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chsetae, but not the resistant resting forms, which later develop into spirochset?e and again produce syphilitic lesions when the effect of the salvarsan has passed off. Incidentally I may refer to the ac- tion of quinine in malaria, Cialis 5mg Price Canada in which the drug is in- effective against the macrogametes of the Plasmo- dium while destroying the other forms of that Cialis 5mg Price Canada or- ganism. Furthermore, it is a remarkable fact that succes- sive injections of salvarsan in cases of Cialis 5mg Price Canada recurrence of lesions are quite as effective in healing the lesions as was the first injection. Ehrlich observed, on the other hand, that repeated inadequate doses of ar- senophenylglycin or of salvarsan in trypanosomia- sis and in relapsing fever, served to render the or- ganisms that survived more resistant to these poisons, so that it was possible by repeated injec- tions Cialis 5mg Price Canada to render the organisms so resistant or fast to the poison, that even maximal doses failed to destroy them. It was indeed on this observation that he based his principle of therapia magna sterilisans : the principle that it was necessary to kill off all the parasites at a single dose, lest the survivors become resistant to the drug. Now, the laboratory experi- ment furnishes us with certain definite facts ; if our therapeutic experiment does not harmonize with them, the error is not in the facts, but in their inter- pretation or in that of the therapeutic experiment. The fact that repeated doses of salvarsan lose noth- ing of their effectiveness against the recurrences in syphilis does not contradict the laboratory experi- ment if we assume that the fresh lesions are pro- duced by spirochzetse that have developed out of their resting stage only after the last injection of the drug, and have therefore ne\-er before as spiro- ch.xtJE been subject to its influence. Moreover, every one who has used salvarsan has been struck by the rapidity and character of the re- currences. When lesions disappear under mercu- rial treatment, we can generally count on a consid- erable period of freedom, a period in tertiary cases often measured by years. After salvarsan not only do lesions recur in the briefest space of time, but the new lesions are often of a character or in a lo- cation which for the given case is entirely new or unusual. It seems as if the salvarsan had directly provoked the development of the new lesions. Or, expressed in terms of the theory of resting forn of the spirochastse, it -eems as if the drug had act( as a stimulus on the resting forms, provoking the! development Cialis 5mg Price Canada into spirochcetse with the resulting ne lesions. In this respect an analogy may be mac with the action of tuberculin. If this view of tl effect of salvarsaji is" correct, it discloses a valuab property of the drug and affords a useful hint ft treatment. To come back to salvarsan, it is evident that drug that is capable of brmging about the ph(' nomenally rapid healing of syphilitic lesions th; we have seen must have a very great value in tl treatment of syphilis. We have spoken of its e fects on syphilitic lesions in general; it remains t consider a few clinical forms. In hereditary syphilis in infants, there have bee some remarkable cases of the curative effect on tl child following injection of the drug into the nur; ing mother ; and there have also been a Cialis 5mg Price Canada number c failures to produce such an effect in this way. the whole, I think, we shall do well in these case to treat the babies directly with extremely minu' doses of the drug,' so as not to overwhelm thes generally Cialis 5mg Price Canada enfeebled infants with the Cialis 5mg Price Canada products c dead spirochseta. Out of seven cases of hereditar syphilis treated by Finger with salvarsan, typic; cachectic, shrivelled babies under two months c age with papules, pemphigus, coryza, etc., hiost <: whom would probably have died, five recovered. In syphilitic affections of the eye, Ehrlich ha from the first strenuously warned against the u< of the drug, especially in cases of optic neuritis an' atrophy. The clinical evidence has gone to sho\ that the fear of harm in these cases is unfoundei Indeed, I can see no a priori reason for placin; syphilitic lesions of the eye in a special categori with the possible exception of optic neuritis o atrophy, and even in these cases I imagine Ehrlic! was influenced by the risk of having the remed unjustly discredited in case the atrophy progresses unfa\orably, rather than by the fear of any harm ful action of the drug on the nerve. Among Wech selmann's" large series of cases were twelve pa tients who had previously been treated with atoxy or arsacetin, who were not injured by Cialis 5mg Price Canada injection wit! salvarsan. He has used the drug in a number o cases in which optic atrophy was already pre.sen without Cialis 5mg Price Canada doing any harm, and indeed in some case there was an apparent improvement in vision Schanz^- reports two cases of neuroretinitis a least temporarily improved and one case of optii neuritis in which the swelling of the disc was di Cialis 5mg Price Canada minished, and the cloudiness of the retina clearec up with improvement of vision the day after an in jection. A fair number of such cases have beei recorded. It seems to me that while a beginnins. optic neuritis may be checked, it is of course quit' out of the question that an atrophic optic nerve should resume its function. Iritis, recent and nodular, and the various ocula palsies, yield with great rapidity to injections of sal Cialis 5mg Price Canada varsan, and in a great many cases have recurre' with equal promptitude. Parenchymatous keratiti '^Deutsche medisinhche IVochensclirift, November 24. iQio, p. »i«' ^-Miinchcncr medizinischc IVoclicnschrift. Novciiibi-r 8, 19" p. 2341. FOLLITZER: SALVARSAX. 209 i hereditary syphilitics shows as a rule very great Cialis 5mg Price Canada ijrovemen't if the process is recent, and less bene- f or none if the process is well advanced. I have tated two such cases, kindly referred to me by I Otto Schirmer, and I copy from his notes : ASE IX. Boy, thirteen years, Wassermann reaction . .^. Left eye moderate interstitial keratitis, vvhicli