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Hydrochloric Acid and the Oxygen Content of Red Cells
Among the reports before the recent meeting in Cambridge of the American
Association for the Advancement of Science was one by Dr. W. V. Macgilvra,
of the Harvard Dental School, on the intravenous use of a hydrochloric
acid solution. He said, "The patient was moribund, due to the
unexpected effects of an anesthetic. The hydrochloric acid was injected
at 10:15 a.m. Eight minutes later, lips began to twitch; in the minutes
the hands moved; in 40 minutes, the patient was talking coherently…Repeated
studies of this patient since have failed to disclose any ill effects." Furthermore,
Dr. Macgilvra said, the acid had been given to six other cases, and
it was found that respiration, blood
pressure, and pulse were increased, and lost reflexes restored. Dr.
Macgilvra also said that was the first time the hydrochloric acid had
been injected intravenously in man.
Within the following week, there was a published report in the Kansas
City Star of the use of the intravenous injections of the hydrochloric acid solution
in 300 guinea pigs after the cessation of respiration following anesthesia.
Miss Pearl Moorman, who made these determinations, said that lactic acid was
also tried, but that the animals in which it was used all died. The report
indicated that a search would be at once instituted for the reasons for these
unusual clinical phenomena. With whatever value there may be in some six years
of observation of patients with all manner of infective diseases under the
influence of the injections of hydrochloric acid solutions, it is possible
something may be suggested to clear up problems that now seem obscure, both
with the patient in Worcester and the guinea pigs in Joplin.
The explanation I am about to lay before my fellows, of course, has, as its
raison d' etre, changes in the blood cells following the injection of hydrochloric
acid solutions. To any colleague who may have read papers of mine in the past,
I will say at the beginning that I shall not discuss the white blood cells
nor the Metchnikoff idea, since neither the phagocytes nor the Metchnikoff
theory played any part in the clinical changes I am about to describe.
Early in the month of January, I was called to see a patient, a man aged 55,
apparently dying from angina pectoris. He was alone in a hotel room and could
give me no history of his ailment. A partly empty bottle of digitalis on the
dresser, and stertorous breathing from water-filled lungs precluded any possibility
of hearing anything of the very rapid and tumultuous heart. With the aid of
a bellboy, I gave him an intravenous injection of a 1-250 hydrochloric acid.
Before the completion of the injection of the 10 cc, the breathing had improved,
and he rested easier. Within a few minutes, he told me he had had angina for
four years, during which time he had taken digitalis, and he had taken a dose
of it a little while before I had been called, but that he could feel no good
effect whatever. During the forty minutes following the injection of acid solution,
while he was still breathing with appreciable effort, improvement was such
as to make me believe that he would recover. Twice during this period, he got
up from his bed and went across the room to the bathroom. At the end of the
forty minutes, however, the breathing became worse, edema in lungs increased,
and within a few minutes, the patient became unconscious, in spite of subcutaneous
injection of the acid. A little over an hour later, he died.
I shall attempt to show that the passing improvement in this case of angina
pectoris and the recovery of the anesthesia case in Massachusetts, as well
as the guinea pigs in the West, were all due to the stimulation of the same
cellular activity by the injection of the hydrochloric acid. The explanation
comes from Wisconsin.
During the summer of 1933, Dr. John Edmonson spent a few weeks in the Battle
Creek Sanitarium with Dr. Paul Roth. Since Dr. Edmonson had been using intramuscular
injections of hydrochloric acid for several years, Dr. Roth heard reports of
the clinical behavior of patients with diverse infections and ailments who
had come under his observation. Some one of these reports so impressed Dr.
Roth that he was determined to make an observation on any change that might
be noted in the red cells. Readers of this paper will note that the subject
of phagocytes is not brought up.
Table 1 shows the changes in Dr. Edmonson's red cells
after the injection of 10 cc of a 1-1000 solution of the acid. (64 KB .pdf)
I quote from Dr. Roth's kind letter: "The above figures show
that the injection of hydrochloric acid intravenously does not materially
change the 'CO2 capacity' of the blood, while the O2 content is markedly
increased in 30 minutes after the injection. The CO2 combining power
is decreased and remains at a lower level for several hours. Similar
results were noted in several other cases, except in one instance in
which very little change occurred in the CO2 combining power only. "I
wish to suggest to you that an increased oxygen content of the blood
is readily, though roughly, observed by merely noting the change in
the appearance of the blood to a brighter color."
In the light of the observations of Dr. Roth, it would seem to me that
the temporary improvement in the angina case and the recovery of the "moribund" anesthesia
case were due to the increased oxygen content following the injection of the
acid.
I am most grateful to Dr. Roth for the information given in this report of
his determinations because of the enlargement of perspective. Phenomena for
which phagocytic activity or chemical change failed to furnish an explanation
now are clear. For example, last December, I was called to see a young woman
with a temperature of 103.5º; respiration, 36; pulse 115; great pain in
involved lobe, lower left. There was marked improvement in the heart, breathing,
and general condition within a few minutes after the injection of the acid.
During the following three days, an injection of the acid was given every day,
and on the fifth day, she sat up in bed to eat breakfast of cereal, eggs, and
coffee. There were no inflammatory reactions following any of these injections.
Although the temperature was normal, I gave as a tonic an intravenous injection
of 1-1500 solution of HCl, following which there was a marked reaction, which
gave the nurse more to do than she had during the activity of the pneumoccocci.
After that, the patient went to an uninterrupted recovery. I did not have an
explanation for the inflammatory reaction. Nor had I any reason satisfactory
to myself for the behavior of the patient after each injection of the acid.
Her clinical improvement softened the regret of my own lack of knowledge. Now,
however, with the information given me by Dr. Roth, the explanation of the
clinical change seems just as simple as it would have seemed if an oxygen tent
had been used. I doubt very much if the inhalation of oxygen in a tent causes
an increase in the content of this element in the red cells so great as that
which follows the injection of hydrochloric acid.
All of us will agree that two important factors in the well-being of these
bodies of ours are copious amounts of oxygen in the red blood cells and the
maximum activity of the phagocytes of the defensive force of the individual.
The Medical World of May 1933 contained a paper showing the marked increase
in phagocytic activity against the staphylococci after the injection of hydrochloric
acid. So, through the use of this basic body acid, two of the cardinal principles
of resistance may be easily induced. In closing, I congratulate Miss Pearl
Moorman, of the Duncan Laboratories, Joplin, Missouri, and Dr. W.V. Macgilvra
on their use of intravenous injections.
Quinine and Chlorides
Dr. W.B. Guy has just sent to me a copy of The
Medical World, describing
his use of the hydrochloric acid injection and your most interesting
discussion of the effects of quinine in gonorrhea. In all of the
determinations I have done, the increase in the exudate of such infections
is the direct result of the increase in numbers and activity of the
white cells. In the old books on therapeutics, quinine sulphate in
very large doses was highly recommended in the treatment of puerperal
sepsis. So, basically, I think we must attribute the results to an
induced phagocytic activity from the potent effect of the administration
of quinine. Several years ago, I treated a number of cases of furunculosis
by the intramuscular injection of dihydrochoric of quinine, with
excellent results
Since all these drugs that seem to do so well have a bit of chlorine
as an active principle, I use HCl in the treatment of all infective
diseases that I happen to see. Not only because of the chlorine, but
because this acid not only stimulates the essential factor in the inflammatory
reaction, but also seems to have a most potent influence on the acid-base
balance of the blood stream. And, with the modification of the pathological
alkalosis, the phagocytes seem to engulf the invading organisms with
increased avidity.
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