CONSIDERATIONS ABOUT ANTISYPHILITIC THERAPY
Old and current concepts. —The following problem is a difficult one to resolve: antisyphilitic therapy. Time will definitely tell us which is the most effective. Taking the time factor into consideration — the most important in this illness — in the clinical cases that we are going to expose, the majority of which have more than 20 years of continuous observation, we haven’t seen the least recurrence or the smallest symptom that indicates the existence of the disease in patients treated with Cellular Therapy.
Each time that the laboratory puts in the hands of the doctor a new medication, enthusiasm overflows and it is always believed to be the final step in the resolution of the therapeutic problem. Recalling now everything that has happened in this century:
Said at the beginning of this century: “Mercury is the heroic medication for syphilis.” It was administered by mouth, intramuscularly, dermatologically, or externally.
Each one of these procedures had its special indications. Frictions [rub-downs] with pomades or ointments with double dose of mercury or calomel were prescribed especially for children, because they did not produce digestive disorders and because the mercury salts were not used much in the injectable form.
Soluble salts were applied parenterally, the most usual being iodide, cyanide, and benzoate of mercury, and the insoluble as metallic mercury in oil suspension. It was called gray oil, and calomel was also in oil. The application was always intramuscularly.
Soluble salts were also applied intravenously. And finally, with certain preparations, soluble salts were applied by spinal injection. They were called mercurized serum.
Surely in many cases the curative results were due to the use of mercury. We are going to refer to the clinical history of one of our patients, where only mercury and arsenic were employed as medications, with truly amazing results.
The iodide of potassium was another one of the medications in use during the same epoch as mercury. According to syphilis specialists, it should be used in: tertiary ulcerous syphilitics, gummas, visceral and vascular lesions, and in syphilis of the nervous system. Also it was useful in phagedenic chancres, secondary cephalalgias, periostitis, aching bones, arthralgias, etc. It came to produce slight accidents of intolerance: iodic acne and coryza.
It was very common for both mercury and iodides medications to be administered simultaneously and by mouth.
According to Professor Fournier, the treatment should last 5 years to be effective.
The arsenical drugs found application for syphilis since 1842, when Bunsen employed them in the form of cacodylates. But it was Ehrlich who studied the action of the arsenical drugs upon trypanosomiasis, leading to the discovery of the drug “606.”
The “606” or Salvarsan [arsphenamine] is the chlorhydrate of p. dioxy-diamino-arsenobenzol.
The manufacturers presented it in small ampoules sterilized in a vacuum and ready for use. Its application was done by diluting it in 250cc. of physiological serum and neutralized with caustic soda, therefore its reaction was very acid. Almost always after their application the patients had strong thermal reactions preceded by shivering. These were called Herxheimer reactions. As it gave symptoms of arsenical toxemia, ending up causing death, it was substituted by Neosalvarsan, and this was really less toxic. But the observation of patients led to the conclusion that Salvarsan was a great deal more effective than the Neo.
To test the susceptibility of the medication, begin with a small dose of 150mg until arriving at 1g and more.
With the syphilitic lesions that were called “florids” is when the almost theatrical effects of arsenical drugs were observed: the patient immediately “whitened”. Its effect did not seem to have been so kind on the visceral lesions. However, many years ago some syphilis specialists were injecting one gram daily, drop by drop, until the patient was saturated. But for its application it was necessary to do an extremely careful study, especially of the emunctories, to insure the correct elimination of arsenic.
As with all new things, at first it had great acceptance, but in view of the high percentage of deaths, it fell into disuse and has currently disappeared from the system.
Still the application of some arsenical drugs is done when it is determined that the patients do not show clinical or serologic changes with the new antibiotics.
Our opinion regarding the arsenical drugs is that they are really good medications for all syphilitic manifestations; the concrete fact is that some patients who were treated, many years ago, only with Salvarsan and with Neosalvarsan are healthy, the former being a great deal more effective for all forms of syphilis.
The serious inconvenience was that in certain patients they caused death by arsenical intoxication and this was not possible to predict, because we did not have the means to do it.
To Levaditi and Sazerac, we owe the studies (1921) about the treponemicidal action of bismuth. These studies were confirmed by Fournier and Guenot. And after this confirmation began its extensive use by all the syphilis specialists of the world. The first salt used was bismuth tartrate of sodium and potassium that contained 60% bismuth. Its application was intramuscular in oily suspension. Many other salts followed this one. Currently it seems that they are going to be ousted by antibiotics, although they still have extensive applications. For maintenance treatments, and to negate luetic reactions, we used bismuth.
Wanting to express the antisyphilitic power of each one of the medications mentioned, Millan said: Mercury has a therapeutic value of 4, Salvarsan 10, and bismuth 7.
Since the first works of Erh, Mendel, Krafft, and others in Germany, and Fournier in France, who confirmed the syphilitic origin of Quadriplegic Paralysis, the use of chemotherapeutic methods was initiated in systematic manner. At first, mercury was preferred intramuscularly in oily suspension form, and at the same time iodide was administered orally. At last the doctors came to the conviction that the results with this therapy were completely disheartening.
Our Indian natives, isolated from civilization, employed Temaxcal to fight all the diverse forms of syphilis. This consisted in smearing the patient with quicksilver, and introducing him in a very hot bath where vapors of water were released. The principle, according to them, was to open the pores so that the mercury would penetrate. We have knowledge that syphilis at least did not progress very much with this procedure. We do not have any statistical data about the final results.
