Prontosil

Last month Mrs. Franklin D. Roosevelt, who loves few things better than a big family feast, gave up Thanksgiving dinner at Hyde Park to rush to Boston where Son Franklin Jr. lay abed with what was described to the press as "sinus trouble." The young man did have infected sinuses, and he was in the capable, Republican hands of Dr. George Loring Tobey Jr., a fashionable and crackerjack Boston ear, nose & throat specialist. He also had a graver affliction, septic sore throat, and there was danger that the Streptococcus haemolyticus might get into his blood stream. Once there the germs might destroy the red cells in his blood. In such a situation, a rich and robust Harvard crewman is no safer from death than anybody else.

Not until last week, when his mother and his fiancee, Ethel du Pont, went home, was Franklin Jr. out of danger and fit for Dr. Tobey to operate on his infected right antrum (in the cheek) and ethmoid sinuses (in the brow). Simultaneously, Dr. Tobey let it be known that his notable young patient had been pulled through his crisis by a notable new drug.

When Franklin Roosevelt's throat grew swollen and raw and his temperature rose to a portentous degree. Dr. Tobey gave him hypodermic injections of Prontosil, made him swallow tablets of a modification named Prontylin. Under its influence, young Roosevelt rallied at once, thus providing an auspicious introduction for a product about which U. S. doctors and laymen have known little.

The drug which cured young Roosevelt seems to be a specific cure for all streptococcic infections--septic sore throat, childbed fever, postabortal septicemia. It has helped to cure cases of peritonitis due to ruptured appendix, perforated stomach ulcer or gallbladder. It has been effective in postoperative wounds, endocarditis, suppurative mastoiditis, and tonsillitis. Some cases of erysipelas (also a streptococcic infection) have yielded to Prontosilmedication. The drug also has ameliorated severe cases of carbuncles and cellulitis due to staphylococcus, a different kind of germ.

So far as pharmacologists can ascertain, Prontosil does not attack the streptococci and staphylococci directly in the way that salvarsan ("606") inactivates the spirochete of syphilis. In some undeciphered manner Prontosil* stimulates the production of white blood corpuscles, guardians and scavengers of the blood stream, retards the growth of cocci.

Credited with the invention of this drug, which some responsible doctors last week were calling the medical discovery of the decade, were Professors Heinrich Horlein and Gerhard Domagk of the German Dye Trust. Dr. Horlein, director of the Trust's pharmaceutical research at Elberfeld, and Dr. Domagk, a chemotherapist, designed Prontosil's complex molecule of dyestuff. After Dye Trust synthetists made it. Dr. Domagk experimented on mice, found that it did not kill them, that it did cure them of streptococcic infections. Other German doctors tried the material on human beings, began to report success in 1935. Last June two London gynecologists reported encouraging results with Prontosil in cases of childbed fever.

Last month Dr. Perrin Hamilton Long of Johns Hopkins risked criticism by presenting a brief, preliminary report concerning Prontosil to the Southern Medical Association. Up to last week the Journal of the American Medical Association, which has the biggest (95,200) circulation of all medical publications, printed not a word about Prontosil or Prontylin. Cautious Editor Morris Fishbein, who was educated to be a pathologist, has on at least one previous occasion nearly scorched his editorial nose by prematurely poking it into news of chemical drugs. It will be a long time before he forgets publishing in his Journal a hasty report by Drs. Cutting & Tainter of San Francisco that dinitrophenol was a useful drug for fat people to take to reduce weight speedily. Dinitrophenol does reduce weight. But as Dr. Fishbein warily editorialized, ". . . it is a two-edged sword with appalling possibilities for harm as well as for good." It was soon found that dinitrophenol also causes cataracts, scarcity of white blood cells, other disabilities (TIME, July 31, 1933 et seq.).

Like dinitrophenol, Prontosil is an aro matic coal tar product. Prontosil's full chemical formula is the disodium salt of 4-sulph-amido-phenyl-2-azo-7-acetylamino-1-hydroxynaphthalene 3.6-disulfonic acid. All doctors fear new drugs derived from coal tar. They may exhibit unexpected deadliness. In the case of Prontosil, since like dinitrophenol it affects the production of white blood cells, it comes under the medical rule of thumb: what ever stimulates may also destroy. And it may be that the new drug by which Dr. Tobey cured Franklin Roosevelt Jr.'s septic sore throat may have exhausted the young man's reserve of white blood cells to be used against some other infection.

* Trade name copyrighted by Winthrop Chemical Co. Inc. of Manhattan, the German Dye Trust's U. S. representatives.

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