Evening star. [volume], January 01, 1939, Page B-5, Image 21

About Evening star. [volume] (Washington, D.C.) 1854-1972

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Medical History Records Frantic Search by FederaFMen for ‘Death Elixir’ [
- *
Every Ounce
Of Mixture
Is Traced
Mountain Side and
Deserted Home
Delayed Hunt
By Rex Collier.
Death in violent, mysterious form
Stalked across the country.
Men, women and children were
being stricken—at first by twos, then
by tens, finally by dozens.
Physicians, hospital authorities
and public health officials were fran
tic. The dread symptoms were the
same in all cases—agonizing ab
dominal pains, kidney paralysis,
convulsions—then death.
Suspicion gradually was directed
toward certain bottles labeled “Elixir
Sulfanilamide” and containing a
new, fragrant, sirupy solution of the
tested, efficacious drug, sulfanila
^ mide. This drug, widely approved
for its remarkably curative proper
ties in some types of streptococcus
Infections, ordinarily was marketed
in powder or tablet form.
A telephone call from a New York
physician brought to the Food and
Drug Administration of the Depart
ment of Agriculture first word of
deaths attributed to the new medi
cal preparation. The physician had
no personal knowledge of the facts,
but he relayed to Federal officials
reports he had heard of fatalities in
Tulsa, Okla.
That telephone call set in motion
an investigation which soon was to
send practically the entire field
force of the administratiqn's in
epectors and chemists into a grim,
dramatic race against time and
death.
It was a race to retrieve or account
for every drop of 240 gallons of an
insidious “elixir of death” concocted
from a healing drug and a poisonous
commercial solvent known as
diethylene glycol.
.eteiore me strange race was over |
at least 73 persons had died horrible
deaths as a direct result of taking
the mixture and a score of other
deaths had occurred—“probably”
due to the potion.
The full story of the “death elixir”
has never been told. Many of the
details could not be revealed pend
ing the outcome of criminal pro
ceedings brought by the Govern
-ment against the manufacturer of
the solution. Dr. Samuel Evans Mas
sengill, head of a drug firm in Bris
tol, Va.-Tenn.
Dr. Massengill has pleaded guilty
to numerous counts of two Federal
criminal informations charging vio
lation of the Food and Drug Act
and he was sentenced recently to
fines totaling $26,100.
The story goes back to June, 1937,
When several of Dr. Massengill’s
salesmen reported a demand for
sulfanilamide in solution. The firm,
like many other pharmaceutical
manufacturers, was dispensing the
drug in tablet form at that time.
The comparatively new medicine was
being acclaimed everywhere for its
markedly beneficial effect on pa
tients suffering from septic sore
throat, venereal disease and various
other infections.
Dr. Massengill and his laboratory
staff tackled the problem of prepar
ing a solution of the drug for the
market. It proved to be quite a
problem, as sulfanilamide is In
soluble in water, alcohol and other
liquids commonly used for medical
solutions.
After considerable experimenta
tion. it was found that sulfanilamide
would dissolve in diethylene glycol,
a glycerine-like chemical with many
commercial uses.
In fact, the Journal of Phar
macology and Experimental Thera
peutics has contained a number of
I articles warning of the toxic prop
erties of diethylene glycol—of the
fatal effects of the compound on
rats and other animals.
Dr. Massengill apparently had
never read of these dangers that
lurked in the thickish, colorless,
odorless liquid w'ith which his lab
oratory proceeded to experiment
He did not take the trouble to try
out on dogs or other animals the
solution which he was planning to
place on the market by hundreds
of gallons, for human consumption.
Had he done so. the first experi
mental batch of the stuff undoubt
edly would have gone down the
sewer and the remainder of the
solvent would have gone back to
the commercial market, where it
belonged.
Dr. Massengill later admitted that
the solution was tested in his lab
oratory only for taste, color and
cdor.
Medicines, to be popular, should
have a pleasant taste, appearance
and aroma. So a dash of rasp
berry' extract wras added, and a small
quantity of saccharin for sweeten
ing, and then some caramel and
finally some elixir flavoring—until
the potentially deadly concoction
tasted fairly delectable. Amaranth
was added to give the liquid an ap
pealing reddish color.
