SULFANILAMIDE–A FRAGMENTARY PROVING


SULFANILAMIDE–A FRAGMENTARY PROVING. Ever since para-amino benzene sulfonamide, or Sulfanilamide, came into general use as a therapeutic agent I have had a desire to make a proving of this substance. When Dr. Roberts asked me last fall to prepare a paper for the Bureau of Materia Medica, I determined to begin this project and to report my findings to this Bureau.


For five years Sulfanilamide has made the headlines of medical news, not only because of the startling cures assigned to its actions, but also because of the no less startling by-effects attributed to this drug. As physicians we are interested in the cures, but as homoeopaths we should be equally interested in the by-effects, because the latter represent a rather crude pathogenesis of Sulfanilamide.

Ever since para-amino benzene sulfonamide, or Sulfanilamide, came into general use as a therapeutic agent I have had a desire to make a proving of this substance. When Dr. Roberts asked me last fall to prepare a paper for the Bureau of Materia Medica, I determined to begin this project and to report my findings to this Bureau. Through the kindness of Boericke and Tafel of Philadelphia I was able to obtain Sulfanilamide in the crude form and also in the 3x. and 6x. triturations. The crude Sulfanilamide powder was manufactured by Merck & Co. and the triturations made from that. Dr. Roberts supplied me with the 200th, also prepared by Boericke and Tafel.

There was some difficulty in finding provers, but eventually a man and a woman volunteered and the proving was begun.

The first prover, a man aged 23, was given given five grains of crude Sulfanilamide at 10:30 a.m. on January 4, 1940. At 11:30 a.m. he began to experience pain in the belly of the right triceps muscle which he described as lameness. The lameness was < on beginning motion of the part and was > by rest and by continued motion. At the end of two hours the pain was gone.

The same prover was given some tablets of the 6x. trituration with instructions to take one tablet every two hours until he noticed symptoms, then to take no more as long as symptoms were present. He began taking the drug on January 17, 1940 at 3 p.m. No symptoms were experienced up to nine oclock at which he went to bed. On rising in the morning on January 18 he experienced the same pain in his right arm as previously described with > from exercise.

He began to take the drug again at 7 a.m. and continued its ingestion until 9:30 p.m. About 3 p.m. he noticed a dull ache in the back of his head accompanied by ringing in the ears. The latter continued about a minute and was followed by a sensation as if the ears were stuffed up. The dull ache in the back of right head lasted for two hours and was relieved when he went into the fresh (cool) air. He stated that the stuffy feeling in the ears was relieved at the same time. On January 19 he started the drug at 12:40 p.m. and thereafter “each two hours that afternoon”.

On retiring in the evening of this day he complained of an ache in his shoulder which seemed to proceed up the back of his neck and was worse when lying down. The next morning he complained of stiffness in the right arm with lameness and < from raising the limb above his head. This symptom was worse on this occasion than on others. He further stated in his report to me, “On the fourth day (Jan. 20) after I took the first dose, I noticed a bruised spot on the front of my body by my shoulder, this may have been caused by exercising too much on the bowling alley previous to taking the medicine.”.

The same prover was given the 3x. trituration on another occasion but developed no symptoms from it.

On one occasion I took one tablet of Sulfanilamide 3x. Fifteen minutes later I experienced a peculiar taste in my mouth. This taste was similar to that noticed when one is working in a chemical laboratory where the air is impregnated with the fumes of hydrogen sulphide.

On another occasion I took the 3x. in the following manner: One tablet at 10 a.m., 2 tablets at 11 a.m., 4 tablets of 12 noon, 6 tablets at 2 p.m. Symptoms were noticed after the first and second doses, but none thereafter. About three minutes after the first dose there appeared a sensation of lightheadedness, not a real vertigo. This symptom was < by smoking and disappeared in the open air and was > when thinking of other things. Soon after the second dose there appeared a prickling sensation on the tongue, as if fine needles were touching it.

This sensation lasted for less than five minutes. No further symptoms were experienced with the drug.

The female prover, a young woman of 29, was given the 6x. trituration of Sulfanilamide and later the 200th. The trituration was given as follows: One tablet every two hours until symptoms were experienced. The 200th was given in a single dose.

