Alt K (1909)
Behandlungsversuche mit Arsenophenylglyzin bei Paralytikern [Treatment experiments with arsenophenylglycine in paralytics]. Muenchener Medizinische Wochenschrift 56:1457-1459.
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Key passage(s)

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Translation

“Counsellor [Paul] Ehrlich, to whom we owe identification of the chemical structure and effect of atoxyl, has succeeded in finding, through ingenious and indefatigable work, an arsenical, arsenophenylglycine, which cures every animal with induced sleeping sickness.

From this finding it was easy to assume that a drug that is so immediately effective in animals infected with trypanosomes would also have an effect on syphilitic processes in patients with progressive paralysis, and that the Wassermann reaction might be influenced by it. The influence on the latter is actually true in many cases of progressive paralysis. Entrusted by Counsellor Ehrlich with a clinical trial of arsenophenylglycine for 7 months, I succeeded, together with my colleagues from Uchtspring, to determine the dose and route of administration tolerated without harm by patients with progressive paralysis, and which brought about permanent recession of the [positive] Wassermann reaction. This happened without any disastrous incidents. In some cases the previously strongly positive Wassermann reaction disappeared as early as 24 hours after the treatment, and has since remained negative…

In total, 31 patients with progressive paralysis were treated, all of whom had previously had a definite positive Wassermann reaction (repeatedly demonstrated); 7 of them lost the [positive] reaction completely, in one it returned after 5 weeks, [but] in the others it remained negative. In a larger number, the Wassermann reaction decreased substantially, but returned to its former level after some time. Initially we had not treated patients with high doses, so some of the cases may not have responded for this reason. It seems that it was cases of less than 2 years duration of paralysis who were mostly influenced…”

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Translation

“The assumption that the Wassermann reaction can be induced to disappear in patients with progressive paralysis by treatment with arsenophenylglycine has been confirmed in some of the treated cases. The basis of this effect, and why it worked in some patients but not in others, is not yet understood. Anyhow, this is a very remarkable fact per se, and prompts continuation of the trials.

The question of whether and how the clinical course of paralysis has been affected is obviously crucial. It would be premature to make a judgement in so changeable a disease on the grounds of such a small number. We have seen a rapid and noticeable improvement not only in some patients who lost the [positive] Wassermann reaction, but also in many others. Whether this was due to the treatment can only be decided after a larger test series and a longer observation period…

Our treatment trials with arsenophenylglycine in patients with progressive paralysis are being extended to a larger series. One may claim already, without being overhasty, that our preliminary results support the hope that it should not be completely ruled out that, sooner or later, we will no longer be forced to confront entirely with folded arms the future course of patients with an early diagnosis of progressive paralysis. As the remissions of such patients show clearly, the paralytic process can at least be brought a standstill, even if not to a cure.”

Translation by Ulrich Tröhler

Portrait(s)

Konrad Alt (1862-1922)

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