Discussion of Dr. Harry Most's Report on Therapy of Schistosomiasis

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The use of tartar emetic (antimony and potassium tartrate) in preference to Fuadin has been emphasized properly, in combatting schistosomal infections. Of the clinical forms mentioned, S. japonicum infections are most resistant to therapy, and also are not infrequently overlooked in differential diagnosis. Four deaths have occurred fairly recently in San Francisco in personnel returned from overseas (personal communication from Dr. H. G. Johnstone).

Not all physicians using tartar emetic are aware, I believe, of the need for beginning with very small doses and after some tolerance to antimony has developed, build up the dose to much higher levels than originally possible. This technic is based on sound pharmacologic evidence in animals.

Dr. C. Pak (now Surgeon General of the Korean Navy), when working in Shanghai (before the Japanese-American conflict) at the Henry Lester Institute for Medical Research, found that rats or mice, given a dose equivalent to ⅓ of the lethal amount of an antimonial, within 5 to 48 hours can be given a surely fatal dose of the same antimonial without harm.

Author Notes

University of California, San Francisco.

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