276 DISEASE CONTROL 



the number of vegetative organisms was considered important in order 

 to reduce the danger of the carrier as a source of infection to others. It 

 has found application in oral infections, in acute infections of the ear, 

 nose, eyes, in bone infections, meningitis, human anthrax, subacute 

 bacterial endocarditis, and many other infections, such as rat-bite fever. 

 In the case of some infections, such as those caused by CI. welchii, peni- 

 cillin must be used in conjunction with good surgical principles. Peni- 

 cillin can also find application in certain chronic cases, as in the treat- 

 ment of chronic dermatitis and in preparing infected surfaces of hands 

 for skin-grafting and infected stumps for amputation. 



Penicillin is an effective agent in the treatment of clinical infections 

 due to sulfonamide-resistant bacteria. Several strains of A^. gonorrhoeae 

 isolated from patients in whom the infection was resistant to treatment 

 with sulfonamide preparations were found to be inhibited completely by 

 penicillin. The number of organisms decreased greatly at the end of i 

 or 2 hours' contact with the substance, and no viable organisms were 

 found after 3 to 4 hours' contact. The complete absence of toxicity fol- 

 lowing the intravenous administration of penicillin, the lack of discom- 

 fort to the patient, and the rapid disappearance of clinical symptoms 

 were observed in cases of sulfonamide-resistant gonorrheal infections. 

 In all the cases reported, in addition to the clinical response noted, nega- 

 tive bacterial cultures were obtained some time between 1 7 and 48 hours 

 after the institution of penicillin therapy. Sulfonamide-resistant gonor- 

 rhea cases responded to injections of 100,000 to 160,000 O.U. Favor- 

 able responses have also been obtained in the treatment of sulfonamide- 

 resistant strains causing staphylococcal pneumonia and empyema and 

 other diseases. The susceptibility of various bacteria to penicillin can be 

 determined by means of a very simple technique. 



A favorable therapeutic response was obtained by administering peni- 

 cillin intravenously to patients with staphylococcal infections and by 

 mouth to a baby with a persistent staphylococcal urinary infection. In 

 patients suffering from meningitis, penicillin was found to be absorbed 

 more rapidly than in normal persons, and a larger part of the dose was 

 excreted in the urine. 



Penicillin has not been found to be effective in trypanosome infec- 



