Massengill's Elixir Sulfanilamide: The Scramble to Confiscate (2)

In the East, state-by-state confiscations of Massengill's Elixir Sulfanilamide were coordinated through the FDA's Baltimore and Atlanta offices—and, in most cases, in conjunction with a state's health board authorities.

Maryland

Two drug stores and a physician received the elixir. In Salisbury, a Mr. Gordy of the Gordy Drug Company acknowledged his receipt of 3 pint bottles in late September from a local Massengill salesman, who claimed that the elixir "would appeal especially to children." From one of these bottles, 2 ounces were prescribed in early October by a local doctor (Albert W. Kitts) to a "small boy" for a "throat irritation." After rushing to the boy's house, investigators found that the patient had taken only one-half teaspoon. The boy's prescribing physician had ordered the medication to be discontinued, given the child's improvement. Most important, "there were no ill effects" from the elixir dose. Commenting on his investigation, the FDA inspector "found Mr. Gordy most cooperative and it is hoped that his firm will have no notoriety in the matter that might reflect on his business and his professional standing in the community" [1,2].

Two 1-pint bottles of elixir were shipped to a Dr. A. J. Fazenbaker in Westernport, Maryland, on September 13. "Crippled with arthritis," Dr. Fazenbaker learned of the new elixir at a bridge party, where a Massengill salesman advised him that "sulfanilamide in this form would not be objectionable and that it was a good way in which the preparation might be administered to children to whom tablets or pills are generally repulsive." Intending the elixir primarily for himself, Dr. Fazenbaker ordered the bottles; "but after receipt of the medicine forgot about it until he read accounts of deaths in the Washington, DC papers." A state inspector arrived at Fazenbaker's office to seize the elixir, just before the doctor found time to act on Massengill's recall telegram of October 19, which warned of the product's deadliness [1,3].

Virginia

Twelve shipments from Bristol, Tennessee, found their way to 3 physicians and 9 drug stores scattered throughout the state. In addition, 3 dozen physician samples were distributed by a local Massengill salesman. In many cases, Virginia physicians had already heard of the elixir's danger from their local pharmacists and had poured the medication down the drain [4]. However, a dispatched FDA investigator found one physician in tiny Mannboro, about 40 miles southwest of Richmond, who had given the elixir to 2 "small children" and an 18-year-old boy. The investigator discovered that all 3 prescriptions had been used up, or nearly so, without ill effect. But the teenager had noticed clouding of his urine on the third day of treatment [5]. 

A close call also occurred in the mining hamlet of Mineral, Virginia, where a physician dispensed 4 ounces of the elixir to a "large, healthy woman" for an ear infection. When the doctor received Massengill's recall telegram, he immediately visited the woman, on the pretense of a casual follow-up. He found her alive, but she had just taken the last 3 teaspoonfuls of the medication. The FDA inspector described the ensuing reaction: "The doctor attended her breathlessly in fear of the results. She became prostrate. To use her own words, '—was never so sick in [my] life.'" But by October 25, the woman had recovered completely, her health manifest in her ability to walk "to town several times" [6].

Two other Virginia citizens were not so fortunate. Dr. D. C. Mayes of Church Road, another small dot on the Virginia map, admitted to dispensing 6 elixir prescriptions; however, he assured the visiting FDA inspector that none of his patients had suffered any ill effects. Persistence from the inspector, nevertheless, revealed that 2 of Dr. Mayes's patients had died after taking the elixir: Mrs. D. T. (Martha Agnes) Cairns (age unknown) of Petersburg on October 7 and Robert Harrison Mayes* (age unknown) of Church Road on October 17 [1,7].

The determination of the FDA to retrieve Massengill's elixir is exemplified by the case of a 19-year-old woman, Bettie, who lived 20 miles outside of the already very rural town of Emporia. After driving over "muddy dirt roads," the assigned inspector found Bettie's home, where her stepmother and father were picking cotton in the field [8].

Bettie said she had taken all the medicine she had bought...and had thrown the bottle away. She was questioned closely about how much of the medicine she received and how much she took each day, etc., and she seemed to be trying to mislead me, or is in about the class of a moron. She claimed that she couldn't remember all about the medicine and just when she did get through taking it. I think she was really trying to keep me from knowing why she was taking the medicine. I explained to her that I was not investigating her...but was just interested in the medicine, but she still claimed she had taken all the medicine and had thrown the bottle down in the woods. Her parents didn't seem to know as much about the medicine as she knew.

