Wednesday, April 8, 2015

Elixir: The American Tragedy of a Deadly Drug, by Barbara J. Martin

Reviewed by William Wade

Elixir: The American Tragedy of a Deadly Drug, by Barbara Martin is the story of an event in the history of The S. E. Massengill Company, a Bristol pharmaceutical concern, which in 1937 brought out a liquid version of a sulfa drug advertised as Elixir Sulfanilamide that could be taken orally and overcome patient objections to swallowing a very bitter pill.  Confident that it would be a best seller, the Massengill Company sent out large quantities of the product to its salesman, drug stories, and other outlets.

But in preparing the medicine Massengill scientists had unwittingly dissolved the sulfa in a solution of diethylene glycol, generally known to be toxic to humans.  Within a very short time frame, news reports came from physicians that their patients were dying.  Initially the Massengill firm insisted that their drug could not be the cause, for it was known that sulfa was safe in limited quantities.  But rapidly increasing deaths of those using the product brought in the Federal Drug Administration, which operated under very limited powers given it from a 1906 act of Congress.  The Massengill Company ordered a recall of the product, but saying nothing about its danger.  The FDA was not satisfied and launched a thorough going national search for every ounce that had passed into the hands of hospitals, doctors, or druggists, sometimes skirting the very limited bounds of their authority.

Much of the book is given over to this search, which federal agents termed a race against death.  As much of the medicine had been sent to rural areas in Southern states, it was not an easy matter.  Simply notifying American consumers of the threat was difficult in a nation without television, national radio broadcasting of  news, and where many newspapers were locally oriented.  In one case, heroic agents recovered a vial of Elixir Sulfanilamide resting on top of the coffin of a victim in the cemetery where he had been buried.  In all, more than hundred persons, many of them children, died from the drug.

Dr. Samuel E. Massengill, head of the Bristol firm, was arrested and placed on trial, charged with adulterating and misbranding his product, but the likelihood of a long contentious trial caused government authorities to accept his admission of limited guilt and a monetary fine.  Harold Cole Watkins, his lead scientist who had developed the product, committed suicide.  Within Bristol public opinion was strongly on the side of Dr. Massengill, who had built his company from scratch over the years to one of the city’s leading employers.  Shortly after the conclusion of the trial he was elected head of the local Chamber of Commerce.

The Massengill Company suffered for a few years with declining sales, but after World War II became larger and  more profitable.  Perhaps the major outcome of the entire episode was the enactment by Congress of a new law giving much greater authority to the federal government in the regulation of pharmaceuticals.  Indeed, this was the beginning of federal responsibility to actively ensure American citizens that their medicines were safe and efficacious.  This book is a detailed, gripping, and a valuable account of that important event.

Elixir: The American Tragedy of a Deadly Drug, by Barbara J. Martin.  Lancaster, PA Barkerry Press, 2014.  320 pages.

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