In 1914 appeared the Salvarsan of Erlich, that was the hope of many syphilis specialists. They applied this arsenical drug to every preparalytic or Quadriplegic Paralytic. Some promptly died and the majority went more quickly toward dementia. Some were cured. It was however, rejected because it was dangerous. Later came into fashion the salvarsanized and the mercurialized serum, but their use being very dangerous as well, sometimes producing almost instantaneous death, was equally rejected.
When the fad of arsenical drugs of the Salvarsan type came, and it was observed, after some time, that those patients went straight to nervous syphilis, it was said that the arsenical drugs only WHITENED the patient. But the evolution continued in its nervous location and therefore they began to reject its application. The same was said of mercury and of the other antisyphilitic medications. Some syphilis specialists claimed that these medications were actually responsible for all forms of nervous syphilis.
Then were instituted rules for the best cure of this serious illness and one of many said: the treatment should be followed in a regular fashion during FOUR YEARS, whether or not appreciable clinical accidents existed. Mercury was then the fundamental medication, later it was arsenic, and finally bismuth, six to eight months during the first year, six the second, and three months the last two. During the months of rest, the habitual thing was to apply some frictions [rub-down] of mercury, the double ointment was the favorite. We do not have knowledge of any patient who followed all this time, what Fournier was considering necessary to cure syphilis. Daily we see doctors who have patients who for many years have followed various systems, and ended up with the serious symptoms of Quadriplegic Dementia. The last observations show that for all the remainder of their lives, the treatment should be followed, with short intervals of rest.
In spite of all this, day by day the number of Neurosyphilis cases increases, and particularly the cases of Progressive Quadriplegic Dementia. We will remember, that about ten years ago, it was announced that Already syphilis was mastered in only a few days, and therefore the so serious nervous localizations were avoided. It was said that the arsenical drugs of the Neosalvarsan type, injected a gram on a slow drip throughout a day, until completing four or five grams in the same time interval, achieved complete sterilization of the organism. But that procedure has been abandoned. Is it because it was extremely dangerous? Is it be because it caused many hardships? Or is it because it did not give any results?
Wagner von Jauregg, 29 years ago, initiated experiments with nonspecific therapy, and these works were continued by a great number of researchers, creating a sort of yard-stick according to which artificial fever was generated.
The Malaria Therapy of Wagner von Jauregg, only obtains remissions with its precocious application. This is actually extremely difficult, because we have already shown the many obstacles against making the correct diagnosis in time. Even so, we have had the opportunity to see a great number of patients in the nick of time and before the apparition of mental symptoms. Yet in spite of subjecting them strictly to the usual rules of application of antisyphilitic medications, they have become General Paralytics during this application. This comes to prove once more that the classic medical world does not know the effective way to cure syphilis, and with greater regard localizations in the nervous system.
The methods that are based on the injection of a nonbacterial product, such as sodium nucleinate, peptone, casein, milk, etc.: avirulent or virulent bacterial products, as the former tuberculin, multipurpose staphylococcic vaccine, bovine typhoid, and others. Provocation of certain infectious diseases by the inoculation of live organisms such as intermittent Malaria, Tercian, or Cuartan, Sodoku and other fevers.
And production of fevers by physical means, such as hot baths, diathermy, electropyrexia by waves of high frequency, or equivalent. Of all these procedures, Malaria Therapy holds the attention in the classic world, or rather it is preferred; next follows that of the artificial fever, or electropyrexia.
In 1919, Plaut and Steiner proposed recurrent fever as a means to cure Quadriplegic Dementia, two years after the Wagner von Jauregg procedure was presented. The Duttoni spirochete was utilized, 5cc of blood was extracted from a patient infected with the disease, and was immediately injected intramuscularly. After a period of incubation from 2 to 10 days the injected patient had migraine, fatigue, and various pains. Spontaneously, after 20 days more or less, the infection disappeared and the patient recovered his previous situation. When it did not work, arsenic or quinine were injected and right away brought down all infections.
Since it presented a series of difficulties and the therapeutic results were less than mediocre, the system was abandoned.
Sodoku (Japanese spirochete), leishmaniasis, fever induced by virulent and avirulent bacteria, the tuberculin of Koch by means of dilution, the typhoid vaccine, in short, almost all these systems applied were abandoned after showing less usefulness than Malaria Therapy. At the present time , for their control but not for their results, and for lack of another therapy, two methods are preferred: Malaria Therapy and electropyrexia.
Unfortunately the best of these two procedures only manages to slow down the evolution. In some cases it does no more than stabilize it, and in almost all cases the patient remains more or less demented, but never with total recovery, that is to say mental and neurological. Those in favor of Malaria Therapy say that 20% of the patients treated when the very first symptoms have begun, remain in state of remission for some years, being able to make their life as it was before the disease. And the rest of the malaria induced patients are left with a marked mental deficit, with psychopathic crises forcing a high percentage into permanent internment and into a compelled family life, with acute accesses [episodes] like seizures or periods of great excitation. These disabled patients, remain in this situation until an intercurrent disease or the same paralysis brings them death.
The classic medical world says: “It seems extreme to express that no treatment is or will be able to reintegrate a function whose organ has suffered a serious lesion.” “The patients do not return completely to their previous state. Many of them seem much happier, have lost some inhibitions, are not worried about certain activities that engulfed them before the disease, and are doubtlessly happier and more affectionate”. All the classic authors in the medical world agree that, with all the therapies known, there are only remissions.
ANTIBIOTICS IN SYPHILIS
For the 8 years since the honeymoon of these wonderful drugs began, one would think with justification that the cure for syphilis had been definitively resolved. But certain facts still leave many doubts with respect to their effectiveness proclaimed by the North Americans.
Following exactly the indications from North America for the correct use of Penicillin, at least here in Mexico, we have not seen these so flattering results they told us about on the other side of the Rio Bravo.
