Medicine: Fatal Remedy

The newest and most spectacular specific to come to the aid of ailing man last week caused the deaths of at least 41 people, the disability of countless more, the probable ruin of a Southern drug manufacturer and a nation-wide scare, the like of which had not popped out of medicine cabinets since the Jamaica ginger paralyzed Southwestern swiggers in 1930.

Most victims of last week’s medical catastrophe suffered from gonorrhea, some had septic sore throats. Latest remedy for those grave conditions—and a good remedy in case of scarlet fever, erysipelas, and cerebrospinal meningitis—is sulfanilamide. Noting a great demand for sulfanilamide, 61-year-old Dr. Samuel Evans Massengill, who compounds veterinary medicines in a good-sized factory at Bristol, Tenn., this summer decided to add that drug to his line. Knowing that his Southern customers prefer their medicines in bottles,* he sought something in which to dissolve sulfanilamide, which had hitherto been taken in tablets and intravenous injections only. He decided to use diethylene glycol, a close relative of the alcohol used to keep motorcar radiators from freezing, never before put to this purpose. Whether diethylene glycol is poisonous by itself or in this solution was not made clear last week. The one indisputable fact was that S. E. Massengill Co. made up several 80-gal. batches of sulfanilamide solution. This was labeled an elixir, a technical pharmacological term for a drug sweetened and dissolved in alcohol, and shipped to 375 retailers. The retailers, one as far away as Puerto Rico, dispensed this “elixir” with and without prescriptions, in reddish brown flasks whose yellow labels read:

Elixir SULFANILAMIDE, suggested for the treatment of all conditions in which the hemolytic streptococci appear. Dose—begin with 2 to 3 teaspoonsful in water every four hours. Decrease in 24 hours to 1 or 2 teaspoonsful and continue at this dose until recovery. S. E. MASSENGILL CO., manufacturing pharmacists.

First warnings of trouble sounded when people who took this medicine for sore throats developed nausea, cramps and inability to urinate. First known deaths occurred in Tulsa, Okla.; next in East St. Louis, Ill.; next at Mount Olive, Miss.; then in Madisonville, Tex.; Carey, Miss.; Copley, Ohio; Clayton, Ala.; and St Louis, Mo. Autopsies revealed destroyed kidneys and livers.

Chief of the Federal Food & Drug Administration, a pugnacious Kentucky lawyer named Walter Gilbert Campbell, has agents posted throughout the country, watching for just such pharmaceutical accidents. Those men last week confiscated every last flask of the Massengill “elixir” upon which they could lay their hands. A Federal agent at Bristol said to Chief Campbell: “The most amazing thing about the company was the total lack of testing facilities. Apparently they just throw drugs together, and if they don’t explode they are placed on sale.” Dr. Massengill cooperated with the Food & Drug men by sending warning telegrams to all his sulfanilamide customers.

The Pure Food & Drug Bill up before Congress last session would have made Dr. Massengill liable to Federal prosecution. But the bill failed and there is no law which makes a pharmacist responsible to the Federal Government for selling untested drugs. However, Dr. Massengill is liable to civil damage suits from relatives of the 41 dead.

*New Englanders prefer pills.