F. C. MINETT AND W. P.
S.EDWARDS
15
a equine strangles. This would appear
to be proved by the effect of the drug on
the temperature curve, noted by other
authors and also independently in the
present series of cases by ourselves and
the Veterinary Officers on the spot.
There is also the evidence that the strep-
-ococcus of strangles is susceptible in vitro
to the drug. It should be noted, however,
that in strangles we are dealing with a
streptococcus which has a pronounced
tendency to cause suppurative changes; in
the tissues, just the sort of morbid changes
in which sulphanilamide is least likely to
produce a dramatic effect. Granting,
however, that the drug has some value,
he question to be decided, perhaps, is
how at the present time the sulphanilamide
drugs should be used, since owing to the
cost (prewar price of sulphanilamide in
India was about 18 shillings per lb.) they
could scarcely be given to every affected
animal. Certainly in outbreaks of the
magnitude commonly encountered in re-
mount depots rigid selection of cases to be
reated would be required, especially as
half measures are likely to be of little
value and an expenditure of at least 1 lb.
f sulphanilamide is to be predicted for
each adult horse. What is important is
hat sulphanilamide should not be used in
ractice in a routine or stereotyped man-
er. As Whitby [1939] has put it: 'Both
linical judgement and common sense are
necessary to get the best effect with these
rugs'. Admittedly, more information is
required but in the circumstances it would
seem best to reserve sùlphanilamide (a)
r young stock on stud farms, because
ey are valuable and the cost of treat-
ent is relatively less; (b) for strangles
ses which are not running the normal
ild course; (c) probably most important
r very early cases where there is a good
ance of reducing fever, of inhibiting
scess formation and possibly of leaving
æhind a serviceable naturally acquired
munity.
In any event the policy may be adop-
had of giving larger doses during the first
two days and then continuing with smaller
doses—but not less than 1 gm. per 10 lb.
body weight—up to 10 days. It may also
be advantageous to divide the daily dose
into three or four parts instead of into
two parts.
In connection with (b) the widespread
and careful use of the clinical thermome-
ter should be urged. Officers should not
leave the taking of temperatures in the
hands of subordinates without first ascer-
taining that they are able to record accu-
rately. It is particularly important that
the bulb of the thermometer be introdu-
ced as far as possible into the rectum and
be in contact with the mucosa. Tempera-
ture-recording should be continued for
some little time after an initial attack, as
a rise of temperature during this period
may mean the onset of pyaemia. Unfor-
tunately, we do not yet know just what
influence the drug may exert on the pyae-
mic complications of strangles, but as
such complications are the main source of
mortality it would be right to test the
drug on such cases. At the same time,
the possibilities of sulphanilamide as a
local dressing for abscess cavities, which
are not closing with ordinary rapidity,
might well be borne in mind. For this
purpose the cavities should first be well
opened up and thoroughly cleaned of pus.
The words 'at the present time'
(above) have been emphasized because
production costs may come down and
because, as Fleming [1941] has pointed
out, the field of therapeutics is expan-
ding with the discovery of new sulphona-
mides. One may with some confidence
anticipate the marketing of still more po-
tent drugs, and also the elaboration of
other very active antibacterial agents
formed during the course of bacterial or
mould growth. For instance, the product
known as penicillin, which was obtained
in 1929 by Fleming from a Penicillium
mould, has a bacteriostatic effect on hae-
molytic streptococci 100 times as power-
ful as sulphanilamide and 20 times as
powerful as sulphapyridine. Moreover,
penicillin is not inhibited by pus. Peni-
cillin has now been considerably purified,