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To the Editor:
—In The Journal of April 21, 1951 (page 1223) there appeared an article on penicillin treatment of syphilis, recommending specific treatment schedules for the various stages of syphilis. For neurosyphilis, a total dosage of 6 million units of penicillin is advocated as minimal adequate treatment. This amount may be sufficient in most patients with meningovascular syphilis. In dementia paralytica, 6 million units is an entirely inadequate dosage.In the early days of penicillin therapy, mainly as the result of underdosing up to 5 million units, the treatment of general paralysis with the antibiotics did not give the same results as malaria therapy. Through clinicoanatomic studies, it soon became apparent that with an increasing total amount the effectiveness of the antibiotic usually (but not always) augmented, and the amount of 10 million units of penicillin was found to be about equivalent to a course of malaria fever (Dis.
Bruetsch WL. PENICILLIN TREATMENT OF SYPHILIS. JAMA. 1951;146(4):396. doi:10.1001/jama.1951.03670040096029
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