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  ANNUAL 
  REPORT 
  SMITHSONIAN 
  INSTITUTION, 
  1943 
  

  

  phylococcus 
  aureus 
  infection 
  is 
  illustrated 
  in 
  plate 
  5. 
  An 
  infection 
  

   of 
  this 
  type, 
  complicated 
  by 
  blood 
  poisoning, 
  is 
  almost 
  universally 
  

   fatal. 
  The 
  patient, 
  a 
  4-year-old 
  girl, 
  presumably 
  became 
  infected 
  

   after 
  biting 
  the 
  inside 
  of 
  her 
  cheek. 
  Redness 
  and 
  swelling 
  of 
  the 
  

   jaw 
  appeared, 
  and 
  within 
  a 
  few 
  days 
  the 
  child's 
  condition 
  had 
  become 
  

   critical. 
  Much 
  of 
  the 
  tissue 
  of 
  the 
  floor 
  of 
  the 
  mouth 
  had 
  been 
  killed, 
  

   and 
  the 
  tongue 
  was 
  nearly 
  frozen 
  to 
  the 
  hard 
  palate. 
  She 
  was 
  unable 
  

   to 
  sleep, 
  could 
  breathe 
  only 
  with 
  difficulty 
  and 
  had 
  a 
  temperature 
  of 
  

   104°. 
  There 
  was 
  evidence 
  of 
  pneumonia 
  in 
  one 
  lung. 
  Penicillin 
  

   administration 
  was 
  begun. 
  Within 
  36 
  hours 
  the 
  staphylococci 
  had 
  

   disappeared 
  from 
  the 
  blood. 
  Within 
  96 
  hours 
  the 
  child 
  was 
  again 
  

   able 
  to 
  swallow, 
  was 
  breathing 
  easily, 
  and 
  could 
  take 
  a 
  liquid 
  diet 
  by 
  

   mouth. 
  By 
  the 
  next 
  day, 
  she 
  was 
  able 
  to 
  eat 
  solid 
  foods, 
  and 
  by 
  the 
  

   ninth 
  day 
  the 
  temperature 
  was 
  normal. 
  The 
  total 
  amount 
  of 
  penicil- 
  

   lin 
  administered 
  during 
  the 
  12 
  days 
  of 
  treatment 
  was 
  only 
  a 
  little 
  

   more 
  than 
  1 
  gram. 
  In 
  another, 
  somewhat 
  similar, 
  case 
  in 
  which 
  

   penicillin 
  therapy 
  was 
  begun 
  at 
  an 
  earlier 
  stage, 
  the 
  damage 
  to 
  the 
  

   tissues 
  and 
  the 
  bacterial 
  invasion 
  of 
  the 
  blood 
  stream 
  were 
  prevented. 
  

  

  Many 
  other 
  types 
  of 
  staphylococcus 
  and 
  streptococcus 
  infections 
  

   have 
  responded 
  to 
  penicillin. 
  Cases 
  of 
  gonorrheal 
  infections 
  which 
  

   were 
  not 
  benefited 
  by 
  sulfonamides 
  have 
  also 
  been 
  cured 
  with 
  dra- 
  

   matic 
  rapidity 
  by 
  penicillin 
  treatment. 
  So 
  far, 
  the 
  results 
  of 
  exten- 
  

   sive 
  trials 
  have 
  not 
  been 
  reported 
  in 
  detail. 
  In 
  the 
  United 
  States, 
  

   clinical 
  studies 
  have 
  been 
  organized 
  by 
  the 
  National 
  Research 
  Council. 
  

   Early 
  in 
  1943, 
  clinical 
  trials 
  were 
  begun 
  by 
  the 
  United 
  States 
  Army. 
  

   Among 
  the 
  cases 
  subjected 
  to 
  treatment 
  were 
  many 
  soldiers 
  returned 
  

   from 
  the 
  Pacific 
  area 
  with 
  unhealed 
  compound 
  fractures, 
  osteomye- 
  

   litis, 
  and 
  wounds 
  with 
  long-established 
  infections. 
  Very 
  promising 
  

   results 
  have 
  been 
  obtained 
  and 
  the 
  tests 
  are 
  being 
  greatly 
  extended. 
  

   In 
  animal 
  experiments, 
  it 
  has 
  been 
  found 
  that 
  the 
  early 
  administra- 
  

   tion 
  of 
  penicillin 
  is 
  a 
  powerful 
  prophylactic 
  against 
  gas 
  gangrene, 
  

   one 
  of 
  the 
  most 
  serious 
  complications 
  of 
  battle 
  and 
  air-raid 
  wounds. 
  

  

  For 
  systemic 
  infections, 
  penicillin 
  is 
  usually 
  administered 
  intra- 
  

   venously. 
  Inasmuch 
  as 
  it 
  is 
  destroyed 
  by 
  acids, 
  inactivation 
  occurs 
  in 
  

   the 
  stomach 
  when 
  the 
  drug 
  is 
  given 
  by 
  mouth. 
  However, 
  oral 
  ad- 
  

   ministration 
  is 
  possible, 
  although 
  less 
  efficient, 
  if 
  large 
  amounts 
  are 
  

   taken 
  together 
  with 
  sodium 
  bicarbonate 
  to 
  neutralize 
  the 
  gastric 
  

   acidity. 
  

  

  Of 
  the 
  chemotherapeutic 
  agents 
  of 
  microbial 
  origin 
  which 
  have 
  

   thus 
  far 
  been 
  studied, 
  penicillin 
  is 
  preeminently 
  the 
  most 
  promising. 
  

   At 
  the 
  moment, 
  the 
  principal 
  handicap 
  in 
  its 
  application 
  is 
  its 
  limited 
  

   availability. 
  The 
  outlook 
  for 
  the 
  future, 
  when 
  the 
  problems 
  of 
  pro- 
  

   duction 
  shall 
  have 
  been 
  solved, 
  is 
  very 
  bright 
  indeed. 
  

  

  