We will give a brief note about this treatment:
For primary syphilis the treatment is: 600,000 Units of procaine penicillin in monostearate of aluminum every 4 days until completing 2,400,000 Units; meaning this dose is given once. It was said that in clinical, serological, and by investigation of the Treponema in chancre, all the signs and symptoms of the disease disappear. But we know from our practice that the first manifestation, sometimes disappears very frequently even without local treatment and sometimes with any one of the antisyphilitic predecessors of penicillin. Now with respect to the serological reactions, these take sometimes more than two months in appearing positive in the blood, thus, definitive conclusions cannot yet be reached, with respect to the action of penicillin, in the first manifestation of syphilis.
The North American school treats the secondary manifestations in the same manner as the chancre. We also know that these manifestations sometimes disappear without treatment, or simply with the least effective antisyphilitic.
The most important aspect of the antibiotic treatments for syphilis is in asymptomatic syphilis tarda, and in visceral syphilis.
According to that school, the application method is 600,000 Units of penicillin 2 times per week (in all this exposé we are speaking of procaine penicillin in monostearate of aluminum) until completing 6,000,000 Units.
In our 3 years of practicing this technique we can say that only 1% of the patients have returned to negative blood tests, the rest obtain slight improvement, and in the great majority there has been no serologic change.
It is recommended by the same school, for any form of Neurosyphilis, to use every third day 600,000 Units until completing 8,000,000 Units or 10,000,000 Units.
Of course some clinical improvement is observed, and sometimes serological change in the cerebrospinal fluid, but in the great majority there is no change worthy to be taken into account. We must wait six months to a year to see the change in the cerebrospinal fluid, which is totally antisocial and anti-medical, since these patients always suffer some symptom that prevents them from living in their family, or for them this situation is unbearable. No one is going to wait 6 months and much less a year to find out how his disease turns out. Objecting this point, the North Americans say: “The absence of clinical improvement is not always evidence of therapeutic failure, because irreparable damages of the central nervous system may have taken place with continued clinical manifestations.”
Cardiovascular syphilis has a very similar treatment to that of neurosyphilis.
In neurosyphilis, as in cardiovascular syphilis, and in general all forms of the visceral syphilis, many doctors recommend to increase the dose up to 12,000,000 Units, applied in the same manner.
Every 6 months to a year, repeat the clinical and the laboratory examinations.
In the treatment of neurosyphilis, Malaria Therapy is associated with penicillin in the same dose. Some say that in rebellious cases bismuth must also be added.
We must apply this method more or less for 5 years, substituting other treatments. This length of time is absolutely insufficient to show something conclusively. But in our practice we can see that the result is not as satisfactory in all the manifestations of syphilis, as it was observed by the North Americans. In a chronic and polymorphic disease it is impossible to pronounce judgments if at least 20 years have not elapsed. We think that much before this time, some conclusions very similar to ours, which we believe closer to reality, will have already been reached.
Of course it is a formidable weapon against syphilis, almost inoffensive, or rather innocuous, since the reactions presented are always benign and perfectly controllable. Its application is easy and economical, it does not require special techniques, and it is applicable anywhere the patient happens to be. It is said that procaine penicillin in monostearate of aluminum is bringing the greatest advantages of application and therapeutics.
FORMULAS FOR SYPHILIS WITH CELLULAR THERAPY
The content of the first # 5 syringe that is going to be injected intramuscularly, at the time of the beginning of hypoglycemia, is:
Sodium Thioglycolate of bismuth 200mg,
Amino semihexamethylene mercury cyanide,
(representing cyanide of mercury) 10mg,
Sodium or potassium penicillin G crystallized 1,500,000 Units,
Glucose Serum at 5% 3cc.
Bismuth and mercury have the same contraindications as in routine therapy, and they dictate the dose in each patient.
Normally penicillin does not have any special contraindication; the dose can be increased up to 2,000,000 Units, or reduced to 500,000 Units according to the particular indications of the case.
The 20cc syringe that is going to be applied intravenously when the THERAPEUTIC MOMENT has reached its maximum contains:
4–oxy–3–acetylamino–3'–glucosamino–4'–oxyacetate of sodium arsenobenzene 20mg,
Calcium Gluconate 100mg,
Calcium Formate 50mg,
Calcium Bromide 350mg,
Glucose solution at 50% cbp. 20cc.
The second 20cc syringe for intravenous use contains:
Vitamin C 10,000 U,
Vitamin B1 20,000 U,
Vitamin B2 20,000 U,
Vitamin B6 20,000 U,
Calcium Gluconate 100mg,
Calcium Formate 50mg,
Calcium Bromide 375mg,
Iodide of Piperazine 500mg,
Glucose solution at 50% (enough to fill the syringe).
At the second presentation of the Change of the Blood Physico-Chemical Properties, that we know takes approximately 45 minutes and that is much less intense, he is going to ingest orally:
Nicotinic Acid: 250mg,
Calcium of Magnesia: 3g,
Iodide of Piperazine, (no dosage in Spanish version),
In a glass containing sugar at saturation starting from this moment. The ingestion of any kind of beverage cold or warm but always very sweet.
NEUROSYPHILIS -- NINE CLINICAL CASES
Case # 1: C.S., Male, Age: 39, Weight: 50kg (110lbs), the treatment began January 14, 1930.
Chronic alcoholism for many years, fermented as well as distilled liquor. Liver is swollen and presenting some digestive disorders.
