NOTE ON SERUM TREATMENT IN SYPHILIS. By Surgn.-Major Gr. M. Shewan, i.h.s.
As the disease is
contagious,
been most
the
pathogenic
other, has of course searched for. Klebs, Aufrecht, eagerly
agent in syphilis, germ
or
Birch, Hirschfeld and others have for long attempted the culture and inoculation of bacteria found in syphilitic tissues and secretions, but all experiments as yet have failed. Lustgarten
INDIAN MEDICAL GAZETTE.
186
(1884-85) believed he had found the specific germ when, with a colouring of his own, he disclosed
the presence of a certain bacillus in the chancre and in gummata, and which bacillus had a strong resemblance to the bacilli of leprosy and tubercle. Such a likeness, taken with the slow evolution in, and the striking degree of general resemblance of lesions in sjTphilis, leprosy and tubercle together, might incline us to believe in Lustgarten's microbe* were it not that its cultivation has been found impossible and that Alvarez and Tavel, followed by Mattersctock, obtained the same bacillus in preputial smegma and healthy secretion from the anus and vagina. The two plates here are taken from the micro" photographic atlas of Itzerott and Niemann.
T
?_
'*
.?
Bacilli of preputial Smegma.
The micrococci,
.
iS
1
I
.
1896.
known their As
joint results, and their belief in a disease.^ in speaking of our vaccination treat-
treatment of
serum
do of rabies, so in a serum treatment for syphilis, and in anticipation here, we might go on and refer to a microbe, t its "toxines" and its antitoxines." But unfortunately we have an added hindrance here in the difficulty and perhaps the impossibility we encounter, in implanting syphilis on animals.? It would seem that we have first to conquer such a resistance in animals, and at any rate to arouse in animals some declared morbid action as result of the virus before we can hope to succeed in a curative and preventive serum treatment at all. We come to see, therefore, that the lines of we
ment
"
*?] '"
Gentian Gentian Violet.?1000 Violet.?1000
: :
1. 1.
constantly seen in secondary have apparently no causal
syphilitic eruptions,
relation in the disease.
Richet and Hericourt who jointly in first formulated laws*f- ih serum treatment, who were also the first to apply such laws in syphilis. After experimenting in association two other French physicians in 1891 they made Ir,
[April
was
1888 had
Bacilli of
Syphilis (Lustgarten). Secretion from Condyloma Lustgarten's Stain.?1000 : 1. _
conduct open to
syphilis
are
us
in the
comparatively
serum treatment of few. We may assume syphilis may provide
that animals refractory to a sprum that will confer an immunity to man, or that one "syphilitic" may furnish a vaccine to attenuate virulence of recent infection in others. The practice as yet, then, has been limited to the following : 1. Injection of the
serum
of
"
syphilised"
man:? "The bacillus of syphilis has been demonstrated tissues by Lustgarten, who stained his sections of syphilitic new growths in Weigert's aniline gentian violet solution decolorized by means of a solution of permanganate of potash and then washing with sulphuroue acid ; this is repeated until the sections are colourless, when the bacilli stand out prominently. The bacilli of leprosy and tubercle are stained by the same method, but they may be distinguished from the syphilis bacillus by the fact that the latter l?.ses its stain on the sections being washed with a mineral ****** It has more recently been found, acid. however, that other bacilli take on a similar stain."?Sims Woodhead's Bacteria and their Products."
(>/)
*
in
"
In 1888 they made known the result of experiments " named with a microbe they themselves Staphylotill then had always proved fatal in which and pyosepticus, the rabbit. They showed that an immunity against that microbe enjoyed by dogs might be transmitted to the susceptive rabbit, and in a second communication they further proved that such natural immunity in the dog and the protecting power of the dog's serum are both strengthened by inoculating the dog itself with a culture of the same mic-
j
robe.
(b)
?
from subjects in the tertiary without actively advancing indistage cations of the disease. Taken from subjects in the secondary while undergoing successful speciTaken
stage
fic treatment. Injection of the natural unaltered
2.
of
refractory animals. 8.
sense
Injection of prepared:?
(a) B}' "
the
serum
serum
of animals in
a
to it a serum from with disease in active
previously adding
syphilitics,"
course.
J The experiments of Tommasoli and Pellizzari, wlio by some are given credit for being first in this treatment, were at any rate not published until 1892. ? As far as we have yet gone, and according to Bernhorse appears to be the only animal that perhaps heim, the " we may syphilise. "
April
81LC0CK ON MACROGLOSSIA.
1896.]
(/>) By
previously adding to it fluid prosyphilitic lesions generally.
ducts from
"
understood that in the prepared serums the injection of the added products is made into the blood stream, such prepared serums are only drawn for use five to fifty days after this addition. It is of
course
"
the
results up to date, promised more than has Brown-Sequard's method of injecting organic It now seems estabfluids in other conditions. lished that injections of a pure water have effect quite equal to that of the composite organic solutions proposed by, and invested with, special curative powers on the statements of Brown-Sequard and others. All such injections, and our serum injections for syphilis have had a general tonic action on the system, and this action as yet is unexplained. A varying degree of fever is produced by the injections. Mauriac reminds us that febrile movement, spontaneous or provoked, temporarily disperses manifestations in this disease, and cautions us therefore against always attributing results to a specific curative action of our injections.