In this case the proving of the 6x. was begun on January 26 at 2 p.m., one tablet being taken every two hours until 10 p.m. She stated that in the morning of this day, before beginning the proving, she felt as if a cold was coming on but that all those symptoms had disappeared by noon. The same symptoms were experienced in the morning of January 27, but were not present on the 28th or thereafter. I do not believe these symptoms were due to the Sulfanilamide, nor do I feel that they were cured by the drug. Between January 26 and February 2 a total of 60 tablets of Sulfanilamide 6x. were taken.

There were only two manifestations that might be attributed to the action of the drug. The first of these appeared in the afternoon of February 2 and was described in the provers notes, as follows: “This afternoon my right leg ached just as it does a rule after my period starts.” The second symptom which might be taken as due to the action of Sulfanilamide was noted by the prover, as follows: “Saturday, the 3rd (Feb.) period started, the same as any, but not as much flow the first few days.”.

The results of the proving with Sulfanilamide 200 are very interesting. They were almost all referred to the skin and lasted from the first of March until the last of May, a period of nearly three months. The proving began on February 27 when she took a dose of Sulfanilamide 200 before breakfast. No symptoms appeared until March 1 at 4 p.m. at which time she began to experience aching from small of back down the legs to the ankles. There was aching pain in the lower abdomen accompanied by bearing down in the pelvis. At five oclock she felt as if the period had started (the period was due). All these symptoms had disappeared by 9 p.m.

The menses did not appear until March 3 but apparently were influenced to some extent by the drug. The prover describes the effect in these words, “… the flow wasnt as great as the whole thing was shorter by two days.”.

Now follows a period of quiescence lasting until March 13. But on this date begins a series of skin manifestations that lasted until May 29. From March 28 until May 20 there was another period of quiescence. Strangely enough, all the skin symptoms were confined to the region of the face: nose, eyelids, eyebrows, chin and angle of the left jaw. The actual eruptions were manifested as pimples, pustules, moist, scabby sores and styes. On three occasions during this time the prover felt as if a cold in the head would appear, but instead of a cold an eruption would appear. At each menstruation she would have a red pimple at the angle of the left jaw.

This has now disappeared but there is a brown scar at the site. Almost all the skin symptoms were distributed to the left of the midline. All the skin manifestations were > by hot applications, < by touch or pressure, during menses, and after taking cold. The sensations produced were burning, soreness, prickling and pulling. The discharges from the skin lesions were watery (serous), yellowish pus or bloody pus. Accompanying the stye on the left lower eyelid at the inner angle there were pricking pains “like pins all around eye”, swelling of both lids, sclera “very bloodshot”.

An attempt to compare the toxic effects of Sulfanilamide with the symptoms resulting from these provings in my opinion in useless. Symptoms due to poisonous drug-effects are as coarse and crude as the substances which have produced them. The finer and distinguishing characteristics of drug action are only brought out when proved in attenuated form. I believe that the results obtained in this very imperfect and incomplete pathogenesis prove that the greater the attenuation, the more pronounced are the symptoms produced in the provers.

I believe there is more work to be done on Sulfanilamide: three provers really prove nothing. The symptoms I have obtained should be confirmed from other sources, and more added.

I am appending a Schema which is composed of the symptoms produced in my provers plus the toxic manifestation, gathered from various sources, which have appeared in patients under treatment by the crude drug. Toxic symptoms are marked T; those from the proving are marked P.

SCHEMA

MIND.

Dullness. T.

Confusion. T.

Loss of memory, accompanied by deafness. T.

Sensation similar to alcoholic intoxication. T.

SENSORIUM.

Vertigo. T.

Lightheadedness, as if drunk. T.

Lightheadedness, aggravated by smoking, ameliorated in the. open air and when thinking of other things. P.

INNER HEAD.

Headache. T.

Dull ache in the occiput with ringing in the ears, better. in the open air. P.

Allan D. Sutherland
Dr. Sutherland graduated from the Hahnemann Medical College in Philadelphia and was editor of the Homeopathic Recorder and the Journal of the American Institute of Homeopathy.
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.