SULFANILAMIDE — SPINK 483 



Hospital, were among the first in this country to show the value of 

 sulfanilamide in the treatment of scarlet fever. 



Acute otitis media, an infection of the middle ear which is so 

 common in children, is a dangerous disease. It may cause permanent 

 loss of hearing, mastoid disease, or it may extend to the meninges and 

 brain resulting in a fatal outcome. Sulfanilamide, judiciously ad- 

 ministered under the watchful eye of the physician, may often in- 

 terrupt the progress of the infection and terminate the disease 

 permanently. 



Streptococcal meningitis is the most serious of all infections caused 

 by this biological agent. Recovery from this disease was an un- 

 common occurrence before the present era of chemotherapy. The use 

 of sulfanilamide has been follow^ed by startling results. The mortality 

 rate has been reduced from 98 percent to around 20 percent. 



While the results are less dramatic in patients with streptococcal 

 pneumonia and empyema, sulfanilamide is of benefit. Mention should 

 be made of the treatment of acute tonsillitis, and pharyngitis due to the 

 streptococcus. This includes the so-called septic sore throat. Sul- 

 fanilamide is of value in those cases where the condition is definitely 

 due to the hemolytic streptococcus. But I would like to emphasize the 

 dangers inherent in administering the drug to every patient who has 

 a sore throat. As shall be pointed out, sulfanilamide and its related 

 compounds often cause severe toxic conditions which may be of more 

 serious consequence than the disease for which it is given. 



Although sulfanilamide and its related compounds were introduced 

 primarily for the treatment of streptococcal infections, it was soon ob- 

 served that other types of infections were favorably affected by their 

 use. Among these other diseases was gonorrhea. It has been esti- 

 mated that this infection afflicts around a million people a year in 

 this country. It has caused untold suffering and chronic illness in 

 its victims, some of them having acquired the disease through no fault 

 of their own. Treatment has been very unsatisfactory. Because of 

 the social stigma attached to the disease, these patients often ferreted 

 out quacks and pseudo-physicians in an attempt to obtain a cure. One 

 of the good fortunes of this age was the announcement coming from 

 Johns Hopkins University that sulfanilamide would cure gonorrhea. 

 It is now accepted that this compound is a specific therapeutic agent for 

 gonorrhea. One of its outstanding contributions is that the devastat- 

 ing complications that gonorrhea causes, such as crippling arthritis 

 and blindness, are prevented. On the other hand, the drug may have 

 caused a social menace in that infected individuals often take the 

 drug without the advice or jurisdiction of a physician. Lacking 

 laboratory confirmation of a cure, they often have a latent form of 

 the disease, and are capable of transmitting it to others. 



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