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Meningitis, the great killer


The impact of sulfonamides
Harold Lambert Physician
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You see I think the... the magical moment about this would have come not in your generation or even in mine because people always talk about penicillin, Fleming and Florey and blah, blah, they're all very important, but the really biggie - which is funny, people don't write about so much – was sulfonamides. And sulfanilamide, I think, was about 1936 and some of the sulfonamides came into general use in 1938 and what did you see? You saw meningococcal meningitis being cured. Children now that's growing up, well. You saw puerperal sepsis – a lot of abortion, septic abortion. You saw women dying of puerperal sepsis, living. You saw pneumonia being cured. I mean, to me, it's funny people don't say sulfonamides as much as they do penicillin. It must have been the most amazing time. Within a year or so, the... there was a chap called Stanley Banks who was the grand old man of infectious diseases at... at a hospital in South-East London, one of the big fever hospitals. He was sort of Dwyer, very energetic chap – I must tell you about that... he interviewed me at my consultant interview. He... wrote a series of about, I don't know, about 30, 40 patients meningococcal meningitis, and there was one death – unthinkable. By 1943, there were thousands being reported with mortalities of between 5 and 9%, which is about now. This was before penicillin.

[Q] Really, yes.

Can I tell you about being appointed as a consultant?

[Q] Yes.

Again, it was very stately at St George's. There was a board of governors and they had prayers before the meeting and the new, no I'm... no, that was different. That was not getting my gold watch. No, the interview for the... for the consultant thing was, mostly was... would have been just, you know, kind of trying to talk about your career and what you were interested in, but at that level it wasn't a viva. But Stanley Banks – there was this strange chap, general physician, coming into the fever territory, not having seen 50,000 cases of... which he obviously thought it was a put up job by these teaching hospital bastards, you see. So, rather to my surprise, he gave me a viva in, in the, in the consultant interview, you know! It was quite comical really. So, anyway I obviously answered to satisfactorily cause at some point he said, 'Yes, yes, fine, fine, go on', but it was a steep learning curve, yeah. Sorry, I diverted on...

[Q] No, no, I think that, I think it's very, very interesting. I mean the... am I right in saying sulfonamides were, it M&B, what...

Yeah M&B, M&B693. Very poisonous things, but they were a whole lot less poisonous than dying of meningitis. That's for sure. Yeah. No, they were... we, we used them quite extensively for many years after I... they're still used for some things, rather unusual infections but, for many years we used them for meningitis among other things and if you used them carefully... I did make several people ill by using them not right but, they, they, you know, they're better than meningitis.

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: St George's Hospital, learning curve, Stanley Banks

Duration: 3 minutes, 14 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008