﻿CHEMOTHERAPEUTIC 
  AGENTS 
  — 
  WEINTRAUB 
  559 
  

  

  The 
  action 
  of 
  penicillin, 
  like 
  that 
  of 
  the 
  various 
  sulfonamide 
  drugs, 
  

   s 
  different 
  from 
  that 
  of 
  the 
  older 
  antiseptics, 
  in 
  that 
  these 
  newer 
  

   ihemotherapeutic 
  agents 
  act 
  only 
  on 
  certain 
  strains 
  or 
  species 
  of 
  bac- 
  

   eria 
  and 
  also 
  in 
  that 
  their 
  action 
  is 
  primarily 
  an 
  inhibition 
  of 
  the 
  bac- 
  

   erial 
  development, 
  rather 
  than 
  a 
  killing 
  of 
  the 
  germs. 
  The 
  mode 
  of 
  

   iction 
  of 
  penicillin 
  appears 
  to 
  be 
  an 
  interference 
  with 
  the 
  processes 
  of 
  

   :ell 
  division 
  while 
  growth 
  may 
  be 
  allowed 
  to 
  proceed, 
  resulting 
  in 
  very 
  

   greatly 
  lengthened 
  rods 
  or 
  swollen 
  spheres. 
  

  

  Among 
  the 
  micro-organisms 
  most 
  susceptible 
  to 
  penicillin 
  in 
  test-tube 
  

   experiments 
  are 
  the 
  gonococcus 
  (the 
  causal 
  organism 
  of 
  gonorrhea 
  in 
  

   nan), 
  the 
  meningococcus 
  (responsible 
  for 
  about 
  70 
  percent 
  of 
  all 
  acute 
  

   ?ases 
  of 
  cerebrospinal 
  meningitis), 
  Staphylococcus 
  aureus 
  (the 
  most 
  

   frequent 
  cause 
  of 
  abscesses, 
  boils, 
  and 
  many 
  surgical 
  suppurations), 
  

   ,he 
  pneumococcus 
  (principal 
  etiological 
  factor 
  in 
  lobar 
  pneumonia), 
  

   Streptococcus 
  pyogenes 
  (found 
  in 
  human 
  infections 
  of 
  very 
  varied 
  

   :ypes), 
  Clostridium 
  tetani 
  and 
  Clostridium 
  welchii 
  (the 
  tetanus 
  and 
  

   ^as 
  gangrene 
  bacilli, 
  respectively), 
  and 
  the 
  anthrax 
  bacillus. 
  Rela- 
  

   tively 
  resistant 
  pathogenic 
  organisms, 
  on 
  the 
  other 
  hand, 
  include 
  the 
  

   aacillus 
  of 
  tuberculosis, 
  the 
  vibrio 
  of 
  Asiatic 
  cholera, 
  the 
  organisms 
  

   }f 
  undulant 
  fever, 
  and 
  certain 
  types 
  of 
  dysentery 
  bacilli. 
  

  

  The 
  exact 
  potency 
  of 
  penicillin 
  cannot, 
  of 
  course, 
  be 
  ascertained 
  

   until 
  the 
  pure 
  compound 
  is 
  available. 
  Nevertheless, 
  the 
  activity 
  of 
  

   even 
  the 
  impure 
  material 
  far 
  exceeds 
  that 
  of 
  most 
  other 
  antiseptics. 
  

   Thus 
  1 
  part 
  of 
  penicillin 
  in 
  60 
  million 
  parts 
  of 
  culture 
  fluid 
  com- 
  

   pletely 
  inhibits 
  the 
  growth 
  of 
  staphylococci; 
  partial 
  inhibition 
  is 
  

   obtained 
  at 
  dilutions 
  of 
  more 
  than 
  300 
  million. 
  In 
  comparison 
  with 
  

   gramicidin, 
  the 
  antibacterial 
  agent 
  obtained 
  from 
  certain 
  soil 
  bacteria, 
  

   penicillin 
  is 
  20 
  to 
  40 
  times 
  as 
  potent 
  against 
  staphylococci. 
  Addi- 
  

   tional 
  advantages 
  of 
  very 
  great 
  importance 
  are 
  the 
  remarkably 
  low 
  

   toxicity 
  of 
  penicillin 
  toward 
  animals 
  and 
  its 
  lack 
  of 
  inactivation 
  by 
  

   pus, 
  blood 
  serum, 
  or 
  products 
  of 
  tissue 
  break-down. 
  Indeed, 
  it 
  has 
  

   been 
  reported 
  even 
  that 
  the 
  bactericidal 
  action 
  of 
  penicillin, 
  in 
  some 
  

   cases, 
  is 
  enhanced 
  by 
  blood 
  and 
  serum. 
  It 
  is 
  so 
  innocuous 
  that 
  it 
  can 
  

   be 
  introduced 
  directly 
  into 
  the 
  eye 
  in 
  the 
  treatment 
  of 
  

   conjunctivitis. 
  

  

  Even 
  the 
  first 
  clinical 
  trials 
  by 
  the 
  Oxford 
  workers, 
  although 
  per- 
  

   formed 
  with 
  an 
  impure 
  penicillin 
  preparation 
  of 
  relatively 
  low 
  po- 
  

   tency 
  and 
  hampered 
  by 
  lack 
  of 
  material, 
  were 
  attended 
  by 
  dramatic 
  

   results. 
  In 
  these 
  studies 
  the 
  scarcity 
  of 
  the 
  therapeutic 
  agent 
  was 
  so 
  

   great, 
  indeed, 
  that 
  advantage 
  was 
  taken 
  of 
  its 
  rapid 
  excretion 
  by 
  the 
  

   kidneys; 
  penicillin 
  was 
  recovered 
  from 
  the 
  urine 
  of 
  treated 
  patients, 
  

   repurified, 
  and 
  reused. 
  

  

  With 
  the 
  increasing 
  availability 
  of 
  penicillin, 
  it 
  has 
  been 
  possible 
  

   to 
  confirm 
  the 
  early 
  promise. 
  A 
  successfully 
  treated 
  case 
  of 
  Sta- 
  

  

  