For four months, the insomnia and nervous excitation that initiated the present disease have increased, in such a way that now he does not sleep at night, in spite of the narcotics provided to him. He displays persecution delirium, he is afraid of everything and as a result avoids all those surrounding him. He is also scared of his relatives; he is not tranquil for a moment, moves around constantly from side to side. Kathisophobia, motor hyperexcitation, dysarthria, slight anisocoria, cutaneous and tendinous hyperreflexia. He cannot fix his attention, constantly distracted, does not follow orders or directions, has left his house several nights and walked around town aimlessly.
The reactions in the cerebrospinal fluid, were intensely positive.
He was treated with intervals of five days, due to the gravity of his condition, and because he was the first patient of Quadriplegic Dementia to whom the Cellular Therapy was applied, using only Neosalvarsan and mercury cyanide as medications.
As of the first application, the symptoms began ostensibly to disappear. After the third application, the patient and his relatives, in agreement, suspended his treatment because he had resumed his activities in the National Arms Factory, where he calibrates Mausser rifle barrels. His conduct since then was normal in all his actions. To the family, as much as to the patient, we insisted on several occasions to continue the treatment, but since he felt all right, they thought that it had been sufficient with the three applications in fifteen days.
He was visited in his home, and according to the whole family and the aspect he presented, was a normal man; we were informed that he continued with the alcoholism and that he was getting drunk very frequently. During the 18 years we were observing him, outside his chronic alcoholism, which continued, his mental state was perfect.
Case # 2: P.A., Male, Age: 33, Weight: 68kg (139lbs), originally from of Tuxpan, Vera Cruz, dedicated to agriculture and cattle ranching.
From childhood his physical and mental development was normal, submissive and obedient to everyone; of moderate customs, his conduct in the home was characterized by his affection, kindness, and tenderness, not only with his relatives but also with strangers.
Three months ago this same patient noticed that he was beginning to lose sleep and was getting excited about the smallest contrariety, and in spite of his good will could not avoid it. Very quickly these two symptoms increased until he got to a state of psychomotor excitation for the twenty-four hours a day, in spite of the various sleeping aids he received. By this time he was no longer aware of his physical and mental conditions; the family observed with fear that he had clearly developed a mental disorder. In addition to the previously mentioned symptoms, they had increased along with delirious, polymorphic, unstable, and incoherent ideas. Because of these symptoms, they consulted several doctors in town and he assaulted one of them. All the symptoms were on the increase, which motivated that he be transferred to Tampico, without getting any improvements. For this reason, he also consulted several psychiatrists of Mexico City, where the patient was transferred, but tied with copper wires, because of the extraordinary force he had. All the strings that were used on him had broken.
Male individual, unimpaired physically, of robust constitution; his demeanor reveals total neglect, dirty clothes and sloppy dress, long hair, beard, and mustache. His general attitude shows great excitation, the gaze is fixed and penetrating, his pantomime is exaggerated and in discord with the constant logorrhea displayed, showing obvious dysarthria. Injuries observed in the face and the fists of both hands are caused by contusions inflicted when trying to subdue him.
He has lost the respect for his family, has become amoral, sometimes has committed exhibitionism acts, is disdainful and distrustful of all his relatives, fearing they can do him bodily harm and even cause his death. He refers to his family, who in addition to the doctors they consulted, took him to witches, and when they were giving him exorcisms, were saying it was to extract the bad spirits from him. He assaulted all the attendants because he thought they wanted to kill him. In general he is indifferent to everything surrounding him, but this indifference is unstable. Indeed he says he brought his family to Mexico City to cure them because they can infect him.
As in several occasions they have had to subdue him because he has become aggressive; displays negativism to everything that is ordered to him; is not tranquil anywhere; kathisophobic that makes him flee and that was on the verge of throwing himself in the water during his passage from Tuxpam to Tampico; exaggerated psychomotor agitation, goes and comes across the places he frequents, makes incoherent gestures, has torn all his clothes to pieces; if someone tries to counter this activity, he then becomes aggressive with all those surrounding him; his delirium is unstable and polymorphic.
Well apparent dysarthria, with constant logorrhea; we spared him the special examination. He did not let us make any examinations, but we observed pupillary inequality, fibrillary tremor in facial muscles, and cutaneous and tendinous hyporeflexia. He has lost considerable weight.
The analysis of cerebrospinal fluid produced the following result:
Mexico. D.F., September 10, 1934.
Aspect: Clear as spring water,
Dr. Gabriel Leyva.
The general emaciation, the continuous insomnia that lasted three months, the character change so marked that made him aggressive with everyone, the delirium of persecution appearing on occasion of some contrariety, the complete loss of morality, the lack of self-criticism that kept him dirty, his state of psychomotor excitation, dysarthria, anisocoria, and the abnormal chemical, cytological and serological reactions. By these signs and neurological, mental, and serological symptoms, Mr. PA has a full fledged General Progressive Paralysis.
The obvious improvement was perceived from the first application of the Cellular Therapy. The first three were every five days because of the gravity of the patient’s condition, later every eight days until the end of the first month, in view of which apparently his mental and physical state were normal. Extraction of the cerebrospinal fluid was performed on him. The results were the following:
Cerebrospinal fluid Analysis of Mr. P.A.
Mexico City, D.F., October 10, 1934.
Aspect: Clear as spring water,
Signature: Dr. Gabriel Leyva.
In this clinical case the serological reactions agreed with the mental and neurological state of the patient; dysarthria, lack of reflexes, tremors and other neurological signs have disappeared. The patient related to us that he was awakening from a dream and he told us with all sorts of details all the incidents, and everything he did during his madness. This totally contradicts the classic theories accepted by all the psychiatrists. According to them they never revert to remember the latest part of their life previous to the disease except the state of their disease. They say that the loss of memory is definitive. All the patients we have cured, and there are a few thousands, in all or almost all of them, memory has returned to normal.
