Arsenical Therapy Research Articles

SHOULD FUSOSPIROCHETAL INFECTIONS BE TREATED WITH ARSENICALS? REPORT OF CASES

In a recent article in The Journal of the American Medical Association , Lichtenberg, Werner and Lueck 1 questioned both the pathogenicity of the fusospirochetal organisms and the success of treatment with the arsenicals. After a number of years of experience with the disease in the laboratory and in the clinic, I have arrived at the conclusion diametrically opposed to that of Lichtenberg and his associates, that this group of anaerobic organisms has under certain conditions a primary pathogenicity, and that arsenical therapy is usually the most efficient treatment. In view of this difference of opinion, it seems advisable to review the evidence in favor of the pathogenicity of this group of organisms and to report some cases which illustrate the indications, dangers and limitations of arsenical therapy in fusospirochetal infections. In 1894, Veillon 2 observed in necrotic, foul lesions of the throat the following mixture of

Fuso-spirochætal diseases of the lungs

Clinical, bacteriological, pathological, and experimental studies indicate that pulmonary gangrene, most cases of pulmonary abscess, certain types of unresolved pneumonia, and bloody bronchitis, putrid bronchitis, and chronic bronchiectasis are not separate disease entities but different manifestations of infection with an anaerobic group of organisms acting in symbiosis. This group of organisms include: (1) Spirochetes ( Treponema microdentium, Treponema macrodentium, Spirochæta vincenti , and Spirochæta bronchialis ); (2) fusiform bacilli; (3) vibrios; (4) cocci. These forms are constantly present in the (1) washed pulmonary sputum, (2) in the pulmonary tissue at necropsy, and have been found in the (3) pulmonary tissues of animals dying of the disease transmitted to them by injection of the sputum from patients with abscess and bronchiectasis. Similar organisms are normally present in the gums of patients with pyorrhoea, and these pyorrhoea organisms will produce typical pulmonary abscesses when introduced into the trachea of mice, guinea-pigs, rabbits or dogs. The patient's own gums are probably the most common source of the infection, although infection of the pharynx with Vincent's angina may be a source of danger to others as well as to the patient. Rest in bed, postural drainage, and arsenical therapy in the early stages, and skilful surgical interference in the resistant cases will produce a fairly good percentage of cures. Proper oral hygiene is the most important factor in preventing the disease.

INFLUENCE OF MALARIAL TREATMENT ON THE SPINAL FLUID IN GENERAL PARALYSIS

I shall report data to illustrate the influence of malaria treatment, without subsequent arsenical therapy, on the spinal fluid observations in general paralysis. These data consist of observations on: the cell count in ninety cases, quantitative determinations of the total protein in the spinal fluid in sixteen cases in which the patients were treated recently and in thirty-eight patients under observation for two years or longer subsequent to treatment, and quantitative determinations of the Wassermann reaction in the spinal fluid in forty-seven cases over a post-treatment period of from two to three and three-fourths years. The Vernes test 1 has been applied in the majority of these cases, and this will form the subject of a future communication. The results are reported without reference to the work of others; of the latter, a comprehensive bibliography will be found in the recent article of Ferraro and Fong. 2 CELL COUNT A

STOVARSOL IN THE TREATMENT OF SYPHILIS

Many clinical observers feel that the present method of intravenous arsenical therapy is not entirely satisfactory in all cases of syphilis. Patients are often seen who have received the usual intensive intravenous arsenical therapy early in the course of the infection and yet develop latent manifestations. The search for more efficient remedies has persisted. Recently, French investigators have called attention to an important arsenical product which is used orally in the treatment of syphilis. This product is known as stovarsol or 190. In 1760, Louis Cadet of Paris discovered the first organic arsenical compound. This product, known as Cadet's arsenical liquid, was studied intensively by Robert Bunsen during the years from 1837 to 1843. He separated it into its predominant elements of carbon, hydrogen, arsenic and oxygen, and showed that the oxygen was replaceable by nonmetallic elements. Berzelius recognized this oxygenated arsenical compound and gave it the name of cacodyl

EXPERIMENTAL INFECTIOUS STREPTOCOCCUS ENDOCARDITIS AND ITS ARSENICAL THERAPY (SODIUM CACODYLATE)

Definition Etiology Experimental Observations by Others Mortality Reports Specific Therapy Animal Experimentation Production of Endocarditis Methods Results Arsenical Therapy Methods Results Discussion Conclusions DEFINITION Names have been introduced at various times descriptive of the pathologic changes occurring in heart valves following infections. Such names as simple acute benign, infectious, bacterial, chronic, and ulcerative endocarditis and more recently endocarditis lenta and subacute endocarditis have been suggested by clinicians. Litten, 1 in 1900, classified infections of the heart valves into acute, malignant and chronic, by the first two meaning infections causing in patients severe symptoms and death in a short time, by the last one mentioned those less severe and of much longer duration. Litten's classification prompted a lively discussion regarding or malignant endocarditis referred to by the early writers. Simons 2 prefers the term bacterial endocarditis, a designation more accurate than malignant, septic or ulcerative. Libman 3