Dakin's Solution Research Articles

Maintenance of Life in Isolated Animal Organs

THE preliminary announcement of the work of Carrel and Lindberg on the maintenance of life in isolated organs, to which reference has already been made in our columns1, can now be amplified with further details of their method, from which an idea can be obtained of how the difficulties involved have been surmounted2. The organs are removed with complete aseptic and antiseptic precautions from an animal that has just been killed by bleeding under anaesthesia; adult cats or fowls are generally used. With the organ are removed the surrounding tissues, arteries, veins, nerves and lymph vessels: for example, in the case of the ovary, with the organ itself are removed the Fallopian tube, and a flap of peritoneum and connective tissue containing the ovarian artery. During the operation the abdominal cavity and the organ are protected with gauze pads soaked in Dakin's solution.

Relative Toxicity of Antiseptics on Bacteria and Tissues in Cultures.

Lambert,1 Lambert and Meyer,2 and German3 believe that an ideal antiseptic is one which kills the bacteria without harming the tissue cells and they have accordingly devised methods of comparing the toxic effects of antiseptics upon bacteria and tissue cells in vitro.Lambert after exposing fragments of connective tissue for several minutes to a saline suspension of Staphylococcus aureus transferred them into various concentrations of mercuric chloride, potassium mercuric iodide, potassium cyanide, Dakin's solution, iodine, phenol, tricresol, argyrol, hydrogen peroxide, glycerol, or alcohol. After one hour the fragments were transferred to physiological salt solution where they remained from a few minutes to half an hour until explanted. Although most of the antiseptics killed the tissue cells at concentrations that did not kill the bacteria, a good growth of cells was observed after exposure for one hour to a 1:2,000 iodine solution, a strength sufficient to sterilize the tissue completely in most instanc...

THE EFFECT OF ACUTE EXPERIMENTAL CHOLECYSTITIS ON THE EMPTYING OF THE GALLBLADDER

Mann, 1 in 1921, first reported the production of specific cholecystitis by the intravenous injection of Dakin's solution (a solution of chlorinated soda). At that time, however, studies were not made on the emptying time of such acutely inflamed gallbladders, as there was no evidence to show that the gallbladder emptied. Many attempts were made to produce chemical cholecystitis by the use of a solution of chlorinated soda subsequent to the discovery that the gallbladder emptied after the ingestion of a meal of fat, but because of variation in the commercial product, positive results were not attained. In the light of present, recently acquired knowledge concerning the emptying of the normal gallbladder following a fat meal, I was prompted to determine whether or not an acutely inflamed gallbladder empties, and to what extent such emptying occurs following the ingestion of a meal rich in fat. METHOD OF STUDY In these

The diagnosis and treatment of chronic dysentery

A series of cases of chronic bacillary dysentery is reported, the duration varying from one month to ten years. B. dysenteri˦ was recovered from 56 cases. The appearances found by sigmoidoscopy are described. In the treatment of chronic dysentery good results have been obtained from colon lavage with Dakin's solution. Six cases treated surgically are reported and discussed.

The Effect of X-rays on the Gall Bladder: Experimental Production of an X-ray Cholecystitis

DESTRUCTIVE lesions of practically every organ of the body, it would seem, have been produced experimentally by exposure to roentgen rays. However, in reviewing the literature we have been unable to find any reference to a destructive action on the gall bladder. To us it seemed quite feasible that a destructive dose of X-rays might reach the gall bladder during the course of a treatment to the right breast, base of the right lung, or right upper quadrant of the abdomen. Experimentally, a bacterial cholecystitis has been produced by many investigators, and there is considerable evidence to show that there is a more or less specific strain of streptococcus (1) and Bacillus coli which attacks the gall bladder (2). F. C. Mann (3) has produced a cholecystitis in dogs by injecting Dakin's solution intravenously. The reaction following this injection is completed within 24 hours and is very intense, consisting of a breaking down of the capillaries and an infiltration of the gall-bladder wall with blood. Burgess ...