This is one more refutation of the theories accepted all over the world. But we must say that they are absolutely right, those that have observed that these patients definitively lose the memory, as this is one more demonstration that they are not getting cured with the treatments in use, because if they were cured, they would recover all their faculties, and among them, their memory; and they have never observed it. This patient has come to the capital on several occasions and continues in perfect physical and mental condition, working with real pleasure, and has regained, as before the disease, his affectionate way with everyone, (observations of 1952). See graph.
Case # 3: C.G., Male, Age 35, Weight 55kg (121lbs.), with 88mg of blood glucose. See graph. He lives in the Hacienda de Alazán, Ver.; was examined on August 7, 1935:
In 1927 he had chancres with non suppurating inguinal adenitis.
More than 3 months ago it began with loss of sleep, excitability to the smallest contrariety, with symptoms increasing up to a true state of madness, which was how the relatives brought him to the clinic. He has delirious persecution, logorrhea, he is scared of all of them, he insults them without any reasons, he has attempted suicide several times. With the logorrhea, dysarthria is easily detected; he has global amnesia, mental confusion, speaks without any cohesion, he does not answer any questions because he is totally distracted. During the examination, which is very difficult, a slight anisocoria is detected, cutaneous and tendinous hyperreflexia, kathisophobia, disturbingly moves around the room. Since these symptoms began, he was treated with fevers and the specific treatment without obtaining the least improvement. In the first days of his disease several doctors were treating him for neurasthenia; but when they observed that the mental symptoms had increased and other alarming ones appeared, then they all agreed it was PGP (Progressive General Paralysis or Quadriplegic Dementia). The same day, August 7th., 1935 Dr. Gabriel Leyva performed the cerebrospinal fluid analysis.
“Dr. Gabriel Leyva. - Clinical analyses;
August 9, 1935.
Mr. C.G. in town.
Analysis of cerebrospinal fluid
Signature: Dr. Gabriel Leyva.”
As in all the cases where there has not been much progress of the disease, the improvement began as of the first applications of the Cellular Therapy. There were altogether 9 applications before he was discharged, but after his tenth we extracted cerebrospinal fluid from him, and the results were:
Dr. Gabriel Leyva. - Clinical analyses.—
Rep. of Cuba 73, Mexico, D.F.
September 19, 1935.
Mr. C. G. in town.
As the number of leukocytes observed was still abnormal, we gave him two more treatments, with the indications that after a few months have passed, he would return for more tests, and in effect on the April 12th., 1943 the second analysis reports:
“Medical Laboratory of the Regina Clinic.
Dr. Teodoro Chávez T.
Regina 24, Mexico, D.F. Tel. Eric. 12-25-78,
April 12, 1943
Regards, Dr. T. Chávez T.”
The serological data of cerebrospinal fluid amply confirmed the state of mental and physical health of Mr. C.G. Since 1935, we have been observing him almost continually, and he has never had anything resembling the serious disease he had and which was classified as incurable: At the present time –1952–he has been having premature ejaculations for two years. Are they due to the gonorrhea he suffered when he was younger?
Case # 4: A.C., Male, Age: 27, lives 838 Insurgentes Ave., at the beginning of National Ave., December 12, 1938.
Over 20 days ago, the family reported: All of a sudden he experienced contractions, which have been increasing in intensity and frequency, like epileptic seizures, without losing consciousness. In each access [episode] he has bitten his tongue to such degree that he constantly bleeds from the mouth. He has not been able to eat all that time, swallows some liquids with great difficulty, because it seems that he chokes when they are ingested; does not sleep, has lost much weight, and has severe chronic constipation since he has been in this situation.
He had pains in both legs before being in this condition, complained of pains in epigastric area that, according to some doctors who were treating him, were from a gastric ulcer.
Individual of very weak constitution, emaciated, almost unconscious, has sporadic contractions, and during these, he remains in episthotonos, he bleeds abundantly from the mouth, he is not understood when he speaks, he is conscious of everything and he has a distressed expression.
He shows his tongue with difficulty, lacerated by the biting, the face twisted by muscular contraction of the facial and neck muscles, which are showing perfectly through the skin. During this examination he had eight epileptiform convulsions with predominance of the extensor muscles and especially those from both limbs. He has anisocoria, cutaneous hyperreflexia, causing the contraction and convulsions. At the examination, the muscles of the thorax, abdomen, and inferior limbs are very contracted. It was not possible to flex these limbs. The pulse is frequent and hypotensive (130 pulsations per minute), with a 38.5ºC (101.3ºF) temperature.
The sudden loss of life-related functions, first the decrease of the reflexes and soon their increase, the duration of the semi-comatose state, anisocoria, elevation of temperature, the state of the pulse and the cerebrospinal fluid results, that were performed by Dr. Gerald Varela, whose Pandy, Wassermann and Kahn tests were intensely positive, take us to the diagnosis of Neurosyphilis with cerebral hemorrhage by miliary aneurysm.
Because of the gravity of the patient’s condition, at 3:30 PM of December 4, 1938, without the customary preparation and previous warning to the relatives that he could pass away from his grave condition, the first Cellular Therapy treatment was given to him. That same day he experienced some improvement, because he could pass liquid foods. As the treatments were applied to him, gradually all the symptoms disappeared until 10 of them were completed. He was discharged and to date he continues in a state of perfect health.
Case # 5: M.P., Male, Age 22, Weight 41kg (90lbs.), residing on Coral street of this capital.
