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The mechanism of the action of the anti-infective drugs
BBSTRACTS OF CURRENT LITERATURE The Mechanism of the Action of the Anti-Infective D. A. 12: 436-442, October, 1946.
Drugs.
405
John C. Krantz,
Jr.
J. Canadian
Dr. Krantz, who is Professor of Pharmacology at the University of Maryland, has acquired quite a reputation in being able to develop great interest in the dry subject of pharmascology by his colorful dramatizations in his many lectures and writings. The subject of the ianti-infective drugs is one of his best efforts. He started his story in 1675 when Anthony Leeuwenhoek took one convex lens, set it ‘upon another, and with this improvised microscope eavesdropped upon bacteria from the water in the canal at Delft. In 1845, in Vienna, Ignatz Semmelweis reasoned that the fact that one out of every two women delivered would succumb to puerperal fever was because of outside hands. After every man delivering a woman in the clinic washed his hands first in chlorine water, the deaths dropped in two years from 455 to 52. Lister rose to fame and Semmelweis was forgotten. Oliver Wendell Holmes warned the medical profession that clean hands can carry germs. In 1900, there were only four antiseptic drugs in the physician’s armamentarium: iodine, carbolic acid, chlorine water, and bichloride of mercury. These were protoplasmic The next step in the development of the anti-infective drugs was the search for poisons, an agent that exhibited specificity against the invading organisms. The discovery and refinement of the arsenicals are discussed. Then mercurochrome was developed and thought to be the great blood stream sterilizing agent. Its results in vivo were, however, quite different from in vi.tro. Hexylresorcinol or ST. 37 was discovered and was thought to be the wonder drug because of the phenol coefficient of 40 with no toxic results. Unfortunately, it is inactivated by the elements of the blood. Cold compounds were developed and found to be very toxic. The subject is then brought up to date by telling of how and why the various forms of the sulfonamides were developed, and how the nontoxic penicillin came.into usage.
Chemotherapy
in Surgery.
John S. Lockwood, M.D.
J. A. NT. A. 135: 747, Sov.
22, 1947.
“The world’s research laboratories have brought to him (the surgeon) a bewildering succession of new drugs of increasing scope and usefulness in his war on sepsis: not only has the risk of all major surgical procedures been significantly lessened through the use of chemotherapeutic agents in the prevention and treatment of adventitious infections of operative wounds, but the surgeon is now enabled to treat most of the established infections in his field by a combination of surgical procedures and chemotherapy, rationally timed and adapted to the bacteriologic and pathologic conditions peculiar to each case. In general, the infections of living tissues and the fluids which bathe them respond to chemotherapy on the Operative provascularity of the area and the susceptibility of the infecting organism. cedures, when necessary, are directed principally toward aiding the body in the removal of tissue which through local necrosis has become, in effect, a bacteria-laden foreign body, and secondarily toward plastic correction of the consequences of loss of t,issue. . . . Infections 1. 2. 3. 4. 5. 6.
which may respond to chemotherapy
alone:
Cellulitis, lymphangitis, bacteremia Acute hematogenous osteomyelitis Suppurative arthritis Acute thoracopulmonary suppuration Spreading peritonitis Furuncles and carbuncles
In this type of infection
surgery
is deferred
until
specific
objectives
are clearly
defined.
Drugs.
405
John C. Krantz,
Jr.
J. Canadian
Dr. Krantz, who is Professor of Pharmacology at the University of Maryland, has acquired quite a reputation in being able to develop great interest in the dry subject of pharmascology by his colorful dramatizations in his many lectures and writings. The subject of the ianti-infective drugs is one of his best efforts. He started his story in 1675 when Anthony Leeuwenhoek took one convex lens, set it ‘upon another, and with this improvised microscope eavesdropped upon bacteria from the water in the canal at Delft. In 1845, in Vienna, Ignatz Semmelweis reasoned that the fact that one out of every two women delivered would succumb to puerperal fever was because of outside hands. After every man delivering a woman in the clinic washed his hands first in chlorine water, the deaths dropped in two years from 455 to 52. Lister rose to fame and Semmelweis was forgotten. Oliver Wendell Holmes warned the medical profession that clean hands can carry germs. In 1900, there were only four antiseptic drugs in the physician’s armamentarium: iodine, carbolic acid, chlorine water, and bichloride of mercury. These were protoplasmic The next step in the development of the anti-infective drugs was the search for poisons, an agent that exhibited specificity against the invading organisms. The discovery and refinement of the arsenicals are discussed. Then mercurochrome was developed and thought to be the great blood stream sterilizing agent. Its results in vivo were, however, quite different from in vi.tro. Hexylresorcinol or ST. 37 was discovered and was thought to be the wonder drug because of the phenol coefficient of 40 with no toxic results. Unfortunately, it is inactivated by the elements of the blood. Cold compounds were developed and found to be very toxic. The subject is then brought up to date by telling of how and why the various forms of the sulfonamides were developed, and how the nontoxic penicillin came.into usage.
Chemotherapy
in Surgery.
John S. Lockwood, M.D.
J. A. NT. A. 135: 747, Sov.
22, 1947.
“The world’s research laboratories have brought to him (the surgeon) a bewildering succession of new drugs of increasing scope and usefulness in his war on sepsis: not only has the risk of all major surgical procedures been significantly lessened through the use of chemotherapeutic agents in the prevention and treatment of adventitious infections of operative wounds, but the surgeon is now enabled to treat most of the established infections in his field by a combination of surgical procedures and chemotherapy, rationally timed and adapted to the bacteriologic and pathologic conditions peculiar to each case. In general, the infections of living tissues and the fluids which bathe them respond to chemotherapy on the Operative provascularity of the area and the susceptibility of the infecting organism. cedures, when necessary, are directed principally toward aiding the body in the removal of tissue which through local necrosis has become, in effect, a bacteria-laden foreign body, and secondarily toward plastic correction of the consequences of loss of t,issue. . . . Infections 1. 2. 3. 4. 5. 6.
which may respond to chemotherapy
alone:
Cellulitis, lymphangitis, bacteremia Acute hematogenous osteomyelitis Suppurative arthritis Acute thoracopulmonary suppuration Spreading peritonitis Furuncles and carbuncles
In this type of infection
surgery
is deferred
until
specific
objectives
are clearly
defined.