THE EFFECT OF SURGICAL SOLUTION OF CHLORINATED SODA (DAKIN'S SOLUTION) IN THE PERICARDIAL CAVITY

Within recent years surgical solution of chlorinated soda (Dakin's solution) has been used to irrigate the pericardial cavity in the treatment of purulent pericarditis. There has been no agreement of opinion concerning its effect in these cases. It is my purpose in this report to show experimentally the effect of surgical solution of chlorinated soda in the pericardial cavity. This solution has won for itself a place of great value in the treatment of certain forms of infection, but its indiscriminate use is not devoid of danger. In the abdomen it produces an inflammatory reaction,1and when brought into contact with normal intestine, it produces perforation of the wall. The cases of pericarditis in which surgical solution of chlorinated soda was used are reviewed to determine if possible the effect that the solution might have had. In the case reported by Pool2two Carrel tubes... were inserted (into

Effect of Intravenous Injection of Dakin's Solution on Cholecystectomized Dogs.

The production of cholecystitis by intravenous injection of a solution of chlorinated soda (Dakin's solution), was first reported by Mann. He found that from 5 to 12 cc. per kg. body-weight, of a solution of chlorinated soda, having an available chlorine content of at least 0.48%, would produce a cholecystitis in dogs in 12 to 24 hours following the injection. Since Dakin's solution seems to act specifically on the gall-bladder, its injection might prove fatal if the gall-bladder were removed, and, if so, the gall-bladder must act as the specific organ of elimination or detoxification. Such an assumption is justified by the observation of Mann, which we have confirmed, that the solution reaches the gall-bladder via the blood stream and not the bile. Eleven normal dogs were injected intravenously with 10 cc. per kg. body-weight of a solution of chlorinated soda (Dakin's solution) containing 0.49% available chlorine. One dog died within 24 hours and the autopsy showed a cholecystitis. The other 10 were etherized after from 40 to 48 hours, and necropsies performed immediately. Of these, 3 showed normal gall-bladders, the remaining 7 all had cholecystitis of varying degrees of intensity. Several of these dogs had small hemorrhages beneath the serous coat of the liver adjacent to the gall-bladder; one having a large area of hemorrhage, 5 cm. × 2.5 cm. Four healthy dogs on which cholecystectomy had been performed 3 weeks previously were then injected intravenously with 10 cc. per kg. body-weight of Dakin's solution containing 0.49% available chlorine. Two hours after the injection all the dogs were noticeably uncomfortable, and 3 of them were vomiting. All of these dogs were alive and apparently in good condition 3 days after the injection.

The Effect of Certain Amides on the Stability of Modified Dakin's Solution

The Effect of Certain Amides on the Stability of Modified Dakin's Solution

Dakin solution

Dakin solution

A Concentrated Dakin's Solution

A Concentrated Dakin's Solution

THE ROENTGENOLOGIC STUDY OF EMPYEMA CAVITIES

The surgical treatment of chronic empyema cavities and sinuses should be guided by two laboratory methods: The first, which is relatively the most important, is the bacteriologic examination of the discharge, and the second is a careful roentgenologic study of the existing pneumothorax. A proper correlation of these findings is necessary, however, to obtain satisfactory results; even though the bacteriologic control guides the surgeon in the correct use of neutral solution of chlorinated soda (Dakin's solution) and indicates that the cavity is sufficiently sterile either to allow healing or to permit a radical operation, the knowledge obtained by means of the roentgen ray is an absolute essential. It not only detects abnormalities in the lung tissue, but also demonstrates the size, shape and location of the draining cavity and affords some knowledge of the walls that surround it. This can be accomplished, however, only by a carefully standardized technic which

RELATIVE IRRITANT PROPERTIES OF THE CHLORINE GROUP OF ANTISEPTICS

1. The use of the ears of rabbits is proposed in testing the irritant effect of antiseptics. 2. It is necessary, because of individual variations, to use solutions having definite irritant actions as controls. 3. 0.5 per cent sodium hypochlorite solutions have minimum irritant effects over a range of alkalinity of from about 100 to 1,000 times that of water (pH about 9 to 10). Solutions may be adjusted within these limits by use of the end-points of powdered phenolphthalein, of alcoholic solutions of either o-cresolphthalein or phenolphthalein. 4. Sodium hypochlorite solutions kept within the above range of alkalinity by either borate or carbonate buffer salts, i.e. Dakin's solution, show the same irritative properties whether made from bleaching powder and sodium carbonate, or from chlorine and sodium carbonate. 5. Electrolytically prepared solutions of the same concentration have similar irritant action. 6. Solutions, however, that have an alkalinity less than that indicated by the end-point of alcoholic phenolphthalein solutions (pH of 8.5 to 8.8) or greater than that indicated by the end-point to powdered phenolphthalein (pH of 10.2) are intensely irritating. 7. 0.5 per cent sodium hypochlorite solution from which most of the calcium has been precipitated and calcium hypochlorite solution of equivalent hypochlorite concentration are only slightly irritating. 8. 2 per cent chloramine-T solution has no irritant action. 9. 5 per cent dichloramine-T in chlorcosane and chlorcosane alone irritate rabbit ears to a slight degree only.

