Preparations of arsenic or bismuth are at present the most effective and dependable therapeutic agents for the treatment of syphilis. Therapy by these two drugs is continuously or alternately employed with the object of inflicting the maximum damage to the causative organism with the minimum injury to the body tissues. It is necessary in the case of bismuth to insure a fairly continuous supply of the medicament for effectively maintaining adequate therapy. This is accomplished by regular administration of additional quantities of the drug. Bismuth therapy by this approach leads to retention of the drug in the tissues. Relatively large quantities of retained bismuth are stored in the body when the preparation is employed over a long period in patients resisting a reasonable amount of medication.
It is possible that untoward effects may result from this storage. Cormia1 called attention to a depressing influence produced by bismuth therapy and
CORSON EF, DECKER HB, WILLIAMS TL. MOBILIZATION OF BISMUTH PRODUCED BY AMMONIUM CHLORIDE. Arch Derm Syphilol. 1940;42(5):868–873. doi:https://doi.org/10.1001/archderm.1940.01490170118010
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