Medicine: Victim No. 18

Toronto’s General Hospital last week reported its 20th death in four years from sulfa poisoning, three within the last month. So aroused were Toronto doctors that the city’s chief coroner held a widely publicized inquest on Victim No. 18, to highlight the dangers of using sulfa without proper medical supervision. From Milwaukee came a similar report: 15 sulfa deaths in the county hospitals in three years. Many another U.S. hospital might have added to the death score from sulfa if it had published its files.

Toronto’s Victim No. 18 was a young man whose doctor prescribed twelve sulfathiazole tablets for him for a tooth infection last summer. After the first box was used up, the young man bought another dozen, took eight. A few weeks ago he felt ill, thought he had “intestinal flu,” took three more sulfa tablets. When he finally went to a doctor, he was vomiting. The doctor said: no more sulfa tablets. But it was too late.

Autopsy showed crystals in the young man’s kidneys (commonest way a sulfa drug kills), damaged liver and heart, inflamed intestines, slight pneumonia.* Medical experts at the inquest laid most sulfa deaths to self-dosage. The drugs, they said, should be dispensed as carefully as strychnine or arsenic.

To prevent this dangerous self-dosing, 18 U.S. states and the Pure Food & Drug Administration have rules against sulfa sales without prescriptions. But bootleg sulfa is fairly easy to get. Chief customers: people with gonorrhea.

* To prevent kidney complications from sulfa, doctorsgive alkali along with the drug, carefully watch kidney output.