Physiologic Solution Of Sodium Chloride Research Articles

TREATMENT OF UNILATERAL CATARACT WITH CONTACT GLASSES

As the name implies, a contact glass is a glass that is worn in contact with the anterior segment of the eyeball, touching the sclera, but leaving a space in front of the cornea which is filled with physiologic solution of sodium chloride. Because of their position while being worn, that is, under the lids and against the eyeball, thus eliminating the necessity of "frames," these glasses are advertised as "invisible spectacles." HISTORICAL REVIEW This type of glass is not an innovation but dates back to 1878, when Rühlmann stimulated interest in the treatment of conical cornea by requesting that a glass be made with a hyperbolic curve. Nine years later, or forty-six years ago, Fick made the first contact glass. There have been two methods of manufacturing contact glass, by grinding and by blowing. There are advantages and disadvantages in both methods, the ground glass being more accurate and

USE OF SALINE IN SOLUTIONS FOR LOCAL ANESTHESIA

To the Editor: —In a recent review of my book on local anesthesia (The Journal, October 28, p. 1418) I am criticized for not advocating the use of physiologic solution of sodium chloride in making up the anesthetic solution. Why should one use it in making up anesthetic solution? I have tried about all the various mixtures advised for the making up of anesthetic solutions in the clinic, in my leg, and in bunnies and bow-wows. There is no difference in the feel injected in one's own skin, and slides of animal tissue show no injury when plain tap water is used. Clinical experience convinces me that anesthesia is more prompt when a hypotonic medicine is used. Wise boys tell me that theoretically a hypotonic solution is more quickly absorbed than an isotonic or a hypertonic one. Be it remembered that after one dissolves a few tablets of procaine in

VACCINATION AGAINST WHOOPING COUGH

As vaccination against whooping cough is still much discussed, the following observations might perhaps be of some interest. The vaccine used in the State Serum Institute in Copenhagen is always made from several recently cultivated strains of Bordet-Gengou bacilli; forty-eight hour blood agar cultures are emulsified in physiologic solution of sodium chloride containing 1 per cent solution of formaldehyde, so that the suspension contains about 10.000 millions of bacilli per cubic centimeter. The vaccine is given in three injections intramuscularly or subcutaneously with intervals of from three to four days: 0.5, 0.7 and 1.0 cc. This dosage is greater than that usually employed. As generally maintained, one of the advantages of whooping cough vaccination is the absence usually of severe reactions following the injections, although it would seem correct to call attention to two deaths that have occurred in Denmark. In both cases, the children concerned were new-born in families

PERITONITIS

There has been a growing tendency in recent years to inject large quantities of fluids intravenously in the treatment of shock, peritonitis and intestinal obstruction. MacFee and Baldridge, 1 1930, reported their results in the treatment of such conditions by the intravenous injection of large amounts of physiologic solution of sodium chloride. They stated that: solution has been given intravenously in amounts ranging from 2000 cubic centimeters to 8000 cubic centimeters at a single injection. The usual amount required has been about 4500 cubic centimeters. Autopsy was performed recently on a patient who died of peritonitis and who had been given large amounts of salt solution intravenously. The peritonitis was generalized, and there was an unusually large amount of fluid in the peritoneal cavity. Following this autopsy it was feared that the extent of the peritonitis had been increased by the fluid that had been introduced and that the

THE USE OF LIVER EXTRACT INTRAVENOUSLY IN THE TREATMENT OF PERNICIOUS ANEMIA

Following the demonstration in 1928 by Beckmann¹and in 1929 by Cohn, McMeekin and Minot²that liver extract could be given intravenously to patients with pernicious anemia with good therapeutic results, numerous forms of the material have been used with success. The first published formula of a simply prepared product was that of Castle and Taylor³in 1931. Their solution consisted essentially of liver extract No. 343 N. N. R. washed with ether and dissolved in physiologic solution of sodium chloride. A later modification (Strauss, Taylor and Castle⁴) was made by using an aqueous solution at a<i>p</i>hof 7.4. Intensive studies of the blood changes following the intravenous use of Castle and Taylor's solution were made in our laboratories in May, 1931, and were reported in November, 1931.⁵As the reactions following this treatment were too severe to make the medicine of routine

THE HAZARDS OF INTRAPERITONEAL INJECTIONS

Intraperitoneal injections of physiologic solution of sodium chloride, first introduced by Blackfan and Maxcy 1 in 1918, have been employed extensively in the treatment of dehydration in infants. More recently the administration of dextrose, 2 diphtheria antitoxin, 3 neoarsphenamine, 4 iron 5 and blood 6 has been recommended by this route. Some authors 7 have considered typing or cross agglutination unnecessary preliminary to this method of blood transfusion. The use of the intraperitoneal route permits more rapid introduction into the body of relatively larger quantities of fluid than is possible by hypodermoclysis. It is also easier than venipuncture; hence its popularity in the treatment of infants by physicians in the numerous small hospitals in which interns are not available. Some of the dangers of this procedure, as illustrated by the cases reported in this article, are: Perforation of the intestine. The introduction of incompatible blood into the circulation. Hemorrhage from

