use of doses of up to 500 mg a week, causing a series of
serious side effects, which led almost to its proscription. This
new form of treatment was introduced in the United States
with considerable scepticism. After almost a decade of In
1938 , Sir Stanley Davidson at the Empire Rheumatism
Council suggested carrying out the first double-blind
multicentre study, a project that was delayed due to the
Second World War. Frazer in 1944 went ahead and carried
out the first controlled study, publishing his results in 1945 ,
finding a clinical improvement in 82 % of the 57 patients
treated and in 45 % of the 46 controls. The reports presented
by Snyder in 1939 and by Ellman in 1940 stand out at this
time. In 1957 the Empire Rheumatism Council initiated its
multicentre study by treating 99 patients with sodium
aurothiomalate (Myochrisine), which was compared with 100
patients receiving placebo in a double-blind study, finding
significant clinical and laboratory improvement in patients
receiving the drug, but no significant relationship with
radiological progression. The cooperative committee of the
Americam Rheumatism Association in 1973 definitively
established its usefulness in RA, and encouraged its
prescription by physicians. Initially, gold salts were only
administered parenterally due to the failure of oral
compounds (e.g. Sorbié aurolevate). In 1976 , a new
compound, auranofin (Ridaura), began to demonstrate its
usefulness by this route.
https://sisbib.unmsm.edu.pe/bvrevistas/reuma/v 03 _n 1 /temas_
revision.htm[ 74 ]Studies: In the early days of scientifically studied
chrysotherapy, in the first cases observed there were never
adequate control groups against which to compare the results
obtained; there was also the fact that in the 1950 s and 1960 s,
different clinics evaluated arthritis on the basis of different
criteria. But this did not stop further clinical and scientific
studies. In a double-blind, carefully controlled study of
approximately 200 patients, part of whom received
supportive care plus small doses of gold 1 / 100000 of the
dose for the treated group, while the other group received
weekly gold treatment for a period of 20 weeks, an
improvement was noted for a period of one year in those who
received gold as judged by functional capacity, number of
analgesic drugs taken, erythrocyte sedimentation rate and
some other indices, but without any change in the
radiological appearance of the joints. Fourteen of the patients
in the treated group developed toxic effects, twice the
frequency of occurrence in the control group. During the
second year and without any further treatment, a reverse
trend appeared, so that by the thirtieth month most of the
advantages that had been obtained in the gold-treated patients
no longer existed at 18 months, although for some criteriaand Junker in pulmonary tuberculosis. These same authors
further reported the lethal dose in rabbits of 15 mg/kg of
potassium auritianide, and established the therapeutic dose in
humans at 20 - 50 mg every 2 - 3 days in adults and 5 - 30 mg in
children. Feldt, also in 1913 , used other gold salts as
antimicrobials in vitro, clarifying that it was the presence of
the gold and not the salt that was implicated in the inhibitory
effect on microbial growth. He also successfully treated
induced streptococcal infections in rabbits. Feldt investigated
various gold salts for clinical use in The first of these was
sadica aurothiosulphate (Sanochrysine), introduced into
practice in 1924 by the Dane H. Mollgaard as an
antituberculous agent. In the following 5 years in the Acta
Tuberculosea Scandinavica, 32 reports related to
chrysotherapy in the treatment of human tuberculosis had
already been published. The first attempt to use gold in the
treatment of non-tuberculous diseases was made by Landé in
1927. His hypothesis was based on the fact that gold had a
non-specific antiseptic effect, and that with the discovery of
low-toxic salts such as aurothioglucose (Solganal), it should
be investigated in the treatment of other infectious diseases.
He then reported the use of Solganal in 29 patients with
bacterial endocarditis and others apparently with rheumatic
fever. Landé was emphatic in reporting that the joint
complaints of the patients he treated were the most improved.
In 1928 , the Frenchman Jaques Forestier initiated the use of
sodium aurothiopropanol (Allochrysine) in the treatment of
rheumatoid arthritis (RA). At that time, the therapeutic
measures used to control the disease were based on
physiotherapy sessions, aspirin, various vaccines, and the use
of chemical substances such as ammonium orthoxybenzoate
in the United States and iodalcoilate in France. Some shared
the microbial aetiology of RA, implicating mainly
streptococcus or tubercle bacillus, or considered it also as a
clinic of syphilis. Forestier initially used sodium
aurothiosulphate intramuscularly in approximately 100
patients, in doses of 10 mg weekly to a total dose of 1. 5 to 2
grams, the clinical experience in 44 of these patients that he
was able to control adequately was reported as very good in
17 , good in 16 , moderate in 10 and negative in 1. In 1935 he
reported his experience in 550 patients, and reiterated his
conviction that RA was infectious in origin. Hartfall et al.
later reported benefits in 80 % of RA patients in a series of
900 cases in England. The use of chrysotherapy in RA and
other forms of arthritis spread rapidly in Europe, notably
with the contribution of Gerald Siot and P.M. Deville, and
the extensive description of both the use of chrysotherapy in
RA and other forms of arthritis in Europe. Deville, and the
extensive description of both the therapeutic effects and
adverse reactions they found in their patients. The
enthusiasm produced by these results led to abuse, with the