Massengill's Elixir Sulfanilamide: The Scramble to Confiscate (6)

The FDA's New Orleans Station, headed by E. C. Boudreaux, oversaw the confiscation of Massengill's elixir in Louisiana, Texas, Mississippi, and Alabama.

Louisiana

Fourteen pints (1.75 gallons) of elixir were shipped to 13 pharmacies in 9 communities, most of which were in the coastal region of the state [1]. The shipments contradicted an early claim on October 20, by the president of the Louisiana State Board of Health, that the state's "model pure food and drug law" of 1936 prevented any of Massengill's elixir from coming into the state [2]. Nevertheless, the sale of the elixir violated the new state law, which required the "submission of all new medical products to the board of health's chemists before it is offered for sale" [3].

Although 11 pints were seized by state or federal officials, before prescriptions could be written, 4 prescriptions were dispensed in late September [1]: 1 in Lafayette to an infant, and 3 in Westwego, also to children. All were partially or wholly consumed "with no ill effect."

On October 24, the Times Picayune-New Orleans States printed a feature article on one of the Westwego children who took the medicine, claiming "Boy Thrives on Death Elixir." A 1-ounce prescription was written for Ecton Terrebonne, Jr, 4, by Dr. Joseph J. Massony on September 29 for a "bad throat ailment." Ecton took the elixir for about 15 days, his mother reported, and improved [4].

"You see, towards the end of September, Ecton started off with a sore throat. Well, the doctor wanted to give him some pills but his throat was so sore that he couldn't swallow them. So he gave him this medicine in a bottle. It looked like when he gave him that he got better right away."

When informed that the medication was poisonous, Ecton's mother replied, "[I]t must have been that novena I said to St. Martha that saved my boy." Little Ecton was also afforded a "very strong constitution."

Texas

Four physicians' offices and 98 drug vendors in 70 different communities received a total of 16¾ gallons, almost all of which were dispersed in pint bottles. Before stocks could be confiscated or destroyed by state and federal officials, 33 prescriptions were either partially or wholly consumed [1].

1. In Hemphill, 1 of 5 prescriptions dispensed from the Post Office Drug Store resulted in the death of a girl, Johnie Faye Kay. The 12-year-old died October 4 of "uremia" and "lobar pneumonia," after taking about 6 tablespoons of Massengill's elixir [1,5].
2. In Wichita Falls, William Taft Parker, 27, died October 10 of "uremia due to acute nephritis," at Bethania Hospital. He had taken nearly half of his 6-ounce elixir prescription [1,6].
3. Robert Montgomery Goode, of coastal Texas City, also died October 10. The 29-year-old fishing pier operator passed away at John Sealy Hospital in Galveston. Causes of death were "acute toxic hemorrhagic nephritis" and "toxic hepatitis," after a 7-day course of progressive symptoms. Goode had taken 4 ounces of his 6-ounce elixir prescription [1,7,8].
4. The first nationally reported elixir-related death of a Texan was that of 19-year-old Levy Kelly. The "colored" Highbank farmer died on October 12 after consuming all of his 4-ounce prescription, which he obtained in nearby Marlin from "negro" physician Allan L. Hunter [1,9].
5. Two-year-old Alberta Yvonne Howell died in Ballinger of "acute nephritis" on October 13. Two ounces of Massengill's elixir were prescribed for a "streptococcic sore throat" [1,10].
6. In Madisonville, a 4-ounce prescription was dispensed for 4-year-old Lois Jean Wilkins of nearby Leona, who was suffering from a "sore throat." She died October 16 after taking half of the medication [1,11].
7. Mollie May Schmitton, 20, a student at the East Texas State Teachers College in Commerce, died October 20 after consuming a little over half of her 4-ounce elixir prescription [1,11].

Deaths associated with the consumption of Elixir Sulfanilamide in Texas but not believed to have been caused by the medication included that of Lillie Maurye Howard, age 5, of Goree. Lillie consumed about 2 ounces of a 4-ounce prescription, which was also intended for her 2-year-old sister. Lillie died October 6 of "Vincent's angina" (or trench mouth) with the contributing condition of a "blood stream infection." She exhibited no renal symptoms before her death, which would be expected with diethylene glycol poisoning. Lillie's younger sister consumed 4 ounces of Massengill's elixir for a streptococcal infection without ill effects [1,12].