An initial batch of 40 gallons of
m0 the finished product was made in
* Dr. Massengill’s laboratory at Bris
tol. and the formula was sent to
his other laboratory in Kansas City,
Mo., with instructions to prepare
40 gallons more for Western distri
bution.
special laoeis were pumcu aim
In the wording of them Dr. Massen
gill made a slip which later was to
prove his undoing under Federal
laws- He labeled the solution
"Elixir Sulfanilamide,” with the
statement that it contained 40
grains of sulfanilamide per fluid
ounce and that it was ‘‘suggested
for the treatment of all conditions
In which the hemolytic streptococci
appear.” The dosage, he stated,
should start with two or three tea
spoonfuls in water every four hours,
decreasing in a day or so to one or
two teaspoonfuls ‘‘until recovery.”
There was no mention of the
presence of diethylene glycol, no
warning of danger of anv kind.
Commercial distribution of the
product in gallon bottles was begun
on September 4, 1937. by a field
force of about 200 salesmen In
order to popularize the medicine
and thus promote sales, the firm
bottled several hundred one and
two ounce samples for physicians
One of the first cities to receive
, a commercial shipmen was Tulsa
Okla, There was a prevalence ol
streptococcic sore throat among chil
dren at the time. Knowing of the
curative power of sulfanilamide ir
such cases, physicians welcomed the
arrival of the drug in a syrupy forir
^ DISTRIBUTION OF MASSENGILllS ELIXIR SULFANILAMIDE ;
\ \ /_ / 0L° *K A N S. |
T LT |~l 0KV*»r
/ I. f \ •’
• POINTS TO WHICH SH1PPE0 \/T-V • » V'A
® DISTRIBUTION POINTS \ 'jpr to \
• DEATHS FROM USE OF ELIXIR SULFANILAMIDE N i/l 1
*' U1 OCMRTMMT Of MUtCUlTUM
A map showing the distribution points of elixir sulfanilamide poison and deaths resulting from it. The chart was prepared by
the Food and Drug Administration._—Department of Agriculture^hotosL
Walter G. Campbell, chief of Food and Drug Administration,
Department of Agriculture, who directed the spectacular round
up of bottles of the poisonous “elixir sulfanilamide
Gallon and pint bottles of the “death elixir” confiscated by
inspectors of the Food and Drug Administration during their
Nation-wide hunt for stray shipments of the deadly poison. Note
the absence of warning of any kind on the labels.
that children would relish. A num
ber of adults also received “elixir”
prescriptions.
Soon after taking the sweet medi
cine, the children with sore throats
became violently ill with nausea
and stomach pains. Within a few
days anuria (stoppage of kidney
functions) developed, closely fol
lowed by convulsions that racked
the little bodies until death merci
fully put an end to the agony.
Physicians and clinic chemists
frantically sought the cause of the
scourge. Sulfanilamide had been
administered in all the cases—but
the drug had never had these evil
effects before- One fact assumed
outstanding significance. In each
of the cases the drug had been
taken in a new form—a solution
manufactured by the Kansas City
branch of the Massengill concern.
By October 11 six deaths had been
reported. The Tulsa County Medi
cal Society wired the American
Medical Association for informa
tion on the composition of Elixir
Sulfanilamide. The A. M. A. tele
graphed Tulsa that it recognized
no solution of sulfanilamide and
asked for samples for analysis. At
the same time the A. M. A., which
had previously refused to accept any
of Dr- Massengill's compounds,
wired Dr. Massengill for the for
mula. He gave it with the request
it be kept confidential.
Laboratory analysis of the samples
from Tulsa confirmed the presence
of diethylene glycol, which was
suspected immediately as the deadly
agent. This information was tele
graphed at once to Tulsa.
In the meantime, on October 14,
the Food and Drug Administration
had learned of the fatalities in
Tulsa. Dr. W. G. Campbell, chief
of the administration, and his aides
issued emergency orders by tele
phone and telegraph that galvan
ized field operatives into action.
When a representative of the
administration arrived in Tulsa on
October 16 he found eight children
and one adult dead and others seri
ously ill. He wired his superiors
in Washington that all had con
sumed doses of Dr- Massengill's
Elixir Sulfanilamide.
Dr. Massengill was being flooded
with inquiries and complaints by
this time. Becoming alarmed, he
dispatched on October 15 several
telegrams to his branch offices and
salesmen, one of which follows:
“Discontinue sale Elixir Sulfanila
mide. Wire all salesmen immedia
tely. Pick up sold. Wire direct
all customers sold to return stock
unused.”
None of these telegrams warned
of the dangerous nature of the con
coction until October 19, when a
Federal inspector insisted that Dr.
Massengill send this telegram:
“Imperative you take up imme
diately all elixir sulfanilamide you
dispensed. Product may be dan
gerous to life. Return all stocks
our expense.”
