The diagnostics and treatment of tropical diseasesStitt, E. R. (Edward Rhodes)
Science
The diagnostics and treatment of tropical diseases
Stitt, E. R. (Edward Rhodes)
Tropical medicine
_Atoxyl._—The first drug to offer hope of cure was sodium
arsanilate, atoxyl, which contains about 26% of As. This is best
given in doses of about 0.5 gram (7½ gr.) in about 15 cc. of
sterile distilled water intramuscularly. Several cases of optic
neuritis were reported but the drug is still a standard treatment.
We give the atoxyl at intervals of five days, Manson gives 3 grains
every third day.
Probably the best treatment is one in which three doses of atoxyl
are followed by from 10 to 15 daily or every other day injections
of 0.1 gram (1½ gr.) of tartar emetic. The course is repeated after
an interval of three weeks. It is advisable to give a hypodermic of
caffein a few minutes before the tartar emetic to lessen depression.
Kérandel received the atoxyl-tartar-emetic double treatment and
ascribed his cure to the tartar emetic. Tartar emetic is also given
intravenously, 0.1 gram in 150 cc. water.
Intravenous injection of arsenophenylglycin, in doses of about
1.0 gram. (15 gr.) intravenously has been highly recommended.
Recent reports from German East Africa state that of 35 treated
with this drug six died of the effects of the drug. Salvarsan and
neosalvarsan have been used but apparently without particular
success.
A combination of treatments in which salvarsan, sodium salicylate
and ethyl-hydrocuprein (a quinine derivative) have been used has
been favorably reported by Morganroth where the action of a single
drug was of little value.
Very remarkable claims in experimental animals have been made for
“trixidin,” a preparation of antimony trioxide which is given
intramuscularly. Even inunctions with this preparation have been
quite successful in curing infected mice. In larger animals abscess
formation is an objection.
Daniels has reported good results from the injection of oxide of
antimony. The preparation used is Martindale’s injectio antimonii
oxidi given subcutaneously in 30 minim doses (1/20 grain of the
oxide). Masters gives this preparation intramuscularly and notes
its greater efficiency than any other drug or combination of drugs.
He gives 3/100 grain every other day until 40/100 grain has been
given. If trypanosomes continue present he gives a .77 gram dose
of soamin. Soamin is a drug similar to atoxyl but said to be less
toxic.
In the treatment of 18 cases of _T. rhodesiense_ infections Newham
notes that tartar emetic alone was as effective as the combined
treatment with atoxyl. He gave the tartar emetic injections twice
weekly intravenously commencing with 1 grain and going up to 3
grains. An organic antimony preparation, “Stibenyl,” has been
recommended. See kala-azar.
Very favorable reports have been made from the use of galyl and
ludyl, arsenical compounds.
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