A STUDY OF SOME OF THE PHYSIOLOGICAL EFFECTS OF SULFANILAMIDE. II. METHEMOGLOBIN FORMATION AND ITS CONTROL

Abstract

Reasonably close agreement exists between the direct spec-troscopic detn. of methemoglobin (mhb.) and the detn. of non-0 carrying Hb. In the majority of patients receiving 0.1 gm. or more of sulfanilamide per kgm. per 24 hrs., cyanosis develops, and so far we have been able to demonstrate the presence of mhb. in every case of cyanosis. There is marked individual variation in both the rate and degree of mhb. accumulation, although the dosage of sulfanilamide, its conc, in the blood, and perhaps also the extensiveness of the infection seem to have a direct relationship. Methy-lene blue causes a very rapid disappearance of cyanosis with simultaneous reduction in mhb. conc, when given intraven. in single doses of 1.0 to 2.0 mgm. per kgm., or when given orally in doses of 1.0 to 2.0 grains (65 to 130 mgm.) repeated every 4 hrs. The latter method also prevents any appreciable formation of mhb. if started simultaneously with sulfanilamide adm.