SINCE the introduction of arsphenamine in 1909, the severe reactions of the central nervous system associated with arsenical therapy have been of paramount significance in the treatment of syphilis. Up to 1935, 158 such reactions have been reported in the literature.1 Of the 158 cases, there were 120 resulting in death, 76 per cent mortality.
Intensive arsenotherapy has been used extensively since 1939, but with constant apprehension because of the increased danger of cerebral complications. Thomas and Wexler2 stated that the incidence of cerebral symptoms was about 1 per cent in all quick methods of treatment.
The treatment of syphilis with penicillin is still in the experimental stage, and it will be years before the true value of penicillin therapy can be determined. Already a high percentage of relapses have occurred, although toxic reactions are practically nonexistent. It would seem that treatment with penicillin alone does not appear
SEXTON GB, GOWDEY CW. RELATION BETWEEN THIAMINE AND ARSENICAL TOXICITY: Preliminary Report. Arch Derm Syphilol. 1947;56(5):634–647. doi:10.1001/archderm.1947.01520110080010
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