Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.803464
Title: A study of early syphilis, its treatment and the management of the reactions to treatment
Author: Granger, Allan F.
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 1946
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Abstract:
Introduction. 1. The objects of the study are given. 2. The material is described and the methods used in case talcing, examination and in laboratory procedures are given in detail. Section I. 1. A clinical study and analysis of the signs and symptoms of primary and secondary syphilis in a series of 250 cases is described and photographs illustrating cases are included. 2. It is concluded that syphilis as studied in this series of cases is a less virulent disease than that described as occurring in the 19th Century. Section II. 1. A study of the reversal of the serological reactions of the blood in relation to treatment, with various schedules of trivalent arsenical compounds and with penicillin, in 979 cases of primary or secondary syphilis is described. 2. It is concluded that:- (a) Neoarsp henamine should be administered regularly, twice weekly, in adequate dosage to obtain satisfactory serological reversal. Satisfactory results in the reversal of the serological reaction of the blood in cases of primary and secondary syphilis can be achieved with mapharside. (c) A total dosage of 2,400,000 Oxford Units of penicillin is not adequate treatment for all cases of primary and secondary syphilis. Further consideration of the optimum dosage and of the "time/dasage" factor in such cases, is required. Section III. 1. A study of the major reactions to the. trivalent arsenical compounds and an investigation into new methods of management of these reactions is described. (a) An injection technique for the prevention of post-arsphenamine jaundice is described, the use of which reduced the incidence of the reaction from 42% to less than 1%. The aetiology of post-arsphenamine jaundice is discussed. (b) Nine cases of erythema of the 9th day are described with their management by a process of desensitisation. (c) One fatal case of haemorrhagic encephalopathy is described and the results of the post-mortem examination are given. (d) One case of agranulocytosis following the administration of neoarsphenamine is described with subsequent arsenotherapy after desensitisation. (e) A typical case of seborrhoeic dermatitis aggravated by the administration of the trivalent arsenical compounds is described with unsuccessful attempts at desensitisation. (f) Seven cases of dermatitis of an allergic type following the administration of neoarsphenamine are described with successful desensitisation using mapharside. (g)Three cases of generalised exfoliative dermatitis following the administration of neoarsphenamine, two of which were treated with B. A. L. , are described. 2. It is concluded that: (a) "Post-arsphenamine jaundice" is usually an infective hepatitis, indistinguishable from epidemic infective hepatitis and its spread amongst patients receiving arseno-therapy can be prevented. (b) Following the administration of the trivalent arsenical drugs, erythema of the 9th day, agranulocytosis and certain types of dermatitis are allergic phenomena and following desensitisation arsenotherapy can be continued. The principles used can probably be applied to the whole group of drugs which cause these reactions. (c) Desensitisation cannot be carried out in seborrhoeic individuals exhibiting dermatitis during treatment with the trivalent arsenical drugs. (d) No definite conclusion concerning the use of B. A. L. in the management of exfoliative dermatitis due to arsenic could be reached.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.803464  DOI: Not available
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