From the above it is seen that the U. S. Public Health Service Research Grants program represents a sincere and continuing effort to supply Federal funds for the support of necessary additional research in the fields of medical and related sciences without interposing any degree of government restriction, control, supervision, or regimentation. The program is a scientific one, scientific guidance of which lies wholly in the hands of scientists.
Previous reports by us 1 have presented the results of studies dealing with the use of sulfanilamide in the treatment of gonococcic infections. In the present paper it is desired to set forth the results of a similar investigation of sulfapyridine and to compare the adaptability of sulfanilamide and sulfapyridine therapy to the treatment needs of the disease. I. SUMMARY OF EXPERIENCE WITH SULFANILAMIDEOur efforts during 1937 and 1938 were concentrated on studies of sulfanilamide therapy in gonococcic infections of approximately 1,800 hospitalized male and female patients. Under ideal conditions sulfanilamide proved to be a valuable agent in the treatment of this disease. By means of large doses (1.3 Gm.) of sulfanilamide given at four hour intervals during both day and night, it was possible to effect a high percentage of cures. Although serious toxic effects did not occur in the series, it is well recognized that the character of toxic manifestations restricted full therapeutic dosages of sulfanilamide, especially in outpatients, and consequently lessened its value as a means of reducing significantly the incidence of the disease. From the information gained from that series, which was reported previously, the following conclusions were drawn : 1. When consideration is given to the duration of the infection there is little if any difference in the curative response of male or female patients.2. Higher blood concentrations of free sulfanilamide approximating 9 to 11 mg. per hundred cubic centi¬ meters appear to be more effective in producing cures than lower levels of 3 to 6 mg. per hundred cubic centimeters. Cures and failures occur at both levels, however.3. The exaggeration of the toxic manifestations occasioned by the large doses necessary to produce and maintain the higher concentration in the blood suggests the advisability of hospitalization at least during the period of intensive therapy.4. Prolonged administration of sulfanilamide is contraindicated. If a favorable therapeutic response is not obtained by the fifth or sixth day, it is not likely to occur. Even with a curative response it is not advisable to continue sulfanilamide beyond the tenth or twelfth day. The prolonged administration even of small doses of sulfanilamide appears to act as the etiologic factor in the production of granulocytopenia.5. If sulfanilamide is given early in the course of gonorrhea, if it is given in small doses or, particularly, if given both early and in small doses it is productive of a low cure rate and apparently establishes in many failures a condition simulating a "sulfanilamide resis¬ tant" infection. 6. A febrile response of 100.8 F. or over, occasioned by sulfanilamide therapy, is an indication to suspend or decrease the amount of sulfanilamide.7. The dosage of sulfanilamide cannot be routinized. Adequate dosage of the individual patient should be decided daily on the basis of laboratory findings and sound clinical judgment.8. Sulfanilamide is capable of producing a subclinical state of gonococcic infection in whi...
AND co, 925 W e have used a Vreeland oscillator, giving a current of pure sine wave form with no direct current component, the frequency of which can be changed by small gradations between 7000 and 300 cycles per second. Since the time of stimulation is one-half of a cycle, the minimum time of stimulation may be determined, our results on the stimulation of gastrocnemius muscle of the frog in Ringer's fluid being 0.000079 seconds. With curarized muscle it was found that the minimum time for stimulation was increased to 0.00009 seconds. The tongue muscle required 0.00013 seconds. The minimal time for stimulation of smooth muscle could not be determined by means of the oscillator because a low enough frequency could not be obtained, but this presents no difficulty since Englemann was able to determine it in 1870. This is a preliminary report. 3640An Indirect Calorimeter for the Determination ,of 0, and CO,.
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