Elixir Sulfanilamide: The Confiscation Roundup and Final Assessment
Massengill’s Distribution of “Commercial Packages”
Nearly 160 gallons of Elixir Sulfanilamide—the majority of which were shipped in pint bottles—were distributed by the S. E. Massengill Company to 620 commercial recipients in 31 states and Puerto Rico.* The elixir was shipped as far north as Harvey, North Dakota, and as far south as San Juan, Puerto Rico, and from coast to coast. However, shipments were disproportionately high in Texas and the Southeast (Georgia, Alabama, and Mississippi), and the number of direct commercial recipients in a state correlated roughly with the total amount of elixir received in that state. For instance, Georgia received more than 21 gallons of the liquid antibiotic, which were shipped in individual packages to at least 83 sites, and Alabama received nearly 16 gallons, which were distributed among 78 sites. The number of prescriptions in each state was also roughly proportional to the number of commercial recipients and the volume distributed; however, elixir prescriptions were also dependent on the peculiar readiness of some enthusiastic and trusting physicians—like Dr. Archie Calhoun of Mt. Olive, Mississippi, and Dr. H. H. Weathers of East St. Louis—to write large numbers of prescriptions for the untested product.
Table. Elixir Sulfanilamide Distribution, Consumption, and Death Tally by State
|
State |
Direct Recipients of Commercial Packages |
Total Amount (Gallons) Shipped Directly Into State |
Known Exposures Through Prescriptions, OTC Sales, or Samples |
Deaths (Confirmed, Probable, or Possible) |
| Mississippi |
42 |
13 |
70 |
26[a] |
| Georgia |
83 |
21.375 |
29 |
12 |
| Alabama |
78 |
15.75 |
46 |
12[b] |
| Oklahoma |
18 |
6.625 |
40 |
11 |
| Texas |
100 |
17 |
35 |
9 |
| Illinois/Missouri |
47 |
11.125 |
67 |
9 |
| South Carolina |
12 |
11 |
19 |
9 |
| Tennessee |
43 |
16.25 |
21 |
4 |
| North Carolina |
24 |
14.25 |
19 |
3 |
| Florida |
18 |
2.375 |
5 |
3 |
| Virginia |
12 |
5.125 |
11 |
2 |
| West Virginia |
13 |
1.75 |
7 |
2 |
| California |
16 |
3.875 |
5 |
1 |
| Ohio |
15 |
2.125 |
3 |
1 |
| Arkansas |
3 |
0.375 |
3 |
1 |
| Indiana |
25 |
4.5 |
8 |
0 |
| Michigan |
17 |
3.25 |
1 |
0 |
| Kentucky |
14 |
2.375 |
2 |
0 |
| Louisiana |
13 |
1.75 |
6 |
0 |
| Pennsylvania |
7 |
1.5 |
— |
0 |
| Maryland |
3 |
0.75 |
1 |
0 |
| Puerto Rico |
1 |
0.75 |
0 |
0 |
| Minnesota |
3 |
0.375 |
0 |
0 |
| North Dakota |
2 |
0.375 |
1 |
0 |
| Colorado |
1 |
0.25 |
— |
0 |
| Iowa |
2 |
0.25 |
0 |
0 |
| Kansas |
2 |
0.25 |
0 |
0 |
| New York |
2 |
0.25 |
— |
0 |
| Oregon |
1 |
0.25 |
— |
0 |
| Wisconsin |
2 |
0.25 |
0 |
0 |
| Connecticut |
1 |
0.125 |
— |
0 |
|
620 |
159.25 |
399 |
105 |
OTC = over the counter.
a. Includes two deaths that occurred in Tennessee (Columbus Bryant and Rev. J. E. Byrd).
b. Includes one death that occurred in Georgia (Ewell Daughtrey).
N.B.—Commercial recipients were drug wholesalers, retail pharmacies, doctors’ offices, and hospitals. The amount of elixir shipped does not account for salesmen’s or physicians’ samples. Among the 399 recorded exposures, eight (2.0%) of these were OTC purchases (one in Alabama, three in Georgia, one in Mississippi, and three in Tennessee); five of these OTC purchases resulted in death (Herman Bolton, Seth Durden, and Will Portwood in Georgia; William Howell in Mississippi, and Charles Miller in Tennessee). At least nine samples were dispensed; two of these resulted in death (Syble Gwendolyn Singleton in Alabama and Jo Anne Cramer in Ohio). Specific prescription data for New York, Pennsylvania, Connecticut, Colorado, and Oregon are not available in acquired FDA records; but no prescriptions were likely to have been written in these states, given the relatively small volume of elixir distributed and the absence of state-specific prescription data in FDA accounts.
* The total amount distributed in commercial packages was calculated by adding values provided in primary FDA and National Archives sources. The calculated number of direct end-recipients of commercial packages of Elixir Sulfanilamide, 620, is somewhat lower than the shipment tally provided by Secretary Wallace in his November 1937 report to Congress (633). The difference is probably because Wallace accounted for drug stores that received Massengill’s elixir indirectly (eg, from another pharmacy).
To confound the FDA’s physical seizure of Massengill’s elixir, endpoints for shipments of commercial packages were frequently tiny settlements, far from any remotely beaten path—like Wink, Texas, Wedowee, Alabama, and Doe Hill, Virginia. For FDA supervisors and especially the agency’s field agents, who were charged with physically chasing down the elixir, Massengill’s weblike network of distribution must have been headache inducing. Nevertheless during the last months of 1937, the FDA managed to pick up, destroy, or otherwise account for 228 gallons and 2 pints* of elixir from the 240 gallons that had been produced. (According to the Massengill company, 1879 pints [nearly 235 gallons] were “found” and returned.)
Notable cases of persistent investigation included those conducted by FDA Inspectors Jesse A. Pitts in Arkansas, Monte O. Rentz in South Carolina, Shelby T. Gray in North Carolina, and Lewis A. Smith in Georgia.
In the end, FDA officials calculated that 11 gallons and six pints of Massengill’s elixir had been dispensed as prescriptions or sold over the counter, and that about one half of this volume had been consumed. (Massengill claimed that only five gallons and one pint had been dispensed as prescriptions or otherwise sold to individuals.) The remainder was taken, in some cases literally, out of the hands of consumers by FDA agents. During the last months of 1937, the FDA managed to pick up, destroy, or otherwise account for 228 gallons and 2 pints of elixir from the 240 gallons that had been produced. (According to the Massengill company, 1,879 pints [nearly 235 gallons] were “found” and returned.) But clearly some elixir recipients or their legal representatives were allowed to retain partially filled bottles, ostensibly for use in civil litigation against Massengill.