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April 11, 1914


JAMA. 1914;LXII(15):1175-1176. doi:10.1001/jama.1914.02560400043023

By a careful review of the fatalities from salvarsan not only under his immediate observation, but also of the cases in the literature, Wechselmann,1 in a pamphlet issued recently, attempts to prove that the cases of encephalitis hemorrhagica following salvarsan treatment were due to uremia. This was the result of the irritation of kidneys which in most cases had been rendered insufficient by mercury. The kidney lesions, while not so severe as to give clinical or laboratory evidences of trouble, yet reacted to salvarsan by a fatal suppression of urine. He supports this argument by the findings in a series of animal experiments showing that mercury, like chromium, damages the tubular epithelium of the kidney, while arsenic, like cantharidin, acts on the glomeruli. He explains that kidneys long irritated by mercury are so injured that the comparatively slight irritation of salvarsan can cause suppression.

On the basis of this

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