EFFECTS ON COMPOSITION OF BLOOD OF PHYSIOLOGIC SOLUTION OF SODIUM CHLORIDE

This paper is a continuation of previously reported studies 1 of the effects of the administration of fluids to animals with low blood pressure. In the previous studies, fluid was administered intravenously and subcutaneously. The changes observed in the protein content of the blood were considered important. The present studies were carried out in order to determine the effects of physiologic solution of sodium chloride when introduced by intraperitoneal injection and by stomach tube into animals with low blood pressure. The subcutaneous injection of histamine and graded bleeding were the methods used to produce low blood pressure. METHODS All of the experiments were carried out on dogs that were anesthetized with morphine. They gave no evidence of pain during the experiments. Shortly following the administration of the anesthetic, the blood volume was determined by the dye method, 2 and samples of blood were withdrawn for the control determinations. Physiologic solution

TREATMENT OF EXTRAPULMONARY TUBERCULOSIS WITH METHYLATED ANTIGEN

A few years ago it occurred to certain French observers that the preliminary removal of the fatty portion of the tubercle bacillus might facilitate the production of a more potent antigen for use in the treatment of tuberculosis. In brief, this was accomplished by extracting the killed and dried tubercle bacilli with acetone. The acetone was then removed by filtration, and the defatted organisms were suspended in methyl alcohol for some days and then filtered. The filtrate thus obtained was designated methylated antigen, and after suitable dilution with physiologic solution of sodium chloride was injected into laboratory animals and later into man. In 1925, Negré and Boquet¹reported the results they obtained with methylated antigen in tuberculous guinea-pigs and rabbits. They concluded from these experiments that antigen thus prepared when injected into animals was capable of provoking an abundant production of antibodies to increase their resistance to tuberculosis. Doses

USE OF LIVER EXTRACT INTRAVENOUSLY

Castle and Taylor 1 have recently shown that maximal responses of reticulocytes were obtained in the treatment of patients with pernicious anemia, during relapse, when the amount of liver extract derived from 100 Gm. of liver was administered intravenously. The solution suitable for intravenous injection was prepared by dissolving approximately 4.5 Gm. of a commercial preparation of fraction G 2 (liver extract) in physiologic solution of sodium chloride after washing the extract in ether. The solution was then filtered or centrifugated, sterilized by boiling for five minutes and made so that 20 cc. contained the amount of material derived from 100 Gm. of whole liver. In studying the nature of the active principle in liver, Cohn 3 and West 4 and their respective associates had previously prepared highly purified fractions of liver which were suitable for intravenous injection and which were found to be potent. The practical application of these

Simple Method for Obtaining Antisera in a Dry State

Several reports deal with the preparation of dry antisera. Evaporation in vacuo and precipitation in the cold with alcohol or acetone are the methods most used. According to reports dealing with the latter method, the low temperature has been assumed to be the factor preventing denaturation and loss of antibody activity. We have found that the concentration of the organic precipitant is an equally important factor. There exists a critical concentration of the organic solvents methyl, ethyl and propyl alcohol and acetone, in the range of 60% to 75% concentration at which denaturation of serum proteins is maximal. As the concentration is increased from about 75% the degree of denaturation is decreased until at final concentrations of 90% or above serum proteins can be precipitated by these organic solvents at room temperatures without loss in solubility or antibody activity. Applying this phenomenon the following method has been used to prepare dry immune sera. To 10 or more (but not less) volumes of acetone add slowly with shaking one volume of the serum. Collect the precipitate on a filter, wash once with acetone followed by 3 washings with anhydrous ether, the precipitated mass being stirred with a wooden spatula after each ether addition. Approximately 5 volumes of ether to each original volume of serum is required for each washing. The final white mass is spread out on the filter paper and placed in the 37°C. incubator for about one hour. The resulting dry mass is readily pulverized with the wooden spatula to an extremely light, white, fluffy powder. This powder is slowly (due to slow wetting) though completely soluble in distilled water or physiological sodium chloride solution. There has been detected no loss in agglutinating activity, hemolytic activity or antitoxin content.

