Against the infection from actinomycosis in human beings there has never been any specific treatment up to now and various therapeutic agents have been suggested and tried ; for example, the internal administration of iodides, the application of Roentgen rays with surgical intervention or the radical removal of the affected part whenever possible.
The mortality in this case, however, is generally very high, although the prognosis of the disease depends on the organs affected. Cerebrospinal involvement and all pulmonary cases are always fatal and the disease of abdominal organs is also in most cases very severe. Recently since the appearance of penicillin its strong bacteriostatic action against pathogenic actinomyces has been recognized, it was clinically tested. Herell (1) treated 12 cases of actinomycosis with penicillin and reported that in the disease of face penicillin yielded very good results in its earlier as well as in its progressed stages, while it was difficult to treat with success the abdominal disease and particularly those cases with fistula. The result obtained by Ushigome and Kimura (2) was about the same. They treated 2 cases of actinomycosis and succeeded to heal one case of the disease of face but failed in another case of the abdominal affection.
As regards sulfonamides, Takemura (3) insisted that sulfonamide was effective for the therapy of actinomycosis in experimental infection of guinea pigs but we could not reach the same conclusion.
Now in our study on the treatment of actinomycosis in experimental infection, Satake (4) investigated first the bacteriostatic action of drugs against a pathogenic actinomyces, isolated from a patient of the abdominal actinomycosis, in vitro, and among 82 compounds (inclusive of 21 sulfonamides, 4 acridines, 16 phenothiazines, 4 phenoxazines, 7 quinolines, 2 quinines, 10 tetronic acid derivatives, 6 natural substances and 10 others), it was found that trypaflavin, dinitrodimethylthionin nitrate, dianilide of phenyltetrone carboxylic acid, penicillin, usnic acid, gyrophoric acid and erythrin were able to inhibit the growth of actinomyces even in the dilution of more than 100, 000 times. Penicillin was found the most effective among these (4, 600, 000), then usnic acid coming next (256, 000) . An experiment was then planned to treat the experimental actinomyces infection of guinea pigs with some of these drugs. Penicillin, usnic acid, trypaflavin and 4 derivatives of sulfonamide were chosen for this purpose. But the result showed that only penicillin and usnic acid was really effective and suggested the successful treatment of the clinical case of actinomycosis with this latter substance.
By chance we could obtain a case of the abdominal actinomycosis, treated in several ways but not cured. The destiny of the patient was desperate. And usnic acid was used for this patient with great success, of which details should be reported below together with its effectiveness in experimental infection.
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