Ordinarily, in treating syphilitic patients with the newer arsenicals, nothing indicating the development of a toxic action on the liver is known until an icterus develops. Furthermore, if permanent liver damage occurs with or without the presence of clinical signs (since clinical symptoms are not necessary to the presence of a low grade hepatitis) the physician, until now, could certainly know nothing of it. In patients who develop a toxic hepatitis in the course of antisyphilitic treatment, clinical cure is the rule (although in a few cases the severity of the hepatitis leads to a fatal outcome), and it has been generally assumed that the liver, at least functionally, returns to normal.
With the reputation for liver-cell affinity possessed by arsenic, and therefore the arsenobenzenes, and with the widespread use of these drugs and other related arsenicals, it would seem, from the facts stated above, as important to know the
GREENBAUM SS, BROWN H. THE PHENOLTETRACHLORPHTHALEIN LIVER TESTIN CASES OF ACUTE AND CHRONIC SYPHILIS UNDER TREATMENT AND IN VARIOUS SKIN DISEASES. JAMA. 1924;82(2):88–91. doi:10.1001/jama.1924.02650280014006