A RAPID METHOD OF PROTECTING THE PERITONEUM AGAINST PERITONITIS

The subject of peritonitis and especially its prevention by active immunity methods lately has aroused the interest of American investigators. The problem of active peritoneal immunity may be said to have been opened by Pfeiffer and Isaeff1with their demonstration of bacterial lysis within the peritoneal cavity in immunized animals (Pfeiffer phenomenon). This lysis was shown by the authors to be humoral and produced by the bacteriolysins of the serum. The next step was made by Pierallini,2who found that a leukocytic exudate could be obtained in the peritoneal cavity by the injection of foreign substances, including physiologic solution of sodium chloride. He was followed by Garnier,3who confirmed the presence of a leukocytic exudate in the peritoneal cavity of immunized animals, and found that bacteria are rapidly destroyed in the presence of such an exudate. Solieri4definitely applied such immune responses to peritonitis. He produced

IMPLANTATION OF IVORY IN OZENA: APPROVED TECHNIC; FURTHER OBSERVATIONS

Since the appearance of my article 1 on ozena over a year ago, so many inquiries about the operation have been made that I decided to write this paper elucidating the operation and adding my further observations on the implantation of ivory. TECHNIC I obtain my ivory from V. Mueller and Company, Chicago, in blocks of four sizes (1 by ⅜ by ⅜ inch), (1¼ by ⅜ by ⅜ inches), (1⅜ by ⅜ by ⅜ inches), (1 by ¼ by ¼ inch). The first two sizes are used most frequently; occasionally the last one is more appropriate. These blocks are taken to a dentist, who rounds off all corners and flattens out all edges with his carborundum driven by an electric motor. The patient's nose is douched thoroughly with physiologic solution of sodium chloride to which a little sodium bicarbonate is added, until all crusts have been removed. He is

THE ABSORPTION OF DEXTROSE FROM THE COLON

Results obtained by us1previously in experiments carried out on dogs indicate that a 5 per cent aqueous solution of dextrose is not absorbed from the colon to any appreciable extent. Tap water and physiologic solution of sodium chloride are rapidly and efficiently absorbed. As a control in those experiments we exposed the ileum simultaneously to the same solutions in the same dog by using the same technic, and variable but considerable absorption was observed. This study was continued in order to observe the fate of dextrose in enemas made up of equal parts of 5 per cent solution of dextrose and solutions of various chemicals that might possibly act as excitants or stimulants to absorption. The fact that a 0.9 per cent solution of sodium chloride was readily absorbed by the large bowel suggested that salt might favor the absorption of dextrose when the two substances are mixed

MERCURIC CHLORIDE POISONING WITH RECOVERY FOLLOWING THE USE OF SODIUM THIOSULPHATE

As one goes through the literature on mercuric chloride poisoning, one is struck with the comparatively few patients who have survived massive doses of the drug. For this reason we report this case because in some respects, which will be brought out, we believe it to be unique. The literature is so vast that to attempt to review it would be beyond the scope of our intentions. However, in preparing this report, we have scanned the literature on the subject and find few, if any, cases reported in which the patient has taken as large an amount of the poison and retained it as long as our patient did and recovered. Hayman and Priestly1reported a case in which the blood urea nitrogen reached 247 mg. on the nineteenth day of treatment and on infusion of physiologic solution of sodium chloride the urea nitrogen was reduced to 83 mg.

PREGNANCY AND LABOR COMPLICATED BY GRANULOMA INGUINALE

Granuloma inguinale is a disease found chiefly in the subtropics, but during the last ten years sporadic cases have been reported from many localities in this country, especially in the South. In Charleston, S. C., it is fairly common; the genito-urinary department of Roper Hospital informs me that it treats about twenty-five cases a year. Kenneth M. Lynch 1 of Charleston and Meredith F. Campbell 2 of New York are to be credited with the most comprehensive study of this condition that has been made in this country. The organisms that are supposed to be the cause of this disease were first described by Donovan in 1905 and are called Donovan bodies. The method for demonstrating this organism is as follows: A portion of ulceration is selected where the ulceration appears to be spreading, not healing. Wet dressings of physiologic solution of sodium chloride are applied to this area for

THE PERMEABILITY OF THE LENS CAPSULE TO WATER, DEXTROSE AND OTHER SUGARS

In a previous paper 1 quantitative studies on the permeability of the lens capsule to various colloid and crystalloid analine dyes were reported, together with qualitative studies in regard to the permeability for various other organic and inorganic substances. In view of the importance of water and dextrose in the normal metabolism of all tissues and in view of the experimentally demonstrated dextrose consumption of the lens 2 it seemed desirable to obtain, if possible, experimental data of a quantitative nature in regard to the permeability of the lens capsule for water and dextrose. The method that was devised for these experiments was very simple. The apparatus is shown in figure 1. The experimental procedure was as follows : Capsules removed from the lenses of freshly enucleated eyes were cleansed by prolonged shaking in frequent changes of physiologic solution of sodium chloride, as described in the previous paper, 1

THE CHEMOTHERAPY AND SERUM THERAPY OF PNEUMOCOCCUS AND STREPTOCOCCUS MENINGITIS: VI. THE CEREBRAL-CISTERNAL-SPINAL LAVAGE METHOD OF TREATMENT FOR SEPTIC MENINGITIS

