, as of course happens with the older preparation as well. The intraspinal treatments have all been well borne, have been unattended by any untoward accident, and the thera¬ peutic results have been identical with those produced by similar injections of old salvarsan. The method employed has been a modification of the Ogilvie method, namely, the introduction of the salvarsan solution directly into the spinal fluid. From my experience with arsenobenzol it may be con¬ cluded that : 1. The immediate therapeutic results are fully as good as those following the use of old salvarsan. 2. Given with the proper precautions, the drug has shown itself fully as little toxic as the older preparation. These two conclusions refer to intraspinal medication as well as to intravenous.