Judged by
our
published
treatment, yet has not
137
As the disease is
contagious,
been most
the
pathogenic
other, has of course searched for. Klebs, Aufrecht, eagerly
agent in syphilis, germ
or
Birch, Hirschfeld and others have for long attempted the culture and inoculation of bacteria found in syphilitic tissues and secretions, but all experiments as yet have failed. Lustgarten
INDIAN MEDICAL GAZETTE.
186
(1884-85) believed he had found the specific germ when, with a colouring of his own, he disclosed
the presence of a certain bacillus in the chancre and in gummata, and which bacillus had a strong resemblance to the bacilli of leprosy and tubercle. Such a likeness, taken with the slow evolution in, and the striking degree of general resemblance of lesions in sjTphilis, leprosy and tubercle together, might incline us to believe in Lustgarten's microbe* were it not that its cultivation has been found impossible and that Alvarez and Tavel, followed by Mattersctock, obtained the same bacillus in preputial smegma and healthy secretion from the anus and vagina. The two plates here are taken from the micro" photographic atlas of Itzerott and Niemann.
T
?_
'*
.?
Bacilli of preputial Smegma.
The micrococci,
.
iS
1
I
.
1896.
known their As
joint results, and their belief in a disease.^ in speaking of our vaccination treat-
treatment of
serum
do of rabies, so in a serum treatment for syphilis, and in anticipation here, we might go on and refer to a microbe, t its "toxines" and its antitoxines." But unfortunately we have an added hindrance here in the difficulty and perhaps the impossibility we encounter, in implanting syphilis on animals.? It would seem that we have first to conquer such a resistance in animals, and at any rate to arouse in animals some declared morbid action as result of the virus before we can hope to succeed in a curative and preventive serum treatment at all. We come to see, therefore, that the lines of we
ment
"
*?] '"
Gentian Gentian Violet.?1000 Violet.?1000
: :
1. 1.
constantly seen in secondary have apparently no causal
syphilitic eruptions,
relation in the disease.
Richet and Hericourt who jointly in first formulated laws*f- ih serum treatment, who were also the first to apply such laws in syphilis. After experimenting in association two other French physicians in 1891 they made Ir,
[April
was
1888 had
Bacilli of
Syphilis (Lustgarten). Secretion from Condyloma Lustgarten's Stain.?1000 : 1. _
conduct open to
syphilis
are
us
in the
comparatively
serum treatment of few. We may assume syphilis may provide
that animals refractory to a sprum that will confer an immunity to man, or that one "syphilitic" may furnish a vaccine to attenuate virulence of recent infection in others. The practice as yet, then, has been limited to the following : 1. Injection of the
serum
of
"
syphilised"
man:? "The bacillus of syphilis has been demonstrated tissues by Lustgarten, who stained his sections of syphilitic new growths in Weigert's aniline gentian violet solution decolorized by means of a solution of permanganate of potash and then washing with sulphuroue acid ; this is repeated until the sections are colourless, when the bacilli stand out prominently. The bacilli of leprosy and tubercle are stained by the same method, but they may be distinguished from the syphilis bacillus by the fact that the latter l?.ses its stain on the sections being washed with a mineral ****** It has more recently been found, acid. however, that other bacilli take on a similar stain."?Sims Woodhead's Bacteria and their Products."
(>/)
*
in
"
In 1888 they made known the result of experiments " named with a microbe they themselves Staphylotill then had always proved fatal in which and pyosepticus, the rabbit. They showed that an immunity against that microbe enjoyed by dogs might be transmitted to the susceptive rabbit, and in a second communication they further proved that such natural immunity in the dog and the protecting power of the dog's serum are both strengthened by inoculating the dog itself with a culture of the same mic-
j
robe.
(b)
?
from subjects in the tertiary without actively advancing indistage cations of the disease. Taken from subjects in the secondary while undergoing successful speciTaken
stage
fic treatment. Injection of the natural unaltered
2.
of
refractory animals. 8.
sense
Injection of prepared:?
(a) B}' "
the
serum
serum
of animals in
a
to it a serum from with disease in active
previously adding
syphilitics,"
course.
J The experiments of Tommasoli and Pellizzari, wlio by some are given credit for being first in this treatment, were at any rate not published until 1892. ? As far as we have yet gone, and according to Bernhorse appears to be the only animal that perhaps heim, the " we may syphilise. "
April
81LC0CK ON MACROGLOSSIA.
1896.]
(/>) By
previously adding to it fluid prosyphilitic lesions generally.
ducts from
"
understood that in the prepared serums the injection of the added products is made into the blood stream, such prepared serums are only drawn for use five to fifty days after this addition. It is of
course
"
the
results up to date, promised more than has Brown-Sequard's method of injecting organic It now seems estabfluids in other conditions. lished that injections of a pure water have effect quite equal to that of the composite organic solutions proposed by, and invested with, special curative powers on the statements of Brown-Sequard and others. All such injections, and our serum injections for syphilis have had a general tonic action on the system, and this action as yet is unexplained. A varying degree of fever is produced by the injections. Mauriac reminds us that febrile movement, spontaneous or provoked, temporarily disperses manifestations in this disease, and cautions us therefore against always attributing results to a specific curative action of our injections.
Judged by
our
published
treatment, yet has not
137
