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October 2, 1943


Author Affiliations


From the Department of Dermatology and Syphilology, Western Reserve University School of Medicine, and the Cleveland City, St. Vincent's Charity and University hospitals.

JAMA. 1943;123(5):253-258. doi:10.1001/jama.1943.02840400001001

Paul Ehrlich worked for years synthesizing an arsenical compound to cure syphilis. The therapia magna sterilisans, he thought, had been achieved with his six hundred and sixth preparation, arsphenamine (introduced as salvarsan), to be injected intramuscularly, one injection sufficing. Relapses as well as reactions disclosed differently and he synthesized another arsenical, neoarsphenamine, and later still others. When none of these worked he and his collaborators suggested use of more than one injection. Every physician agreed to the effect of the trivalent arsenical salts on Treponema pallidum, but it required trial and error as well as evaluation of enormous amounts of case material before medicine finally awakened to the profound effect of these compounds on syphilis. Injections of the arsenical were at first widely spaced between other forms of therapy—mercury. Later a physician here and there had the temerity to use injections perhaps once a month, later once a week. It