A few hours earlier the American
Medical Association had issued
warnings by press and radio in an
effort to prevent .urther deaths.
Virtually the entire Food and
Drug Administration field force of
239 inspectors and chemists was
thrown into the emergency hunt
for the “public enemy” that had
been turned loose on the country.
Co-operation of State and munici
pal authorities was obtained in the
search to recover and destroy every
ounce of the death-dealing “medi
cine” before more victims were
added to the expanding death list.
Many of the inspectors performed
detective work that would have done
credit to J. Edgar Hoover's G-men.
Sometimes they found that death
had beaten them to their objective.
In other instances they arrived in
time to prevent tragic consequences.
In one case an inspector traced a
small bottle of the “elixir” to a
physician in St. Louis, Mo., whose
records showed he had prescribed
the mixture for a man at a certain
address. The inspector hurried to
the patient’s home and found him
alive, but critically ill from the ef
fects of the dose. Learning the
cause of his grave condition, the
patient bitterly denounced the solu
tion and the physician who had
given it to him. Beyond medical
aid, he died a horrible death.
The inability of medical science
to combat the ravages of the poison
made the plight of the victims des
perate, even though their condition
was not far advanced. On October
20 Dr. Massengill wired the A. M.
A : “Please wire collect suggestion
for antidote and treatment fol
lowing use Elixir Sulfanilamide.”
The A. M. A. replied there was no
known antidote.
A curious discovery of the in
spectors was that some persons ap
peared to be immune to the poison.
Several purchasers of the solution
were found to have swallowed ap
preciable quantities without ill ef
fect. Small doses were sufficient
in other cases to cause death. Tests
by Dr. H. O. Calvery, chief of the
Dr. H. O. Calvery, chief of the PMsion of Pharmacology, XJ. S. Food and Drug Administra
tion, in his experimental laboratory where tests on rats and other animals showed the fatal effects
. of the Massengill “elixir.”
f---'V
administration division of pharma
cology, showed the solution was
fatal to animals
One human victim, becoming ill,
poured some of the stuff on the
ground. His pet dog licked it up
and succumbed from the effects.
More often than not the inspec
tors found the victims of the poison
dead and buried, and occasionally
causes other than Elixir Sulfanila
mide had been cited on the death
certificates.
One inspector was sent to South
Carolina to investigate reports of
deaths following symptoms like
those of “elixir” victims in other !
places. He learned that one John
McDaniel, a colored man, had died
at Ellenton, S. C., under suspicious
circumstances. The inspector visited
a lumber mill where the Negro had
been employed and obtained the
address of relatives. At this house
the investigator was told McDaniel
had died after taking several doses
of “red medicine.”
“Let me see that medicine—it
may be poisonous,” the inspector
said.
“We ain’t got it,” came the reply.
“Who has it — where is it?
Tell me quickly- It’s a matter
of life and death,” the Government
men exclaimed, impatiently.
“It's out on John's grave,” the
colored relative declared.
Whereupon, by further question
ing, the inspector elicited the in
formation that folks of that com
munity always deposited on the
graves of their loved ones the medi
cines, glasses, spoons and other
articles of the sick room.
Explaining the necessity of se
curing the bottle, the inspector in
duced several of the Negroes to
accompany him nearly 2 miles across
fields to McDaniel’s lonely grave,
unmarked but for a motley array
of dishes, spoons, a partly filled
bottle of'tomato catsup and several
other bottles. In one 4-ounce medi
cine bottle was about an ounce of
Six-year-old Joan Nidiffer
of Tulsa, Okla., one of the more
than 70 persons killed by the
“medicine.” Her mother sent
this picture to President
Roosevelt with an urgent ap
peal for Federal control meas
ures to prevent the recur
rence of such a tragedy.
the fatal “red medicine,’’ bearing
the prescription label of a certain
physician. An inquiry developed
that this physician had prescribed
more than a pint of elixir sulfanila
mide and that four of his patients
had died after taking doses of it.
Continuing his investigation in
order to account for all of the liquid
dispensed by this doctor, ap inspec
tor visited one bereaved home and
was advised the bottle of fatal med
icine had been thrown in a patch
of weeds back of the house. A care
ful search resulted in recovery of a
4-ounce bottle more than half full
of the toxic substance.
One of this doctor’s patients—a
17-year-old white girl—had been
suffering from an infected leg, the
result of a scratch inflicted by a
piece of barbed wire. She died a
week after taking the “elixir."
