484 ANNUAL REPORT SMITHSONIAN INSTITUTION, 1940 



Another serious infectious disease in which sulfanilamide has pro- 

 voked almost miraculous cures is meningococcal meningitis. Curi- 

 ously enough, the causative agent, which is the meningococcus, has 

 biological characteristics that are closely related to the gonococcus. 

 It has appeared only logical then to try the drug in the treatment 

 of meningococcal meningitis, and it worked. I have seen a child in 

 deep coma afflicted with the disease, to whom sulfanilamide was ad- 

 ministered, and within 72 hours an almost unbelievable transforma- 

 tion in physical well-being occurred. At the end of that time, he was 

 sitting up in bed playing with his toys. Even though we have potent 

 immune serum for the treatment of this disease, sulfanilamide ap- 

 pears to offer the best form of therapy. Whether serum should be 

 used along with sulfanilamide is still an open question. 



There are several other diseases that are either cured or favorably 

 influenced by sulfanilamide therapy. Trachoma, which is a painful, 

 chronic infection of the eye often resulting in blindness, has yielded 

 in some instances to sulfanilamide. Many infections of the urinary 

 tract, such as cystitis, and pyelonephritis are permanently cured by 

 this drug. Sulfanilamide is apparently of some merit in the treat- 

 ment of undulant fever, a disease transmitted to man either directly 

 or indirectly from cattle and hogs. However, we have encountered 

 disappointing results in several patients with undulant fever treated 

 at the University Hospital. 



Wliile we can continue to extol the virtues of sulfanilamide, and 

 enumerate other infectious diseases where limited data show that 

 sulfanilamide is a helpful remedy, time does not permit. It should 

 be pointed out that there remains a group of infectious diseases where 

 sulfanilamide is of very doubtful value, and its use in some of these 

 may be actually harmful. They include typhoid fever, paratyphoid 

 fever, staphylococcal infections such as osteomyelitis, carbuncles and 

 boils, acute rheumatic fever, the common cold, epidemic influenza, 

 Rocky Mountain spotted fever, rheumatoid arthritis, and tuberculosis. 



It is of interest that the drug has been used as a prophylactic; 

 that is, to prevent disease. I shall mention only two examples. 

 Knowing that children who have had acute rheumatic fever are quite 

 likely to have a recurrence when they contract streptococcal infec- 

 tions, certain well-known physicians have given the drug in small 

 doses to these children to prevent streptococcal sore throats. The re- 

 sults are very promising, but demand further investigation to see if 

 the prolonged administration of the drug to growing children has 

 any harmful effects. Another prophylactic use of sulfanilamide was 

 worked out by the surgeons at the Minneapolis General Hospital. It 

 had been recognized for years that when an individual had a com- 

 pound fracture with fragments of bone protruding through the skin. 