During the first days of April 1939, his relatives clearly observed a change of character. Phobias appeared, in particular persecution delirium, with psychic inertia, mutism, and great sadness. Melancholy with complete memory loss and retarded association of ideas. He had no will power, indifferent to everything, showed expression of pain, he did not answer any questions posed to him, he was scared of everything that surrounded him to such degree that he rejected his relatives for the same reason.
After two months, a mental illness was diagnosed, because all the symptoms were defined and others had appeared. After passing through several doctors specialized in these diseases, Dr. D. Santiago Ramirez indicated that he should be committed to the sanatorium of Cholula, Puebla, because his disease was not curable, and according to the opinion of most of the specialists he could have some recovery in that sanatorium. Before being committed, cerebrospinal fluid was extracted from him.
The Chemist Pedro Reynoso F. located Independencia 8, of this capital performed the luetic reactions for him, and the results were:
Wassermann, Kahn and Ballen-Muller, weakly positive; in the blood they were negative. During four months he was subjected to the classic intensive antisyphilitic treatments along with fevers produced by electropyrexia. The result of that treatment is that the patient became extraordinarily emaciated, to such degree that to eat they had to bring food to his mouth, without obtaining any improvement of mental and neurological symptoms improvement. On August 25 of the same year, and as a last resort he was brought from Cholula, ill, cachexic (in a state of general physical wasting and malnutrition), lying in bed motionless, indifferent to everything, weighing 41kg (89lbs.). He did not answer any questions, he was turned over and moved around without the least manifestation of protest, because he was almost a corpse. He had: tendinous hyperreflexia, pupillary inequality (anisocoria), lack of reflexes and adaptation to the light; extremely emaciated, absolute indifference to everything done for his examination.
The cerebrospinal fluid extraction was performed on him, and was sent to the same Laboratory and the results were:
Almost without any hope of improvement, only to please the relatives and to fulfill our mission, we began to apply Cellular Therapy.
There were 17 applications of this Therapy. During the first ones, he had some cardiac collapses that were immediately taken care of. We began to notice the improvement as of the eighth application, as much in the mental symptoms as in his physical state, to such degree that he recovered his memory and recounted to us all the sufferings he had endured during his state of concern. At the present time, he is a young optimist, weights 65kg (143lbs.), works in a store of this capital. In February of 1940, with the same Chemist Pedro Reynoso, performing the cerebrospinal fluid examination the results were:
I still check this patient, his condition is excellent.
Case # 6: F.E.R., Male, Age 47, Weight 60kg (132lbs.), 70mg of blood glucose.
He had malaria about ten years ago, from which he apparently got cured, he does not have any more pathological or personal antecedents of importance.
For about three months, after being during many days without sleep, he began to be anxious, excited, and angry. After a few days of this situation, he became aggressive with the whole family, which motivated him to go to the Military Hospital, where after all the laboratory and mental examinations, he was sent to Manicomio Hospital. At this time, his condition was the following: constant agitation, anxiety, spends the whole day distributing money and jobs, pretends to be a general with enough influence with statesmen worldwide, says that he has a lot of money to buy airplanes and all the material to motorize the army with his own funds. He will speak on the radio to everybody, has ties with the president and with all the generals of the army, he tears up his civilian clothes and improvises military uniforms; he frequently kneels and prays, he repeats three or four times the same syllable, his feelings of affection towards his children and his wife are exaggerated.
The examination was very difficult, nevertheless we collected the following data: the pupil of the left eye is much smaller that the one of the right; there is no reaction to the light in both; dysarthria is very pronounced; logorrhea is clearly obvious; the tendinous reflexes that could be explored were very increased; the results of the Military Hospital laboratory are:
July 20, 1939.
The certificate of the Manicomio says: “The undersigned Director of the Manicomio points out that: from the existing records in the individual file it appears that the patient, entered in this establishment for his medical attention last July 19th, is still being confined for observation and treatment.
Likewise pointing out that, according to the diagnosis written by the attending Medical Officer, that he suffers from PARALYTIC DEMENTIA. At the request of Mrs. N.E. who is constituted his guardian, and for the uses that best suit her, this document is delivered in Mixcoac, D. F., on August 10, 1939.
Director Dr. Manuel Guevara Oropeza."
Since this patient has been under a restraining order, the opinion of the medical experts was: “The Direction of the Legal Medical Service, The Honorable President Judge Armando Zárat, and Judges Arturo Baledón Gil and Salvador Iturbide Alvírez. The Honorable Judge under the terms of article 437 of the Civil Code of Procedures declared the hearing open. Subsequently the Judge continued with the procedure decreed upon by Article 505 of the Civil Code of Procedures, consisting of the Prejudicial Opinion, and by the opinion formulated by the Medical Experts in the following testimony. They answered the questioning formulated in these terms:
I. – That Mr. F.E.R., appears to have a mental illness.
II. – That the illness in question is General Progressive Paralysis.
III. – That said illness is incurable.
Consequently Mr. F.E.R. finds himself incapable of conducting himself in the performance of the acts of his civil and legal life. – Proceeding with the allegations of the parties... Mexico, D.F, on September twenty-fifth nineteen hundred thirty-nine... Resulting:. 1st. ... – A restraining order is declared upon the Captain F.E.R. A true copy extracted from the original decree by the Highest Magistrate, Judge Guillermo Castillo Tielmans”.
Twelve applications of the Cellular Therapy treatment were performed on him. As in all the cases, as of the first applications all symptoms began to disappear. After he had received six, he was found clinically healthy; at the two and a half month mark, he was discharged. All his mental and physical functions were completely normal. In view of that, he was found healthy, and since he was not in full use of his legal and civil rights, the lifting of the restraining order was sought. After numerous examinations of every type, performed by many experts, the Highest Magistrate declared:
“First: – The restraining order in which is found Mr. F.E.R., is lifted, according to the decree of September twenty-fifth nineteen hundred thirty-nine, by virtue of his being found at present fully qualified to conduct alone the acts of his civil and legal life.
