Hydrogen-ion concentration studies of solutions used for intravenous medication and clinical investigation

Abstract

We advance the hypothesis that there is a relationship between the hydrogen-ion concentration of fluids injected intravenously and some of the reactions which follow their use. We base this belief on clinical observations and on extended chemical analyses of fluids commonly used for therapeusis and clinical investigation. We wish to briefly report here some of our more important studies. It should be understood that the hydrogen-ion concentration of normal acid is PH 2; normal alkali PH 14; pure water PH 7; and human blood PH 7.4, and that this latter figure is fixed and cannot be varied without causing serious disaster or death. If a fluid with a much higher or lower PH than that of the blood is introduced into the circulation at a rate or in an amount greater than the blood can neutralize or buffer, reactions, as chills, fever and prostration ensue. This is particularly true in individuals whose blood supply is impaired in either quantity or quality. Since distilled water is the solvent used in most intravenous medication we have studied it with care under the conditions which it is commonly produced in hospitals and laboratories. Rochester tap water has a PH, of 8.29. Boiling was found to increase this slightly. Various samples of stock distilled water varied from PH 6.89 to PH 5.05. Distilled water becomes acid even when the distillation is in progress from the absorption of carbonic acid of the atmosphere when the ordinary type of metal or glass still is used. Tap water, PH 8.27; first distillate (first 10 c.c.) PH 7.30; after 200 G.C. had been distilled PH 6.90. When stored in container, whether sealed with a cotton plug, cork or glass stopper, distilled water becomes quite acid. Example: freshly distilled water has a PH 6.8, after 48 hours, PH 5.23. Proximity to bottles containing fuming HCl or NH40H made no appreciable difference.