Two shipments were traced to
East St. Louis, 111., where it was
discovered that 49 prescriptions had
been filled. All the prescriptions
had been issued to colored persons
and in most cases the identification
of the purchasers was extremely
difficult. One patient was listed
only as “Betty Jane, 9 months old”;
another as “Mrs. Jackson (no ad
dress;.” There was one "Willie
Smith” or. the list. All that was
I known of him was that he was “on
i relief.” After eliminating white per
S sons of similar names, the inspec
i tor was confronted with six colored
j “Willie Smiths” to investigate. He
; Anally found the right one and ob
tained the bottle before enough had
been taken to cause harm.
This same inspector followed the
trail of one prescription to the
home of a colored woman in East
St. Louis. She said she had thrown
the medicine out of the window,
into an alley. The bottle, still un
broken, was found, with enough of
the contents to kill a child.
A large drug firm in St. Louis,
Mo., had received a shipment of
seven pints. The inspector ascer
tained that five pints had been sold
to retail drug stores in various parts
of the city. To find which stores
had received the poison required a
painstaking examination of 20,000
sales slips. Within two days the
five pints had been accounted for,
and four were confiscated unopened.
One four-ounce prescription had
been filled from the fifth pint. The
patient was found—apparently suf
fering no ill effects.
In Memphis it was found that
three eight-ounce bottles had been
sold over drug counters. The names
of only two purchasers were known.
One bottle was traced to a colored
man, who disclosed he had dropped
and broken the bottle after imbibing
a negligible amount. He was able
to Identify the unknown purchaser
as a white man employed in a
grocery. The latter had not been
adversely effected by the dose. The
pair was persuaded by the in
spector to undergo hospital exami
nation.
The hunt for the third consumer
led to one Joe Brown, colored em
ploye of a filling station, who said
he bought the medicine for C. W,
Miller, white employe of the station.
Miller had died at a hospital after
drinking half a bottle of the mix
ture.
The terse hospital record or
Miller's case gives typical symptoms
of the poisoning:
“November 16—Severe abdominal
pain, nauseated and vomiting.
Acute anuria, probably chemical in
origin. Bichloride suspected.
“November 17—Condition about
same. Urticarial rash over body.
“November 19—More stuperous.
Does not answer questions.
“November 20—Acidodic. Hyper
nea. Color bluish. In straight
jacket. Measly rash over body. Hav
ing convulsions."
One Inspector was assigned to in
vestigate a shipment from St. Louis
to Blevins, Ark. He was told by a
druggist that prescriptions had been
filled for three girls. Two of these
were found in time to prevent tragic
consequences, but the address of
the third girl, Jewell Long, was not
known. The Federal officer visited
a number of nearby towns before hs
obtained a clue. At McGaskill he
was apprised that "a Long girl is
being buried down the road a few
miles.” He drove to the girl’s home
while the funeral was in progress
and, when the rites were concluded,
confirmed his fears. Jewell Long
had taken a fatal dose of the
“elixir.”
While groups of inspectors were
pressing their inquiries in cities and
towns, fellow investigators were fol
lowing elusive leads into remots
rural sections.
An inspector in quest of one small
bottle of the solution used several
forms of locomotion before catch
ing up with his quarry in a Southern
mountain region. He went as far by
automobile as roads would permit
Then he hired a horse and traveled
(See DEATH ELIXIR, Page B-8.r
OLD BELIEFS ABOUT HEALTH IN WINTER ARE EXPLODED
i _
i r
What to Do About Room Heat and Clothing Taken Up by Those
Who Have Studied the Subject; How the Cold-Air Fiend May Be
Treated by Citizens; Comfort One of Conditions to Be Sought
By Herbert Hollander.
Do you know' how to keep com
fortable and healthy in winter?
“Sure, anybody knows that," re
torts a voice from the rear pew.
“Just put on your overcoat, stoke
up the old furnace and there you
are.”
And, truth to tell, that is the
way most of us have been dealing
with Old Man Winter—and then
wondering, ruefully, why he has been
giving us such a manhandling.
No. the answer isn't quite so
simple. Because, one finds after
talking the matter over with public
health authorities, diet experts and
a varied assortment of other spe
cialists, there are lots of things all
of us can do to enable us to cope
with the harsh weather of winter
on more even terms.
Some of us do some of the things
they recommend; few follow all their
suggestions.
And the ready-voiced individual
in the rear pew, who just puts on
his overcoat and stokes up the fur
nace, certainly does represent the
average attitude.
Now if that attitude is wrong—
and the experts insist that it is—
just what should one do to keep
comfortable and healthy in winter?
Well, first of all, take the highly
important matter of ventilation.