In the series of papers1published two years ago on the chemotherapy and serum therapy for pneumococcus and streptococcus meningitis, I reported occasional successful results in the treatment for severe experimental diffuse meningitis of dogs by lavage of the lateral ventricles, cisterna magna and spinal subarachnoid space with warm physiologic solution of sodium chloride followed by the intraventricular and intracisternal injections of pneumococcus antibody solution or antistreptococcus serum. Not frequently lavage alone with physiologic solution of sodium chloride resulted in recovery, so that the opinion was expressed that thorough washing of the ventricles to the cistern and lumbar region of the cord was the more important of the two phases of the method of treatment. Among some of the dogs that succumbed to the disease under this method of treatment, necropsies showed the presence of purulent meningitis over the cerebral hemispheres, indicating the necessity of modifying

A NEW CLINICAL TEST FOR TISSUE THIRST

Recent reports by Aldrich, 1 who made tests by intradermal injections of physiologic solution of sodium chloride, showed clearly that edema was due to an increased hydrophilic action of the tissue colloids and not simply to renal obstruction. With this point in view, the following method was devised to study the colloid affinities of the proteins in the blood. EXPERIMENTAL WORK The apparatus used was a glass tube with a bell-shaped end. The bell end was closed with a collodion membrane, and the tube was filled with serum with a fine bacteriologic pipet. The tube was so graduated that when filled to a certain point it would read in percentage of swelling of the original volume of serum, as is shown in the illustration. The ends of these tubes were then immersed in hundredth-normal hydrochloric acid, and the percentage of swelling was noted. Dialysis of the same serum against water, physiologic

STUDIES IN EXPERIMENTAL EXTRACORPOREAL THROMBOSIS

1. Distilled water dialyzes through the collodion tube and causes hemolysis. Clotting of the hemolyzed blood in the collodion tube occurs later. 2. Bile salts accelerate the appearance and development of white thrombi in the heparinized animal. The masses of white thrombi are very loose, soft, fragile and easily broken into clumps of platelets. They are poor in fibrin or the fibrin is abnormal, since they have less retractility than those obtained from the use of physiologic sodium chloride solution or calcium chloride or serum. Despite the increase in number and size of white thrombi, normal clotting does not occur. 3. When the collodion tube is surrounded by 1 or 2 per cent d-glucose solution, tiny and numerous white thrombi appear as radiating figures. The masses of white thrombi are rather loose and fragile. The clotting time of the heparinized blood does not appear to be shortened. 4. When a 1 to 2 per cent solution of calcium chloride is used as the dialyzing fluid outside the collodion tube, or when it is injected into the circulation, the formation of white thrombi is accelerated. They grow very rapidly. In spite of the action of heparin, the white thrombi formed are not so fragile as when bile salts are placed outside of the collodion tube. Fibrin seems to form easily. Obstruction of venous cannula takes place speedily and if the clots in the cannula are not removed, the white thrombi in the collodion tube remain small and become red by sedimentation of red cells. 5. Intravenous use of 10 per cent solution of magnesium sulfate without heparin retards the coagulation of circulating blood and permits the blood to flow through the extracorporeal loop from three to four times as long as normal. The formation of white thrombi, as well as red, is retarded. Magnesium sulfate (1 per cent) in physiologic sodium chloride solution placed outside the collodion tube markedly retards the formation of white and red thrombi in the heparinized animal. Magnesium sulfate (10 per cent), 50 mg. for each kilo of body weight each hour, administered intravascularly in the heparinized animal definitely prevents the first stages of thrombosis, and consequently prevents clotting. 6. It is possible by the combined use of adequate amounts of magnesium sulfate and of heparin intravenously to prevent all stages of thrombus formation for from 1 to 3 hours.

THE HEMATOPOIETIC EFFECTS OF INTRAVENOUSLY INJECTED NUCLEIC ACIDS

Intravenous administration of the sodium salts of nucleic acids obtained from the blood cells of the fowl gave such interesting results on animals 1 that it was thought justifiable to employ the method, with extreme caution, on human patients suffering from anemia. Accordingly, nucleic acids obtained by the Kessel-Neumann method, as previously described, were introduced intravenously in dosages of from 0.25 to 1 Gm., dissolved in physiologic sodium chloride solution, in a series of eleven patients. These patients were under hospital treatment and had been diagnosticated as secondary and pernicious anemia cases, with various associated complications. The smallest dose of sodium nucleate administered, 0.25 Gm., was approximately the same as had been given to rabbits weighing from 2.3 to 2.5 Kg., and the largest dose (one case) was four times this amount. There was therefore a great disparity between the body weights of the rabbits and of the patients treated