ANTIBIOTIC SUBSTANCES 233 



place in the treatment of local and generalized infections in man. Flem- 

 ing was the first (265, 266) to recommend that it be employed for 

 dressing septic wounds. It appeared to be superior to dressings contain- 

 ing purely chemical agents. Isolated penicillin in a dry state was many 

 times more powerful than the most potent of the sulfonamide com- 

 pounds (267, 271 ). Local applications include those to lesions of the eye 

 produced by S. aureus, in which early treatment resulted in the elimina- 

 tion of the organism from the flora of the conjunctival sac (758). 

 Weight for weight, penicillin was found to be four times as potent as 

 sulfathiazole and 100 times as potent as sulfanilamide for the treat- 

 ment of wound infections (7, 272). 



Penicillin proved to be an especially effective agent for the treatment 

 of staphylococcal and hemolytic streptococcal infections in man (725), 

 including streptococcal meningitis (270). Many cases of infected war 

 wounds treated with penicillin gave, in 24 hours, a uniform drop in the 

 number of gram-positive organisms, including Clostridia, staphylococci, 

 streptococci, and corynebacteriaj the gram-negative bacteria were not 

 affected. Excellent therapeutic effects were obtained. Even crude cul- 

 ture filtrates of P. nolatum, applied locally, gave good results (242, 

 707). 



In order to lessen the frequency of effective invasion of the nose by 

 bacteria and the subsequent infection of the nasopharynx, the use of 

 penicillin as an antiseptic snuff was suggested (166). The material acts 

 as a prophylactic against bacterial infections of the upper respiratory 

 tract } the course of a cold could thus be checked by preventing second- 

 ary bacterial infection. The curing of nasal carriers of staphylococci or 

 even the reduction of the number of vegetative organisms was consid- 

 ered important in order to reduce the danger of the carrier as a source of 

 infection to others. Penicillin can also find application in certain chronic 

 cases, as in the treatment of chronic dermatitis and in preparing infected 

 surfaces of hands for skin-grafting and infected stumps for amputation 



(277)- 



Penicillin is an effective agent in the treatment of clinical infections 

 due to sulfonamide-resistant bacteria (39, 136, 137, 143,252,400,576). 

 Se\'eral strains of A^. gonorrheae, isolated from patients in whom the 

 infection was resistant to treatment with sulfonamide preparations. 



