Abstract

THE USEFULNESS of penicillin in the treatment of cardiovascular syphilis is being evaluated by various groups. Several reports 1 of investigations using different schedules and employing varying total doses show that penicillin in various vehicles rarely causes reactions necessitating cessation of treatment in this group of patients. A few articles show important follow-up observations over extended periods, the longest being 1,243 days. 2 Caution against starting any treatment with penicillin before heavy metals have been used is emphasized by some authors 3 and disregarded by others. Some fatalities as well as instances of anginal and precordial pain concomitant with penicillin therapy in cardiovascular syphilis have been reported 4 and undoubtedly have led to hesitation in the use of the drug in similar cases. In January 1947 we started treating patients having syphilitic heart disease with aqueous penicillin G intramuscularly, using a gradually increasing dosage schedule to see whether this manner of administration of penicillin would prevent the buga

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