Two years ago I presented a paper entitled Sulfanilamide: A Fragmentary Proving. During the past few months I have conducted a supplementary proving of the same drug, a report of which constitutes the body of the present writing.
The chief difficulty encountered was the obtaining of suitable persons as provers. In this instance only two people were considered sufficiently fitted for this experiment. One was a young man of 26, the other a married mother age 31. I, myself, refrained from taking the drug because at the time I showed enough symptoms of a chronic nature that I felt a true picture of the drug action could not be obtained.
Both the male and the female prover were given the two hundredth centesimal attenuation of Sulfanilamide, a single dose being taken in the morning before breakfast. This initial dose was allowed to act undisturbed as long as any symptoms traceable to its influence were observable. No interference was made in the provers normal mode of living. In other words, no artificial set of conditions was set up under which the experiment was to be conducted, because I desired to see whether a drug disease could occur under the same circumstances as a natural disease occurs, that is, during the course of the individuals normal routine of life.
In order to allow a better particularization of what happened to each prover during the experimental period, I shall take up each in order.
C.W., Jr., age 26, male, was given Sulfanilamide 200, one dose, on April 22, 1942. There were no symptoms developed as a result of this dose. Therefore on May 5, 6, and 7 he was given Sulfanilamide 200, one dose. No reaction was observed and it was concluded that this prover had not sufficient susceptibility to the potency used to enable him to develop symptoms.
With this thought in mind, it was decided to repeat the experiment, using a lower potency of the drug. Therefore, on May 13 the prover was given Sulfanilamide 3x., a tablet triturate prepared by Boericke & Tafel from crude sulfanilamide obtained from Merck & Co. The instructions were to take a dose every two hours beginning with one tablet and increasing one tablet with each succeeding dose until he was taking five tablets at a time. A total of fifteen tablets was taken.
No symptoms were manifest until the following day, May 14, when at 3 p.m., following a cold drink, there suddenly appeared a “sore throat”! This complaint involved the right tonsil. There was no description by the prover as to the character of the pain, except that he stated that this throat was “very sore.” There was definite amelioration from hot liquids and just as definite an aggravation from swallowing cold water. Additional modalities were to the effect that empty swallowing was more painful than swallowing solid food. The soreness lasted until he went to sleep at 9:30 p.m. and was completely gone the next morning.
Accompanying the pain were swelling and redness of the right tonsil. In addition there was soft, non-painful swelling of the right cervical glands. A contradiction appeared on May 15, the following day, in that the cervical glands were more swollen after sleep, though still not painful. However, the tumefaction gradually decreased during the day and was gone by nightfall.
On June 1 the prover again took Sulfanilamide 3x in the same manner and amount as previously described but no symptoms resulted. The experiment was repeated on June 5, a total of twenty tablets of Sulfanilamide 3x. being ingested, and again no symptoms resulted. The prover was therefore requested to discontinue the experiment.
The story obtained from the female prover paints a picture of rather definite reaction to the drug which manifested itself through the gastrointestinal system, genital sphere, sensorium, skin and extremities. The written report from the prover is rather verbose, therefore I shall condense it into its essential features.
One powder of Sulfanilamide 200 was taken March 25, 1942, before breakfast-time not mentioned. No symptoms were evident until 1:00 p.m. on March 27 when there began a period of tasteless eructations lasting until 3:00 p.m. March 28. These eructations were definitely aggravated when talking. In fact the prover was uncertain, whenever she opened her mouth, whether she would “burp” or bellow-a situation faintly analogous to that produced by Aloes at the distal termination of the intestinal tract!.
Although the above symptom ceased at the time mentioned, it was succeeded by an even more embarrassing one, to wit, “the gas began going down.” Need I say more? Sudden emission of odorless flatus at any time of day or night lasted for six days “without regard,” the prover stated, “to where you might be.” There was no warning, just an explosion, induced particularly by any change of position such as stooping, bending or squatting. No pain accompanied this manifestation, the only discomfort being “bloating” or full feeling in the abdomen after eating, especially after eating lunch.
Just about the time the provers intestinal symptoms were going full blast (!), namely on March 30, there also developed the beginning of a series of eruptions- I refer now to skin eruptions-which lasted until the proving was terminated, a period of four weeks and two days.
