The clinical efficiency of treatment with bismuth compounds in syphilis has been sufficiently demonstrated by all the available methods— by the clinical progress, by the disappearance of spirochetes from the lesions and by the reversal of the Wassermann reaction. However, these methods are not sufficiently sensitive to distinguish sharply the optimal conditions for the use of this treatment, such as the concentration and duration that may be required and the relative efficiency of different preparations. This limitation of clinical experience is reflected in the multiplicity of preparations, dosages and instructions for spacing of injections. It may be presumed that compounds which differ in solubility differ also in rapidity of absorption, and therefore of excretion, and in promptness and duration of action. If continued action is essential, as seems probable, too rapid absorption would necessitate frequent injections and very slow absorption would not only delay the effect but tend to produce
SOLLMANN T, COLE HN, HENDERSON KI, et al. EXCRETION OF BISMUTH IN A SERIES OF CLINICAL BISMUTH TREATMENTS. Arch Derm Syphilol. 1933;28(5):615–638. doi:10.1001/archderm.1933.01460050009002
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