Second: – Consequently, being sufficiently apt to handle your interest on your own, I terminate the guardianship under which you were subjected.
Third: –Consequently, the guardian is cautioned to give a good accounting under the terms established by article 602 of the Civil Code.
Fourth: – Notified. – Thus resolved and signed by the Honorable Judge Rodolfo Castillo Tielmans, the Highest Magistrate of this capital. – In good faith. R. Castillo Tielmans E. Altamirano.”
Case # 7: J.F.A., Male, Age 26, Weight 45kg (99lbs.), with 83mg of blood glucose and with a pH of 7.20. (See graphic). He lives in Zacatecas, Zac. (April 18, 1941). Moderate alcoholism of the father, seemingly died of tuberculosis; the mother is alive and suffers frequent illnesses of the respiratory tract. There were 20 brothers of which 7 lived, and according to the patient, one of them has his tongue in shreds. The others died of various diseases and he only remembers that two were blind.
On September 21, 1940, he began to feel ill, with a strong headache, more intense in the occipital region. As time passed, the feeling spread downward to involve the whole spine, continuous and intense, exacerbated with movements without irradiation, was not relieved with the habitual analgesics. Since it began, noted the apparition of fever of recurring character that was maintained at 37.5°C (99.5°F) until mid-day, rising in the afternoons up to 40°C (104°F). The doctors attending him diagnosed Malta fever, diagnosis that was confirmed by the Laboratory of Dr. Perrin on October 2, 1940. He was treated during 4 months with Tripaflavina, Prontosil and vaccinations of Behring against Malta fever. With these medications the extreme pain disappeared. On December 15th., he considered himself healthy. On March 2, 1941, that is two and a half months later, he felt general asthenia and a great sensation of distention in the testicles, the left one increasing in size in three days. The fever returned with the same parameters of the first time; he had hiccups for three days. New treatment of Prontosil, vaccinations and pomades in the inflamed area, achieving the disappearance of the orchitis and returning to normal temperature. But at the same time he began to feel a great sensation of cold in the lower limbs and a very troublesome numbness in the toes “as if they were clinched,” and this spread to both legs, which hindered him to walk. The fingers began to feel the same sensation as in the toes. The symptoms of the lower limbs progressed until impeding his walking and all movements. He presented himself to the Clinic in this condition on April 19, 1941, by recommendation of Dr. Servando Osornio. Besides the symptoms already mentioned, the patient says that he no longer feels his upper limbs, that there is urine and fecal retention, for which almost daily they have to catheterize him. He has a great deal of difficulty breathing, does not sleep, has phobias, no longer walks, nor can remain standing.
Very pale individual, emaciated, arrives carried in his relatives arms, therefore does not take a single step. Diminished photomotor reflexes, positive Argyll-Robertson, pale buccal mucosa, the mandible ganglions of ligneous consistency are palpable, small, and free. Abdomen deformed in the hypogastric region, of apparently normal volume. The spleen is palpable two and a half centimeters off the rib edge, resistance in the hypogastric region; percussion verifies splenomegaly. The liver volume is also increased. Upper limbs are very emaciated, movement amplitude of the fingers is very diminished; forearm muscles are very flaccid, tendinous hyperreflexia of the upper limbs as well as the lower; sensibility to pain, to temperature, reduced to the touch. Flaccidity and emaciation of the lower limbs, whose voluntary movements are totally missing, the same as the right cremaster muscle, the left only diminished, Babinski-positive, with retrograde amnesia.
For some doctors this picture corresponded to a localization of Brucellosis in the medulla. Facing the gravity of the patient’s condition, and in view of his opposition to the extraction of cerebrospinal fluid in order to make the exact diagnosis of his many disorders, I had to give him a test procedure for Brucellosis, that did nothing but aggravate the condition of the patient.
On April 21, we began antisyphilitic treatment using Cellular Therapy; the improvement was apparent and gave us the right to think that what the patient had was TABES DORSALIS in a paralytic period that quickly evolved.
In inverse order in which they started, all the symptoms began to disappear, meaning that, the dyspnea and the symptoms of the upper limbs, first; then, the lower He began to walk with the help of crutches, then canes, and so on, until walking alone. When he returned to his birth place, there were no symptoms of illness; but he lacked abdominal reflexes. This first period of treatment comprised between April 21, and July 26, of the same year. Dr. Ezequiel Haro of Zacatecas, performed the application of 10 more treatments, and in a letter dated September 3rd. the patient says that he only had a slight numbness in the sole of one foot. On October 29, 1943 he sent a report saying that he is completely cured of all his disorders, that he is dedicated to all his activities better than before the illness. The last letter from this patient was sent in January of 1946 where he maintains that he does not even remember all the troubles he had.
This subject continues to be perfectly healthy, in 1952.
Case # 8: M.D., Female, Age 42, Weight 70kg (154lbs.), lives in the capital of this Republic, (April 28, 1944).
The patient is in her bed, unconscious, lamenting constantly. The relatives informed me that ten days ago after an abundant supper, in the middle of the night, she began to have convulsions and when these ended, she could not speak and was left in that condition, paralyzed on one side, also including the face of the same left side.
Ice on the head, different cardiac tonics, laxative enema, and the extraction of the cerebrospinal fluid was indicated by the doctors, without obtaining any improvement. The result of the examination of the fluid was:
Study of the cerebrospinal fluid of Mrs. M.D.F.,
Results: – Physical study:
Bordet-Ruelens gradual method): Intensely positive († † †),
Reaction Ballon II of Muller: Intensely positive († † †).