In Tahoka, 1 ounce of Massengill's elixir was dispensed on prescription to "Baby" Rosas (possibly Margrita), the daughter of a migrant cotton picker. When the prescribing physician learned of the elixir's toxicity, he located the patient in her family's box-car home, where he recovered about one-half ounce of the elixir. Attempts to follow-up the child's condition were confounded by the itinerant nature of the family's existence; however, it was learned "in a round-about way" that the child developed pneumonia and was admitted to Mercy Hospital, about 20 miles away, in Slaton. She died there October 7. The FDA concluded that an elixir-induced death was questionable in this case [1,13].

Tracing elixir prescriptions to other migrant families posed more than the usual challenges to health officials. Also in Tahoka, a 2-ounce prescription was dispensed to a patient identified only as "Baby." When interviewed, the prescribing physician was finally able to recall that the infant was the child of a traveling cotton picker. After locating the parents, it was discovered that all of the prescription had been consumed. The infant remained alive on October 30 "but was sick with the disease for which it was being treated" [1].

In Munday, 3 ounces of Massengill's elixir were prescribed for a "Mexican baby." The names of the child or its parents, who were probably transient cotton pickers, were unknown to the prescribing physician and druggist. Calls made by authorities to the justice of the peace, the keeper of vital statistics, the mortuary, and the local priest were unfruitful; the child was never identified or located [1].

The complete confiscation of elixir in Texas was hindered by Massengill salesman B. H. Hensley, of San Antonio. Hensley had returned only 42 of 72 1-ounce physicians' samples and 3 of 4 2-ounce case samples to Massengill's Kansas City branch. The salesman claimed he had destroyed the remaining case sample and had consumed 3 1-ounce samples without adverse consequences. If true, the tally left 27 physicians' samples at large.

Both state and federal inspectors encountered "supreme difficulty" in dealing with Hensley, who refused to reveal where he had delivered the drug. For his defiance, Hensley was arrested. After spending a night in jail, Hensley pleaded guilty to "obstructing an officer in the performance of his duties" and was fined $25.00 (along with costs of $13.50). The reformed salesman then enabled inspectors to seize 12 elixir samples in Waco and 15 in San Antonio. In the process of running down the elixir, inspectors found bottles carelessly tossed in wastebaskets and slop jars. One sample each had been passed on to salesmen from Upjohn and Abbott [14,15,16]. None of Hensley's samples resulted in a death.

In Texas, 33 prescriptions for Elixir Sulfanilamide caused 7 confirmed deaths (fatality rate, 21%).

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

2. FDA newspaper clippings. '36 law is barrier to fatal elixir. New Orleans Tribune. October 20, 1937.

3. FDA newspaper clippings. All poison drug on sale in this state traced by officers, seized. Times Picayune-New Orleans States. October 24, 1937.

4. FDA newspaper clippings. Schoenberg P. Westwego child given elixir has no bad effects. Times Picayune-New Orleans States. October 24, 1937.

5. Texas death certificate 52202.

6. Texas death certificate 52954.

7. Texas death certificate 50096.

8. Medicine is fatal to Texas City man. The Galveston Daily News. October 26, 1937; p 12 col 4.

9. Texas death certificate 49948.

10. Texas death certificate 52164.

11. Associated Press. No more Texas deaths expected. The Galveston Daily News. October 26, 1937; p 12 col 4.

12. Texas death certificate 51357.

13. Texas death index, 1903-2000 (certificate 51538).

14. FDA. Part II--Report on Elixir Sulfanilamide manufactured by S. E. Massengill Company, Bristol, Tenn.: disposition of physicians' and salesmen's samples.

15. FDA correspondence. Letter from G. P. Larrick to Samuel A. Lask. December 13, 1937.

16. S. A. elixir danger is removed. The San Antonio Light. October 28, 1937; p 1 col 3.

Photo at Our Lady of Prompt Succor in Westwego, LA, by G. J. Charlet, III, at Flickr.

Photo of Texas cotton field by "Big Grey Mare" at Flickr.