It seems appropriate to state here that the prover was obliged to discontinue the experiment on April 28 because she developed a marked laryngitis. I could not be certain whether this was drug action or natural disease. Therefore it was thought best to disregard all symptoms developing during and following this illness.
Let us return now to the skin symptoms. The first of these appeared as an itching red “rash” appearing on face, neck, scapular regions the first day, about the upper abdomen the second day, about the region of the navel the third day. By the sixth day the “rash” had disappeared save for scratch marks. One modality observed was that the itching was ameliorated from washing in hot water; another was: “After scratching, burning.”.
At the same time, apparently, washing in hot water brought out more eruption.
On April 5, the day following the subsidence of the eruption just described, at 3:00 p.m., a different type of skin manifestation began its development. A smarting, burning papule would make its appearance upon an inflammatory base. In a few hours the papule became pustular, then several more papules would grow around the periphery of the original lesion. They healed in the reverse order. All very “sore” until they opened. In addition a “blind boil” the size of a dime appeared on the chin lasting over three days, very tender and having a continual pulling sensation. A few of the papules appeared between the scapulae.
A week later, April 12, itching papules began to appear on the inner side of the right leg thickest near the knee. They easily broke down with scratching, leaving scabs. a peculiar eruption below the knee described by the prover as “little cores that seem to raise up and you pick them off (more fun)”.
The anal region was next involved-papules smarting and burning. Apparently these became pustular and opened, for the prover says she “felt wet and very sore.” Likewise some superficial ulceration must have occurred, for the prover spoke of “red sores with no heads” which itched. Soreness, smarting and burning were the chief sensation, aggravated by exertion and walking, ameliorated from bathing parts in hot water.
The perianal lesions lasted over a week. The prover has this comment to make, “I used to have this trouble dating back to a kid eight years old when I had that kidney trouble. . . only then it used to cause large sores. . . as the kidney trouble got better, the itching and breaking out stayed on. This was really cleared up by Sulphur and I have had almost none of it in the last five or six years”.
On April 20 some more “pimples” on the face with sensation of stinging and pressing outward.
On April 22 a papule erupted on the inner side of left knee with pricking-outward sensation. The power remarked, “It feels as if I had a piece of steel in it and . . .even scratched my other leg when I walked. Eventually she dug out a little hard core.
On this same day a sudden attack of syncope appeared after breakfast, which was relieved by sting bent forward. The prover reported, “I got up dizzy and a little sick to stomach”.
She felt too hot and immediately another syncopal attack occured, relieved in the same way. “Dizziness” persisted all the morning, described as a wave of heat from stomach to head followed by vertigo; felt as if heard were whirling and there was a sensation as if she would fall to the left. These symptoms were better in the open air, by sitting with head low, or merely by sitting.
On April 20 the prover stated that a great deal of the soreness of the spine which had been present for the past year had disappeared.
With respect to the genital sphere, the symptoms recorded were not many. The prover definitely reported sudden onset of menses in the morning. As a rule she exhibited a scanty flow with much pain and backache and many small clots; pain, backache, scanty flow and small clots always going together. Under Sulfanilamide the picture was different: Colicky pain in lower abdomen the day before menses, then sudden onset of flow which was profuse with more small clots than usual but not much discomfort.
Allan D. Sutherland was born in Northfield, Vermont in 1897, delivered by the local homeopathic physician. The son of a Canadian Episcopalian minister, his father had arrived there to lead the local parish five years earlier and met his mother, who was the daughter of the president of the University of Norwich. Four years after Allan’s birth, ministerial work lead the family first to North Carolina and then to Connecticut a few years afterward.
Starting in 1920, Sutherland began his premedical studies and a year later, he began his medical education at Hahnemann Medical School in Philadelphia.
Sutherland graduated in 1925 and went on to intern at both Children’s Homeopathic Hospital and St. Luke’s Homeopathic Hospital. He then was appointed the chief resident at Children’s. With the conclusion of his residency and 2 years of clinical experience under his belt, Sutherland opened his own practice in Philadelphia while retaining a position at Children’s in the Obstetrics and Gynecology Department.
In 1928, Sutherland decided to set up practice in Brattleboro.