Sandler1 published a case in which congenital syphilitic interstitial keratitis failed to respond to antisyphilitic and foreign protein therapy but rapidly cleared after systemic treatment with azosulfamide (disodium 4-sulfamidophenyl-2′-azo-7′-acetylamino-1′-hydroxynaphthalene-3′, 6′-disulfonate) and sulfanilamide. After this report Arena2 reported 7 additional such cases in which the patients were treated orally with sulfonamide drugs. The clearing of symptoms was described as "remarkable." He stated that evidence as to the pathogenesis of interstitial keratitis does not substantiate the theoretic value of sulfonamide compounds but he felt that his empiric results justified the use of these drugs in conjunction with antisyphilitic therapy.
Four patients with congenital syphilitic interstitial keratitis were treated in the Johns Hopkins Hospital with ordinary antisyphilitic therapy plus sulfanilamide in larger doses than was used by Arena, and in none of these was there any significant improvement which might be attributed to this therapy. One of these patients was also