Killer Killed

Every year 450,000 people in the U. S. get pneumonia. Every year more than 100,000 of them die. Next year, if they receive prompt and proper medical care, there seems to be no reason for more than 36,000 people to succumb to the suffocating disease that up to now has been the nation's third biggest killer. The official news of this medical triumph came from the Food and Drug Administration, which last week licensed the sale of sulfapyridine (M. & B. 693).

Sulfapyridine, one of the 1,000 relatives of sulfanilamide, acts on all 32 types of pneumonia. First used in England last year by Pathologist Lionel Ernest Howard Whitby of London's Middlesex Hospital, the drug was given a seven-month workout by conservative experimenters in hospitals all over the U. S.

In the first large-scale U. S. clinical report on sulfapyridine, published last month, Dr. Harrison Fitzgerald Flippin and associates of Philadelphia cautiously announced that the drug reduced pneumonia mortality from about 25% to 4%.

But last week Professor Charles Fremont McKhann of Harvard threw figures to the winds, joyfully proclaimed to the Dallas Southern Clinical Society: "People just won't die from pneumonia any more."

Sulfapyridine is made in 0.5-gram, yellowish-white tablets, which can be crushed in milk or fruit juices and given in small doses every few hours. Within 24 hours after the first dose, patients usually show remarkable improvement. Sometimes the drug produces nausea, vomiting or severe headache. In other cases, sulfapyridine, like sulfanilamide, may produce a dangerous decrease in the number of red blood corpuscles. Hence, it is necessary for physicians to take daily blood counts of their pneumonia patients, and give them blood transfusions if the action of sulfapyridine becomes toxic.

Contrary to first expectations, sulfapyridine cannot always be used without serums, for some patients vomit the drug immediately and cannot absorb a sufficient amount in their blood streams. And the preliminary typing of pneumococci for their appropriate serums still takes valuable time in pneumonia cases. But Dr. Perrin Hamilton Long of Johns Hopkins, first physician in the U. S. to test sulfanilamide, is already working with Dr. Eli Kennedy Marshall, who has synthesized a sodium salt of sulfapyridine, which will be injected directly into the veins and may make serums unnecessary.

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