Massengill Counters Press Coverage of Elixir Sulfanilamide Tragedy

In December 1937, while continuing to "deny all liability and responsibility for deaths of persons whose relatives claim they took the sulfanilamide compound," the S. E. Massengill company distributed a lengthy question-and-answer statement to their "friends and customers" regarding Elixir Sulfanilamide. The statement, the firm claimed, was intended "to correct the false statements that have been circulated" about the product, with the following qualification: "For legal reasons, we cannot at this time give some information that we would like to give" [1].

Among the 29 questions posed and answered by the company were several concerning the inclusion of diethylene glycol in Elixir Sulfanilamide. Massengill defended the use of the substance on the basis of its solvency and, perhaps unbelievably, its relative lack of toxicity when compared with the common anti-freeze ingredient, ethylene glycol. While attempting to dissociate diethylene glycol from ethylene glycol, the company indicated, nevertheless, that the former substance, if ever used as an anti-freeze, "should not reflect unfavorably upon it"; both alcohol and glycerin had been used for the same purpose. Moreover, ethylene glycol was a solvent in hypodermic injections that had been approved by the AMA, the firm argued.*

Massengill then endorsed its control department, claiming, "[W]e have six graduate pharmaceutical chemists in our employ who spend their entire time in the control and testing of our products before they are placed on sale," and denied that Elixir Sulfanilamide was rushed into the marketplace. When the company asked itself, "Why did your tests not show any bad results?" it replied, "At this time we cannot say, but undoubtedly we will have the answer when it can be shown why many using the identical lots sold had most excellent results." Massengill proceeded to indicate that the reason for elixir-related fatalities may never be known:

Is your company making an effort to ascertain what did happen to cause the ill effects?
Yes, our own chemists are continually working on the problem, and we also have independent sources doing similar work. After working on the problem for several weeks, one body of scientists makes the statement: "It is probable that no chemist or pharmacologist will ever be able to determine exactly what happened," and added, "Theory and guess work on the part of all who are working on this problem is all that has developed at the present time." The latest report of another one of our connections is as follows: "We are making an effort to determine the exact cause of the present trouble, and shall keep you advised of the progress of the work as soon as it has advanced to the stage where any reasonable interpretation of the results obtained can be made."

Last, the company floated the idea that deaths due to the consumption of its Elixir Sulfanilamide were actually the result of adverse drug-drug interactions. The only known drug that could be safely taken with the antibiotic was sodium bicarbonate, Massengill claimed, and a number of drugs—saline cathartics, sulfates, analgesic coal-tar derivatives, and many laxatives—were either probably or definitely contraindicated with sulfanilamide.

* The company cited the 1935 edition of the AMA's New and Nonofficial Remedies, page 132, and the 1937 edition, page 116.

1. Pully P. Masengill Brother Company and the S. E. Massengill Company, 1897-1971. Knoxville, Tenn.: Tennessee Valley Publishers; 1996; Appendix 6.