Chemotherapy of Tuberculosis*

It is the intention to focus anew in this paper the attention of physicians, and particularly phthisiologists, upon a type of therapy which, at present, does not play the role in the treatment of tuberculosis which it deserves. Chemotherapy of tuberculosis has been in eclipse for reasons which are understandable, but do not suffice to justify refusal of its possible benefits to a patient afflicted with tuberculosis. Chemotherapy of tuberculosis is essentially gold therapy. Gold therapy is usually identified in this country with the use of Sanocrysin. In reality, this type of treatment is much older. Original experiments with gold salts go back to Robert Koch. As early as twentyfive years ago, preparations of Aurocanthan, Krysolgan and Triphal gave evidence of a specific effect therapeutically upon tuberculous tissue. However, their high toxicity prevented their use on a large scale. World-wide interest in gold therapy was reawakened by Moellgard's publication of his and Secher's results with Sanocrysin. Enthusiastic reports were followed by disappointment of other workers who were j ustified in pointing out the severe damage done in many cases. It is now generally agreed that this was largely due to the administration of too large doses. However, the result was unfortunate in that the majority of the physicians in this country abandoned the use of gold preparations entirely. European workers and investigators in other parts of the world, as well, insisted that they had seen favorable results in cases where other types of treatment proved unsuccessful or could not be administered. In 1933 Henrichsen and Sweany published a comprehensive report about their experiences with Sanocrysin at the Chicago Municipal Tuberculosis Sanitarium. They arrived at qualified but, on the whole, favorable conclusions and confirmed the now general consensus of opinion that reduction of the dosage markedly reduced the complications attributed to Sanocrysin. Adolf Feldt, one of the pioneers in the field of chemotherapy of tuberculosis, endeavored for many years to develop an organic gold compound having sufficient therapeutic effect without causing