AN AUTOMATIC DISTRIBUTOR FOR NEUTRAL SOLUTION OF CHLORINATED SODA (DAKIN'S SOLUTION)

The successful use of Dakin's solution (neutral solution of chlorinated soda) depends on its delivery in sufficient quantity to all parts of the infected wound at regular and frequent intervals. These conditions can be obtained by a simple apparatus. Wounds vary in size; therefore, this apparatus has two controls, one for time and one for quantity. An irrigator can,<i>A</i>, is elevated on the head of the bed. A short piece of rubber tubing connects with a drop tube,<i>B</i>. A screw clamp on this piece of tubing controls the rate of flow through the dripping apparatus. For example, to deliver 80 c.c. every two hours, the screw clamp is set so that 10 drops each minute fall from the drop tube. A large size test tube,<i>D</i>, of about 100 c.c. capacity, is fitted with a three hole rubber stopper. This test tube serves as a reservoir to collect

EXPERIMENTAL CHEMICAL PNEUMONIA

It is obvious from the experiments reported that concentrations of chloramine-T solutions, even more dilute than those which are well borne by the nasopharyngeal mucosa, are injurious to the pulmonary tissue when introduced directly into. the bronchi in large volume. The pulmonary lesions produced are of the nature of an extensive bronchopneumonia which progresses during the first 2 days after injection of the chemical and then regresses, to disappear, as a rule, by the 7th day. Similar pulmonary lesions were produced by intrabronchial insufflation of Dakin's solution of hypochlorite of sodium. These studies taken in conjunction with the earlier ones of Kline and Meltzer in which aleuronat, starch, egg yolk, and lecithin were insufflated into the lungs, show that pulmonary inflammation may be induced by various chemical substances-with the following differences. Aleuronat and starch set up consolidations containing much fibrin, as is the case with virulent pneumococci; egg yolk and lecithin gave lesions with little fibrin, as is the case with avirulent pneumococci. Both series of substances produced lobar pneumonia, while the pulmonary lesions induced by chloramine-T and sodium hypochlorite were of the nature of bronchopneumonia. The consolidations of the lung produced by chemical substances differ from infectious pulmonary inflammations only in their sterility. These experimental results strongly suggest the view that the anatomical findings in pneumonia represent a part of a mechanism of defense and repair which the animal body creates in its struggle against infection and intoxication.

Ambulance de “L'Océan,” La Panne

THE editor and publishers may be congratulated on the attractive way in which this second number of the “Travaux” of the “Ambulance de ‘L'Ocean’” at La Panne makes its appearance. The papers are copiously illustrated with beautifully executed figures. The researches are naturally devoted to questions concerning the pathology and treatment of wounds and contain many valuable results, which do not admit of a brief account. The following may be referred to as of more general scientific interest. Depage and Maloens show that wounds naturally tend to become sterile; the process, nevertheless, may be aided by the brief action of a strong antiseptic. But prolonged action is injurious to the growing cells. The good effect of Dakin's solution is said to be due chiefly to its solvent action on exudations and dead tissue. Dustin gives a valuable and complete account of the histological changes in injured nerves. De Harven concludes that the choroid plexuses have a secretory function. Sand brings evidence to show that toxic products are produced by the disintegration of injured muscular tissue, whether due to mechanical action or to bacterial infection. Levaditi and Debrez give a detailed investigation of the flora of wounds and of the physico-pathological properties of exudations. Zunz was unable to find “acidosis” (diminution of alkaline reserve) in the blood of wounded men, unless bacterial infection or respiratory obstruction was present. Govaerts points out the importance of transfusion of blood at an early stage after hæmorrhage. Saline solutions were found useless, but the effect of the addition of gum was not tested.