Lange’s Reaction (Borowskaja technique): Positive,
Regards, Affirmed. Dr. D. Diez del Castillo."
She didn’t answer any questions addressed to her. Something moved the mouth that was deviated toward the rightwhen we insisted on questioning her. There is continuous sialorrhea and draining of liquids that were put in her mouth. The left eyelid is semi-closed and does not open. The pupil of this eye is immovable to the light and to the surroundings. The husband and the relatives who have taken care of her say that when she tries to see with that eye she sees double. All these data are telling us that there is a total paralysis of the common ocular motor nerve. The tendinous reflexes of the whole left side were exaggerated, the cutaneous reflexes of the same side are missing, she could not make any movements with that side, the upper and lower limbs being flaccid. The pulse was slow and hypotensive. With a slight fever, she had and complained of an intense headache. The sphincters were asthenic in their operation and for that reason there was retention of fecal matter and urine.
The relatives informed me that a few months ago, she was in intensive care for something luetic that had been diagnosed by all the doctors. This is how this grave condition appeared in the middle of a well directed classic treatment. She was condemned by the last doctors who were at her bedside, because they indicated to her relatives that the most efficient medical resources had all failed, and for this reason they could no longer take care of the patient because, one moment or another she would die. They gave ample authorization to take care of her without any difficulties.
Without the proper preparation we proceeded to give her an emergency Cellular Therapy treatment, with many precautions to treat a patient almost dying. On May 2, we gave her the second treatment, and finally on June 29, of the same year we discharged her because she was completely cured. As the treatments were applied, her improvement increased; the ocular disorders were the last ones in being restored. We confirmed in the course of this treatment that she was positively seeing double with the bad eye. First she began to see well and at the end she could move the left eyelid as before the disease. No trace remained from this disease. After a few months the cerebrospinal fluid was extracted from her, and the results were:
Cerebrospinal fluid tests results:
Deviation of the complement, 0.05 cc. neg. – 0.25 cc. neg.,
Mastic Reaction: 2111000000,
Cells Count: 4,
Nonne Apelt: Negative,
Total Albumin: 26mg per 100cc.
Dr. E. Kunewaider. (Mark). – Reg. – 4513.
Case # 9: A.N.G., Male, Age 54, Weight 80kg (176lbs.). He lives in Miguel Jacintez 22 of this capital.
He does not have personal antecedents of importance. During this disease he had pulmonary congestion.
Three months ago he began having trouble sleeping, somewhat excited and nervous at the smallest contrariety. After a few days of this situation, his nervous excitation became so extreme that he struck all his relatives and since then has delirium of grandeur. He says that he performs miracles, some times becomes a woman, at other times becomes Pancho Villa, and as such, he wants to beat them all up. He sees saints and, according to him, kneels constantly in front of them. At times he believes that he is already dead. In short, his delirium is visual, auditory, and polymorphic. He does not even recognize his relatives, he is unwashed and dresses sloppily.
It was very difficult to give him physical and neurological examinations; nevertheless some reflexes could be explored. He had exaggerated tendinous reflexes, and pupillary inequality.
After having been attended by several doctors specializing in these diseases and in view of the continued gravity of his condition, on April 18, he was brought to us by his relatives tied-up all the way down to his feet, because he was moving continuously and had logorrhea. The previous doctors had already indicated the utility of extracting cerebrospinal fluid but it had been impossible for them. Thus, being helped by many persons and in the presence of Dr. Ernesto Cervera Castellanos, we extracted the fluid the blood from him to make the corresponding analyses. Taking advantage of the opportunity offered by the extraction of cerebrospinal fluid, we gave him the application of the first treatment, in view of the great excitation that did not leave any tranquil moment to the family. The treatment was directed to nervous syphilis that the previous doctors were also treating. Two days later Dr. Ernesto Cervera Castellanos gave us the following report:
As will be observed in the examination of the cerebrospinal fluid, no alterations exist indicating nervous syphilis nor any other disease of the nervous centers. The data expressed by Dr. Cervera corresponds to a completely normal subject, neither are there positive reactions in the blood. — Even though the extraction of this cerebrospinal fluid was during the acute period of the disease, and the mental as much as neurological symptoms were at their peak. Nevertheless, all the doctors give as irrefutable fact that the cerebrospinal fluid is always positive when nervous SYPHILIS evolution exists and during the acute period. This case, and others that we have, so obviously explicitly disproves a medical axiom that daily confuses the specialists of these diseases, and which is also always fatal for the patient.
During the year 1946 we began to use penicillin; but the doses were very low, not more than 100,000 Units, intramuscularly. At first; we were raising the doses little by little this way. Then later, as we use it now, we used it both ways; intravenously and intramuscularly; regularly, 500,000 Units intravenously and 1.500,000 Units intramuscularly. We use this dosage when we do not use arsenic salts. From that date on, we mixed penicillin with Bismuth Thioglycolate of sodium 200mg, representing 75mg of metallic bismuth.
Intravenously, when the Therapeutic Moment arrived at its peak, glucose solution was applied in the first syringe of 20cc, at 50 % as vehicle and
4–oxy–3–acetylamino–3'–glucosamino–4'–oxyacetate of sodium arsenobenzene (whose arsenic content is of 20 %) 10g,
bi-distilled water 100cc.
½ cc of this solution being applied this way.
Obvious signs of improvement were observed from the first application. After the second treatment, the patient let us make all the manipulations of this curative procedure. There were 10 applications needed to become healthy, mentally and neurologically. It has been 9 years and we continue to observe him in full physical and mental activity.
< to continue 4 >