Jflii[i[oi| of Hospital $i[Htlia.

NOTE ON THE INTRAVENOUS INJECTION OF EUSOL.

Br C. BARKY,

LIEUT.-COL., I. M.S.,

Rangoon.

\ As the intravenous administration of eusol is still on its trial, the following six cases in

which this form of medication was used may be of interest. All six cases were under the care of the Rangoon General Hospital staff, three

of them being treated by Dr. Kundu, Resident Surgeon, and the remaining three by myself. The solution used for intravenous injection

was made by dissolving eupad in normal salt solution so as to form a 2'5 solution, equivalent to a 0*5 per cent, solution of hypochlorous acid. The quantity injected was five ounces or approxi- mately 150 cubic centimeters, and was given by means of an hypodermic needle inserted into one of the veins at the bend of the elbow.

Of the six cases treated with intravenous in-

jection of eusol, five recovered and one died. The

condition of the patient that died was practically hopeless. It is, of course, impossible to say what would have been the outcome of the remaining five cases had intravenous injection of eusol not

been administered, but the patients were all

suffering from acute general sepsis, a condition

that clinical experience teaches us to associate

with a high mortality. The injections were

all followed by a rapid lowering of temperature, and what was perhaps more important a great improvement in the general condition of the

patient. In four of the cases more than one intravenous injection was considered necessary. In every case the injections were followed in about half an hour by a very severe rigor, so severe

as in some cases to raise alarm, the patient giving the impression of becoming asphyxiated. Further

experience will no doubt prove if this formid-

able drawback is not capable of being lessened

or avoided. The rigors, though very severe,

appeared to have no bad after-effects once they had passed off. Still they constitute a grave drawback, and it is to be hoped further investi- gation may lead to the discovery of some

method of preventing these rigors, or at any rate of diminishing their severity.

In the light of the above limited experience it would seem the intravenous injection of eusol is likely to prove a valuable remedy more especially in cases of general sepsis, a condition which up to now has proved resistant to most forms of medical treatment.

Case I.?Patient was admitted on the Gtli day after an instrumental confinement with symptoms of acute puerperal sepsis. The patient was

delirious. The uterus was tender but not appar- ently enlarged, the lochia had ceased. The uterine cavity was explored, but no retained

products of conception discovered. An intra- venous injection of eusol was given. The

temperature at once began to fall rapidly and reached normal in 8 hours. As the temperature fell the patient's condition improved wonderfully, the delirium disappeared,and the patient expressed herself as feeling well but weak. The lochia re-appeared and remained normal in quantity; except for a moderate rise of temperature the

following evening, convalescence was uninter-

rupted. Once the temperature had fallen the

NOTE ON THE INTRAVENOUS INJECTION OF EUSOL. My Liect.-Col. C. HARRY, i.m.p.,

Rangoon.

CHART I.

DATE

Day of Dia. TIME M.E

6 M.E.

7 M.E

13 14 15

8 M.E

9 M.E

10 M.E

16 17 18 19

II 12 13 14 M.E M.E M.E M.E

temperature

Fahr.

103

102

39

TF"

; co

W;^pS- ^ = O.uJo n-'5Z :

tr^J : ui O

&

UJ7> Q-uJ

-J

f;l0| 5 P?>| 2 K3

V

CHART I.

CHART II. CHART II.

CHART III CHART III

NOTE ON THE INTRAVENOUS INJECTION OF EUSOL.

By Lietjt.-Col. C. BaRRY, i.m.s.,

Rangoon.

CHART IV. CHART IV.

CHART V.

DATE

Day of Dis. TIME

23

I m.e

2 M.E

25

3 M.E

4 M.E

27

5 M.E

28

6 M.E

29

7 M.E

8 M.E

31

M.E

11 M.E

12 M.E

13 M.E

14

M.E 15 M.E

16 M.E

I 7 M.E

18 M.E

18 M.E

20 M.E

12

21 M.E

TEMPERATURE

41

40

Fahr.

106

IPS

103

39 103

N

2 ?a 100

99*

~jHT A

%

CHART V.

DATE

Day of Dis. TIME

CHART VI.

12 13 14 15 16 17 18 19 20 21 22 23

5

M.E

6

ME

7

M.E

8

M.E

10

M.E

II

ME

12 13 14 15 16

M.E M.E M E M.E M.E TEMPERATURE

Cent.

40

Fohr.

106 * D

IPS

104

103 A 39

102

101

38

37

100

99 VA

?a'

97*

?

CHART VI.

458 THE INDIAN MEDICAL GAZETTE. [Dec., 1916.

patient was allowed to nurse her child which throve well. A laceration of the perineum healed well being treated with eusol fomentations. The intravenous injection of eusol was followed by a very severe rigor.

Case II.?The patient was admitted with a

crushed leg, the injury involving the left ankle

joint. The wound was from the first septic, and the patient after 10 days showed signs of general septic infection. His mental condition was

affected, the patient being semi-conscious though irritable and he was evidently very ill. Eusol was given intravenously on three occasions with satisfactory results, the general condition improv- ing greatly and the effects of the septic absorption being largely counteracted. Eventually a local- ized abscess formed and was dealt with surgically. Each intravenous injection of eusol was followed by a severe rigor, but the patient made a good recovery and left hospital with a useful foot.

Case III.?This patient suffered from very severe sepsis following on child birth. She was first seen six days after her confinement and was then exceedingly ill. Altogether four intravenous injections of eusol were administered ; their effect was very beneficial, and it is doubtful if recovery woukl have been possible without them. After a long illness the patient made a good recovery. Each intravenous injection of

eusol was followed by a severe rigor. Case IV.?This patient was admitted with

acute puerperal sepsis on the sixth day after child birth. Symptoms had manifested them- selves on the third day after delivery. On admission the patient was delirious. The uterus was large and tender, but the cavity on explora- tion contained no retained products of conception. An intravenous injection of eusol was adminis-

tered. The temperature fell rapidly and the

patient recovered consciousness, her general condi- tion showing considerable improvement. The

temperature rose again after 8 hours, and the

patient died somewhat rapidly of heart failure.

The intravenous injection was followed by a

severe rigor. Gase.V.?Patient was admitted with compound

comminuted fracture of both legs just above the ankle joints. Under chloroform the wounds were

cleaned out and the fractures of both legs united with Lane's plates. The patient's .condition from the first gave rise to anxiety, and on the 13th day it was evident he was suffering from septic osteomyelitis; on the 17th day the patient was delirious with all the symptoms of acute general sepsis. After the first intravenous injection of eusol very little improvement was apparent, but on a second injection being given the temperature fell rapidly, the delirium disappeared and the

patient's condition was wonderfully improved. The two subsequent eusol injections were given with the view of improving the condition of the

legs which were greatly swollen and inflamed.

The eusol injections were followed by severe

rigors. Case VI.?This patient was admitted with

symptoms of severe and generalized puerperal sepsis. Symptoms set in on third day and patient was admitted to hospital on the following evening. The lochia were absent and the uterus very tender, but exploration of its cavity disclosed no retained products ? of conception. Two intravenous

injections of eusol were given, one on' admission, the other some 3G hours later. After the first

injection, the temperature fell rapidly and the

general condition was greatly improved. On the

following day the temperature rose again and

symptoms of returning general sepsis showed

themselves, though not so severely as before. A

second intravenous injection of eusol was followed

by a sudden fall of temperature and general improvement. Both intravenous injections were followed by a severe rigor, but the patient made a

rapid recovery.