Experiments on the administration of tartar emetic by various routes.

Tartar Emetic is used intravenously in the treatment of Trypanosomiasis, Kalaazar and Schistosomiasis. It has been found by us in the treatment of Kalaazar that the average dose tolerated by human beings is 2 mg. per kilo of body weight given three times a week by intravenous injection of 2 percent aqueous solution. Intravenous injection is difficult in the case of infants, and the following experiments were made to ascertain if a more convenient route would serve in such cases. It cannot be given by mouth on account of its emetic action; subcutaneous injection leads to painful necrosis and possibly ulceration; there remains the possibility of intraperitoneal, of intramuscular and of rectal administration.

Experiments on intramuscular injection were made in four rabbits and one man; intraperitoneal injection in five rabbits; and rectal injection in three patients with Kalaazar.

Intramuscular Injection. Four rabbits were injected with daily doses, ranging in number from one to forty, of 4 mg. per kilo body weight given in various dilutions, some in one place, others at different places at each injection. The rabbits were autopsied and the tissues examined microscopically. Haemorrhage in the muscle followed by necrosis occurred after every injection.

A patient, male, age 22, weight 48 kilos, suffering from Kala-azar, was given 11 intramuscular injections of chemically pure tartar emetic during 46 days, in doses varying from 2 mg. in 4 cc. to 40 mg. in 10 cc. The larger doses gave rise to severe pain and inflammatory swellings.

Conclusion. This method invariably caused pain, swehling and necrosis, and is impracticable for continued treatment.