The Return of Ehrlich’s ‘Therapia magna sterilisans’ and Other Ehrlich Concepts?

On March 14th of this year, the birthday of Paul Ehrlich, the great German researcher and 'founder of chemotherapy', returned for the 150th time. Interestingly, his later colleague Emil von Behring was born one day later in 1854. Both were coworkers in Robert Koch's laboratory and became Nobel Prize laureates (for their work in immunology), making great contributions to antiinfectious treatments. Emil von Behring's approach was through the use of immunological agents, while Ehrlich favored an approach of antiinfectious treatment by chemical agents. Through an ingenious concept that was a clear continuation of his early days in research with dyes, he found the first chemotherapeutic agents. From his dye work, he had concluded the following: if there are dyes that one can use to stain cells, why not develop pharmacological agents that, like stains, also attach to a structure in the living pathogen and kill them. He gave these agents the emotionally charged name 'magic bullets'. This introductory review will initiate a series of papers on the occasion of Ehrlich's 150th birthday and the 'World Conference on Dosing of Antiinfectives: Dosing the Magic Bullets', which is going to be held in Nürnberg, Germany, from September 9 to 11, 2004 (see www.ehrlich2004.org). Apart from the conference topic, this conference will also commemorate a real science giant of the last century and yet a modest human being whom, as Robert Koch put it, 'one had to like'. This article recalls Ehrlich's ingenious concepts, including modern syphilis treatment, one-dose treatment ('therapia magna sterilisans') of Helicobacter pylori infections and introduction of an arsenic compound, arsenic trioxide, as well as experiments and new exciting data on Congo red, a well-known 'non-Ehrlich dye'.

Chemotherapy of haemobartonellosis in squirrel monkeys (Saimiri sciureus)

Splenectomised Saimiri sciureus squirrel monkeys are being used increasingly as an experimental host for human malarial studies, notably for the assessment of candidate vaccines against Plasmodium falciparum blood-stage infection. Recently, we have reported that colony-reared S. sciureus monkeys are asymptomatic carriers of Haemobartonella sp. and that patent Haemobartonella infection, activated following splenectomy, may interfere with the course of P. falciparum parasitaemia in these animals. For several years, splenectomised S. sciureus monkeys were routinely submitted to oxytetracycline therapy before their use in malarial studies in order to prevent a possible spontaneous Heamobartonella infection. However, we report here that such antibiotic therapy is often ineffective and that neoarsphenamine chemotherapy may be considered as an alternative to cure both latent and patent haemobartonellosis in S. sciureus monkeys.

[First results of treatment with salvarsan in Krakow]

For the first time salvarsan treatment in Cracow was successfully held in Opthalmology Clinic of Jagiellonian University by Prof. Bolesław Wicherkiewicz, who used preparation 606 in three cases at ophthalmic complications caused by syphilis infection. He received this preparation directly from P. Ehrlich.

Quadruple cancer including Bowen's disease after arsenic injections 40 years earlier: report of a case

This report describes the successful treatment of quadruple cancer including Bowen's disease in a 71-year-old man who had been given injections of salvarsan, an arsenic compound, for syphilis more than 40 years earlier. Resection of a skin lesion on his chest subsequently confirmed a diagnosis of Bowen's disease, 3 years after which he was operated on for concurrent gastric cancer and sigmoid colon cancer. A fourth cancer was discovered on his left vocal cord 2 weeks after this operation; it was resected 2 years later. A discussion of multiple malignant neoplasms and the possible relationship between arsenic and cancer is presented following this case report.

Mass treatment campaigns against the endemic treponematoses

In pre-antibiotic times, mass campaigns against the endemic treponematoses required multiple injections of arsenicals and bismuth. The essentiality of a population census, an examination of the total population, and the treatment of clinical and latent cases were all appreciated, as was the value of a multipurpose approach. It was also recognized that, in combination with the anticipated slow correction of economic circumstances and attitudes, chemotherapy was the chief weapon against disease but that this weapon, even if successful in a particular area, could not prevent later reintroduction of infection. With the introduction of single-dose penicillin therapy and the impetus of worldwide, internationally assisted mass campaigns came a dramatic reduction in incidence. However, in some areas continued surveillance by the local health services did not materialize. Thus, there has been not just a low-level continuum of disease but a resurgence, particularly in Africa, where a return to mass therapy has once again proved necessary--this time combined with multipurpose immunization.

Paul Ehrlich: pioneer of chemotherapy and cure by arsenic (1854-1915)

Paul Ehrlich's experiments in staining techniques at the end of the nineteenth century resulted in many discoveries which help to form the basis of present research work. Ehrlich's chemotherapy research led to his formulating the arsenic compound, Salvarsan, which was used in the treatment of syphilis during the first half of this century until it was superseded by penicillin.

The first Harrison Lecture, 1974. The life and times of Colonel Harrison

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