It has been found that the most
comfortable temperature, as well as
the most healthful one, is between
68 and 70 degrees. Humidity should
not be below 30 per cent or above
55 per cent. There should be a slight
amount of air motion in all rooms,
such, for example, as is produced
by a small window opening.
Just a few years ago there was
a lot of talk about “fresh" air and
“foul” air. All outdoor air was
labeled fresh and air indoors was
supposed to be foul.
But modern science has disproved
that once widely held theory. Now
it is known definitely that the bad
effects in a poorly ventilated room
—headaches and general discom
fort—are not due to some mysterious
substance in the air that makes it
bad, but rather to excessive tempera
ture or humidity, or both.
Also it is known today that the air
from out of doors is not always more
desirable than the air indoors, and
this is especially true in those places
where outdoor air is contaminated,
especially during the winter, with
smoke, fog and dust.
The health authorities advised one
to sleep with the window open, and
open wide, if the weather permits.
But, they warn, don’t make a fad
or a fetish of the open window.
As one doctor says, “The man who
boasts to his friends that his win
dow always is wide open, irrespec
tive of weather conditions, simply is
showing off his lack of judgment.”
The point is that direct drafts,
particularly when sleeping, are pro
ductive of colds which lead to flu
and other respiratory troubles.
It is therefore tremendously im
portant to use common sense in
opening the window of your sleep
ing room during the winter. If you
are young and strong and healthy
it may be fine. But children and
old people may be injured by too
much cold so-called “fresh” air.
As one public health worker ex
pressed it: “The main thing is to be
comfortable with the window open.
Physical comfort should invariably
be your rule governing sleeping
room ventilation. If you sleep
better and awaken refreshed with
the window open a fraction of an
inch, that is the best condition for
your individual requirements. If
you sleep better with the window
wide open and the chilling drafts
are pleasant rather than disagree
able, by all means open your win
dow wide. But do not throw open
your window in cold, inclement
weather and retire with chatttering
teeth and sleep with a blue nose and
general discomfort under the mis
taken idea that it is healthful.”
The same authority pointed out
that the person who sleeps .on an
open porch or brags about how few
covers or blankets he uses, or how
flimsy the nightwear, and then
awakens numb with cold, is not
building health, but more than likely
is running the risk of illness.
Closely allied with the question
of ventilation and proper heating
is the matter of winter clothing.
This is more than just a matter
of dressing for the weather out
doors. Of great importance is
proper apparel for indoors wear.
Today homes and offices not only
are as a general rule well heated,
but too often are overheated. And.
so one's clothing must suit, say,
freezing or even zero temperatures
outside and summer heat inside
The selection of clothing also calls
for the exc.cise of common sense.
But common sense doesn’t always
rule. For example, many men who
think it “sissified” to wear under
wear which gives protection to the
legs and arms will shiver and sniffle
through the winter in summer
weight underwear. It is true that
the fverage sedentary worker does
not require woolens or ‘‘red flannels,”
but cotton “longies” often will give
that extra warmth next to the skin
which is valuable to some in cold
and stormy weather.
Much the same thing applies to
the “strong”—and foolish—person
who won't wear rubbers or galoshes
She’s dressed for it. This youngster, therefore, glowing with health, need have no fear of win
ter’s rigors because she is sensibly attired from head to toe. It’s easy to best Old Man Winter if
I you’re careful._____
! when the going is wet underfoot.
Wet feet make one susceptible to
the cold germ by lowering resist
ance. Many a man who thinks
he has ‘‘put one over” on his wife
by leaving his overshoes home soon
finds that he has become the victim
of his own false pride, vanity,
laziness or what have you.
And then there’s the chap who
insists on going hatless all winter
long. Surely, some among us seem
to be able to do it without bad
effects. But doctors say that much
A
sinus trouble is being caused by
this practice. Most of us are better
off for some form of headgear dur
ing the winter months.
There is a close connection be
tween winter health and comfort
and the kind of clothes one wears,
and the individual should do a
bit of experimenting to discover
which weights suit his constitution,
place of employment, home heating
condition and other factors best.
The experts emphasize the impor
tance of finding out just exactly
i
what kind of outer and Inner cloth
ing affords the greatest comfort
and the surest safeguard against
colds.
On this point it should be borne
in mind that too heavy clothing
may be quite as conducive to colds
as too light apparel. If you are
overheated—either by a poorly ven
tilated room, too much clothing,
or both—you will perspire. Then
’when you are chilled by a draft
or by going outside, tha possibility
of patching cold Is vastly Increased.
M