I was afraid some of the medicine might still be on hand so I searched through the house for it and failing to find it I looked about the premises until dark trying to locate the empty bottle.

Bettie claimed that she had no unusual or ill effects from the medicine. She said as she remembered it now she did not even have any headaches or backache while she was taking the medicine. Very little reliance, however, could be put in her statements. Only one thing is sure and that is she is still very much alive.

The inspector discovered later that Bettie's prescribing doctor had already retrieved the elixir bottle from her home, when he learned of the product's danger.

In Virginia, 11 prescriptions for Massengill's elixir caused 2 deaths (fatality rate, 18%).

West Virginia

In 10 towns sprinkled throughout the state, 8 physicians and 5 drug stores received the product in 1- or 2-pint bottles. The FDA found that most had returned their shipments to Bristol on receipt of the company's recall telegram. However, one physician had written a 3-ounce prescription for a 13-year-old girl, who lived in the 1-intersection town of Eglon. The FDA inspector managed to retrieve the entire prescription [1,9].

In Beckley, a "colored" physician with a "large practice" among the town's African Americans, Dr. R. J. Howard, had received 2 pints of Massengill's elixir. However, on October 21, inspectors from the state health department and the FDA were told by Dr. Howard that he had "none on hand." Despite the doctor's denial, the inspectors searched his office and found the 2 bottles. One was empty, "except for a few drops"; the other held approximately 2 ounces. With this discovery, the doctor admitted that he had dispensed the medication for the treatment of gonorrhea, but he claimed that he had no record of the treated patients [10].

With repeated visits, the inspectors finally convinced Dr. Howard to give up the names of 5 treated patients on October 26. Their follow-up investigation revealed that 4 had consumed their 4-ounce prescriptions to no ill effect. Two ounces of a fifth prescription were confiscated from a patient's wife.

On October 25, the state's Charleston Gazette assured its readers that no fatalities had been reported in West Virginia [11]. Further evidence, however, would reveal that 2 of Dr. Howard's elixir patients, whose names were not given to the inspectors, died. On October 11, 17-year-old William Irvin succumbed to "acute nephritis" and "uremia" at Beckley Hospital.** He had consumed probably 1 ounce of Massengill's Elixir Sulfanilamide. On October 18, miner Jonathan Walter Lyons, 35, died of "uremia following acute pyelonephritis," also at Beckley Hospital.** It is not known how much elixir Lyons had taken [1,10].

In West Virginia, 2 of 7 patients who consumed Massengill's elixir were dead (fatality rate, 28%).  

* It's not known if there was a family relationship between Dr. Mayes and Robert Mayes.

** Death certificates were signed by Dr. D. C. Ashton of Beckley. 

1. FDA correspondence. Report from J. O. Clarke to P. B. Dunbar. November 17, 1937.

2. FDA correspondence. Letter from J. F. Earnshaw to Chief, Baltimore Station. October 21, 1937.

3. FDA correspondence. Letter from Chas. F. O'Neill to Chief, Baltimore Station. October 22, 1937.

4. FDA correspondence. Letter from McKay McKinnon, Jr., to Chief, Baltimore Station. October 25, 1937.

5. FDA correspondence. Letter from McKay McKinnon, Jr., to Chief, Baltimore Station. October 23, 1937.

6. FDA correspondence. Letter from K. F. McClure to Chief, Baltimore Station. October 25, 1937.

7. FDA correspondence. Letter from F. L. Wollard to FDA, Baltimore. November 24, 1937.

8. FDA correspondence. Letter from James C. Pearson to Chief, Baltimore Station. November 16, 1937.

9. FDA correspondence. Letter from J. C. Pearson to Chief, Baltimore Station. October 24, 1937.

10. FDA correspondence. Letter from Louis L. Judge to Chief, Baltimore Station. October 27, 1937.

11. Death dealing 'elixir' seized in W. Virginia. Charleston Gazette. October 25, 1937; p 1 col 1, p 2 col 7.