Salvarsan in capsule and in solution in doses varying from 0.1 to 0.6 of a gram was administered by mouth to seven patients suffering from syphilis. Five patients were given full doses of 0.6 of a gram. One patient (case 3) received in the aggregate within four weeks 2.4 grams without loss of weight or any disturbing effects. An ulcerating gumma of the knee was practically healed after a period of five weeks. This was the only patient of the seven, however, in whom notable improvement in the cutaneous manifestations followed the administration of the drug. This ulceration would probably have healed as soon, or possibly sooner, under the influence of mercury and the iodids.
From the above observations, it would appear that salvarsan administered by mouth up to the full dose of 0.6 of a gram, has a perceptible though feeble therapeutic effect on cutaneous syphilitic manifestations. We should naturally expect the influence of any drug to be more evident in the case of a gumma, in which spirochætes are only sparsely present, than in the secondary syphilides in which the spirochætes are present in enormous numbers. Cutaneous gummata are readily healed at times by very small doses of mercury or iodids.
It is interesting to note that the administration of the full dose of the drug by mouth does not appear to give rise to symptoms of systemic arsenical poisoning, unless the vomiting and diarrhea be regarded as such. After some of the full dose administrations, there was neither vomiting nor diarrhea. As salvarsan contains 34 per cent. of arsenic, these patients received the equivalent of five grains of arsenic. In case 3, in the course of four weeks the patient took by mouth the equivalent of over twelve grains of arsenic, without vomiting or having diarrhea, and with no loss of weight or disturbance of health. The urine of this patient was entirely normal. It would seem, therefore, that salvarsan is not converted in the gastro-intestinal tract into an organotropic arsenical compound, and it is possible that it may remain practically unchanged.