A Handbook on Antiseptics

THE object of this little handbook, so the authors state, is to give a concise account of the chief chemical antiseptics which have been found useful for surgical purposes during: the present war. It appears at a very opportune moment, for, in spite of the disapprobation with which the^se substances are viewed in certain quarters, there is no indication that, as accessories to surgical treatment, they are losing in favour-rather the. contrary. The septic character o^most of the wounds received in France emphasised, at an early, period of the war, the importance of a searching and systematic study of antiseptics.. The result has been an array of new active substances. And this fact furnishes an additional raison. d'etre for the volume under review. Dakin's hypo-chlorite solution, Lorraine Smith's eusol, the chlor-amine antiseptics of Dakin and his collaborators, Browning's flavine antiseptics, and Morison's so-called B.I.P. paste, which have supplanted to a great extent the older preparations, have all appeared during the last four years. In most of the larger military hospitals these substances are known and used, but there must be a number of surgeons who have not access to the information except through occasional detached articles in the medical Press.

The prevention of blood clotting by Dakin's sodium hypochlorite solution

It has been shown by Austin and Taylor that Dakin's solution dissolves necrotic tissue in wounds and washes away blood clots. Sweet has stated that the dressing of wounds with this solution favored hemorrhage from them. We made experiments to determine whether the solution prevented the clotting of blood in vitro and wish to record some of the facts observed.We found that Dakin's solution of sodium hypochlorite added to blood in vitro was able to prevent clotting. If blood of a dog is drawn directly into Dakin's solution in the proportion of one part of Dakin's to ten of blood, clotting is usually prevented entirely. In a few instances such blood showed the formation of small, soft clots after standing several days. In no case was there any sign of clotting when as much as 1.5 c.c. of Dakin's to 10 c.c. of blood were used, even after standing as much as four weeks. There is a slight difference between the blood of different species; thus cat blood is prevented from clotting by rather smaller amounts than ...

BEHAVIOR OF HYPOCHLORITE AND OF CHLORAMINE-T SOLUTIONS IN CONTACT WITH NECROTIC AND NORMAL TISSUES IN VIVO

1. The fall in chlorine concentration of Dakin's hypochlorite solution is more rapid in contact with necrotic than in contact with normal tissue. 2. The fall in chlorine concentration of chloramine-T solution is very slight when applied to necrotic tissue and is negligible when applied to normal tissue. 3. The action of the hypochlorite solution on tissue results in the separation of particles of necrotic tissue, hair, epithelial scales, coagulated serum, etc., and a gradual digestion of these substances, taking place over a period of at least 17 hours. 4. The fall in the chlorine concentration of the hypochlorite solution is not complete until the particles are completely dissolved. 5. Chloramine-T solution, 2 per cent, has no erosive effect comparable with that exhibited by the hypochlorite solution. 6. Repeated exposures to the three solutions show the hypochlorite solution to be superior in its cleansing ability on necrotic tissue. 7. The hypochlorite solution is much more irritating to normal rabbit skin than chloramine-T solution or the alkaline control solution. 8. Therefore, the irritating effects must be due to the readily available chlorine.

PREVENTION OF BLOOD CLOTTING BY DAKIN'S SODIUM HYPOCHLORITE SOLUTION

To the Editor: —We wish to record here very briefly a few facts with regard to the action of Dakin's solution on clotting. The solution used was obtained from the War Demonstration Hospital (Rockefeller Institute) freshly prepared every morning. Dog's, cat's and rabbit's blood flowed from an artery directly into Dakin's solution, one part of Dakin's solution to every five parts of blood. Such blood remains unclotted for ten or more days. For older solutions larger proportions must be used. The addition of a sufficient quantity of a calcium salt does not produce clotting. Neither does the blood become clotted by the addition of a foreign body, nor does fibrin form by whipping. The solution in this proportion produces a gradual laking of the red cells. When blood is drawn into an oxalate and centrifugalized, a clear plasma is obtained; when Dakin's solution is added to such plasma and the

THE SOLVENT ACTION OF ANTISEPTICS ON NECROTIC TISSUE

1. Dakin's hypochlorite solution has the power of dissolving necrotic tissue, pus, and plasma clot in the concentration and reaction used clinically. 2. Chloramine-T and dichloramine-T do not exhibit this action. 3. The solvent action of Dakin's hypochlorite solution of the degree of alkalinity used clinically is due primarily to its hypochlorite content, but its slight alkalinity, while in itself without solvent action, enhances the effectiveness of the hypochlorite. 4. In the degree of alkalinity used clinically, the solvent action of hypochlorite is absent below about 0.2 per cent sodium hypochlorite concentration. 5. The hypochlorite concentration at which the solvent action ceases is lower the more alkaline the solution, and vice versa. 6. None of the antiseptics studied had demonstrable solvent action on blood clot.