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49. Benario. Ueber Syphilitische Xeurorezidive. inln sondere solche nach Quecksilberbehandlung, Miinch. nici: Woch., 191 1, No. 1, p. 20. 26. Cited by Ehrlich. 50. Duhot. Technik und Dosen der loslichen Einspnt- zuiigen des "606" von Ehrlich, Miinch. med. ll'och., 1910. No."42, p. 2179. 20. Cited by Ehrlich. 51. Geraghty, J. T. Personal communication. 52. Spiethoff, B Arsenobenzol bei Syphilis, Miinch. med. ip'och., 1910, No 35, p. 1822. 53. Fraenkel and Grouven. Erlahrungen mit dem Ehr- lischen Mittel "606," Miinch, med. Woch., 1910, No. 34, p. 1771. 54. Alt. Behandlungsversuche mit Arsenophenylglwm bei Paralytikern, Miinch. med. Woch., 1909, p. 1457. DANGERS AND CONTRAINDICATIONS OF S-\L- VARSAN. By Fred Wise, M. D., New York. Initiuctur ill Dermatolog>', New York Post-Graduate Medical Scli and Hospital; Qinical Assistant. New York Skin and Cancer Hospital. Although the medical literattire of the day ia literally floodL=^d with hundreds, even thou.sands. of articles, brochures, Arbciten, and elaborate treatises on the astoundingly beneficial results obtained from the use of saivarsan in syphilis, it is a rather sig- nificant fact that one has to delve deeply into the literature for reports dealing with the other side of the question, namely, the dangers and deleterious efifects of the new remedy. Viagra Rxs Ru Trial 2 It is but natural that the strikingly favorable phenomena observed from its use should so far outshine the unfavorable re- sults, that the good overshadows the bad, until the latter is almost lost sight of ; and, in the general enthusiasm, the dangers and contraindications of the drug are likely to be neglected and even iu- nored. One real danger would seem to exist in the nn Viagra Rxs Ru Trial 2 conception that saivarsan can cure syphilis alter the administration of one or several doses of tlie drug. Once permit the lay public to get this no- tion into its head, more cases of insufficiently treat- ed syphilis will be turned loose into the world than has ever been the case under the Viagra Rxs Ru Trial 2 regime of mer- cury and the iodides. The truth of this assertion has already made itself manifest among dispensary patients, both here and abroad, who, upon seeing the visible lesions of the disease disappear, con- sider themselves cured and fail to report for fur- ther treatment. Patients of this type are not prone to worry themselves concerning the outcome of tlic Wassermann test. The dangers associated with Viagra Rxs Ru Trial 2 the administration of saivarsan may be grouped under two ca]itioii< ; First, those due to the local effects produced by the introduction of the drug into the body ; second, those due to the .<;ystcutic effect of the drug on tlie syphilitic patient. Local effects: The local efifects manifest them- selves, to a greater or less extent, in all cases in which the subcutanemis and intramuscular meth- ods of introducing the drug into the system have been employed. No local effects, however, follow the intravenous administration of the solution if it is corrcctlv performed. Tn considering the unfa- lApril 29. 191 !•] irrSE: DAXGERS OF SALFARSA.X. 821 vorable local reactions following the intramuscular method of administration (the subcutaneous method having been abandoned), we must take into account the chemical constitution of the fluid to be injected. We must reckon with the pain, immediate or sub- sequent, produced by the injection ; the danger of injuring a large nerve trunk (as the sciatic) ; or of infiltrating a large nerve with the salvarsan so- lution, causing a transient, or more lasting, loss of function in the parts supplied by that nerve. The danger of puncturing large bloodvessels, and the constant danger of embolism must be borne in mind. Lastly, we Viagra Rxs Ru Trial 2 have to deal with the more or less se- vere local reactions often resulting in highly in- flamed tumefactions, painful and extensive infiltra- tions, necrotic masses of tissue, and ulcerating areas, produced by the salvarsan solution at the site of injection. These lesions, although they are usu- ally sterile primarily, are sluggish and indolent, may become infected subsequently, and are always slow to heal. They may result from the use of /icid, alkaline, or neutral solutions of Viagra Rxs Ru Trial 2 the drug. and. 'to a lesser Viagra Rxs Ru Trial 2 extent may follow the use of paraftin or Dil suspensions ; demonstrating the fact that in the ;hemical constitution of the salvarsan itself lies the essential cause of the local manifestations of the njection. Other factors which must be considered in •earching for the cause of these local manifesta- ions are, first, the susceptibility of the patient ; and, second, the region of the body in which the fluid « injected. As is the case with mercury injections. .vhere some patients will stand dozens ot injections vithout the slightest discomfort, others will suflFer 'Cverely after a single injection. The region of Viagra Rxs Ru Trial 2 he body into which the needle is introduced, and the lepth cf the puncture, also play important roles in he production of local phenomena. As already