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From the Townsend Letter
January 2007


Three Years of HCl Therapy (Part II)
as recorded in The Medical World
with introduction by Henry Pleasants, Jr., AB, MD, FaCP (Associate Editor)
Originally published by W. Roy Huntsman, Philadelphia, PA

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Part I is also online
The entire 50-page article is online as a 516KB .pdf.

Page 1, 2, 3, 4, 5, 6, 7

Hydrochloric Acid as a Germicide
For a very long time chlorine has been known as a potent germicide in laboratories, but clinically no means for its successful use in infected wounds or ulcers has been found, so far as I know. With a few changes, these manifestations of infection are treated now about as was done in the early nineties. Twenty years ago, it was said that the solution had been found from which the chlorine would be liberated. The promised germicide was made from a solution of chlorinated lime, soda, and boric acid, and theoretically, it was the ideal agent for local application on infected lesions. Like the many other agents for such local application, clinical results did not come up to the laboratory promises. The most exhaustive paper on ulcers (JAMA, January 26, 1935) lists the numerous agents used in the Cook County Hospital for these lesions; the solution of lime is not mentioned. Hence, we may conclude that this preparation has not proved to be of any clinical value.

In 1919 and 1920, I had the good fortune to be associated with Dr. Carl Yount, of Pittsburgh, in the Morskoi Hospital, Vladivostok, Siberia, in the service of the American Red Cross. This institution was maintained by the Red Cross for the care of war injuries, and I was a ward surgeon there. Here there were the greatest number of infected gunshot and other wounds I have ever seen grouped in one institution. All manner of antiseptics were used in the treatment of these lesions by direct application and irrigation. When one agent would fail, another would be tried and then another and another, and usually at the end of the round of antiseptics, Dr. Yount would amputate the leg, arm, or finger, or I would sign the death certificate.

A few months ago, in thinking over the problems made by ulcers and these infected wounds, I determined to try cleaning, irrigating, and dressing these lesions with a solution of 1-250 hydrochloric acid. J was seeing its good effects every day following its intravenous or intramuscular injection and, because of the solution's great chlorine content, I could see no reason why it might not be used on such lesions. Results were all that could be hoped for, and in an attempt to get a laboratory observation on the effect of this solution on germs in a culture tube, I asked Dr. Stuart Graves, Dean of the Medical Department of the University of Alabama, for his cooperation. This he very kindly gave me, turning my letter over to Dr. Ralph McBurney, Professor of Bacteriology. After a few weeks, Dr. McBurney was sent me the following report of his observations:

February16, 1935

School of Medicine
University of Alabama
Office of the Dean

Dear Dr. Ferguson:
Dr. Graves turned your letter regarding the germicidal action of a 1-250 aqueous solution of hydrochloric acid over to me for investigation of this property. We have subjected twenty-four-hour beef-infusion broth cultures of staphylococcus aureus and streptococcus hemolyticus to its action in the dilution named. Exposure of both types was at a constant temperature of 37 degrees C. for successive periods of five to ten, 30, and 6o minutes, and for 12 and 24 hours, respectively. Organic matter to the form of ten-percent horse serum was not added to the hydrochloric acid solution.

The following results were obtained:
The five-, ten-, and 30-minute exposures failed to kill both types. The one-, 12- and 24-hour exposures resulted in complete germicidal action, all subcultures from the original tubes being sterile after 24 and 48 hours incubation at 37 degrees C. We were unable to try this out upon gonococci and trcponema pallidum as we do not keep these organisms in stock owing to their fastidiousness in culturing. Because of this and their greater vulnerability to the action of germicidal agents, in general, as compared to the organisms we have used, it may be inferred that a hydrochloric acid solution of the above strength will kill them within the same time period as determined above and in all probability sooner.

We were glad to be of this service to you and trust that the results may reach you in time for your paper.
Very truly yours.
Ralph McBurney, MD
Professor of Bacteriology

I had had the pleasure of working with lesions made by the several germs mentioned (save the streptococcus hemolyticus), and the report from Dr. McBurney gave me a delightful confirmation of the rapid elimination of the organisms which I had seen so many times clinically. I am using the hydrochloric acid in all infective foci to which one may apply it, but as yet, I am not in a position to recommend any particular strength of the solution for other infections of eye, rectum, urethra, or colon.

Sinus Infection
In the winter of 1933 and 1934, it happened often that I met a colleague whose manifestations of infection were such as to make him an interesting subject in a study of the peculiarities of germs. He wore almost constantly a large green patch over the right eye. On lifting it, one could see, in bold relief, apparently every capillary in the choroid coat. The iris seemed pretty well-fixed. At a glance, one could see that a great number of pyogenic organisms were being distributed throughout this eye daily. In response to my efforts to try the elimination of the germs, he did come to the office, where a count was done, and it was found that the white count was 12,500 per cubic millimeter. I tried to convince him that this was nature's effort to rid the eye of infection and that, whatever surgical procedure might be done, phagocytosis gave the only promise of the ultimate elimination of the infecting organisms. He declined vehemently to have me stimulate the white cells and induce a greater activity with hydrochloric acid and to double the oxygen content of the red cells. His comment was amusing: that as uncomfortable as life was at present, he preferred it to the uncertain chances of the hereafter that might follow the injection of an acid into the alkaline blood stream.

As the summer came, I noticed that he had discarded the green patch, although the eye was far from normal in appearance. He told me a specialist had done some work on the ethmoid cells, which were said to be the focus of infection. Gradually the inflamed eye improved, but evidences of the pernicious activities of the germs were still shown in his frequent use of a handkerchief. The exudate was a reddish, mucopurulent discharge, indicating slight bleeding, and phagocytic activity was shown in this pus. Neither discussions of the Metchnikoff idea nor recitals of histories of clinical experiences with other cases of infection of the sinuses carried any weight with my good friend in my efforts to attempt the elimination of the pyogenic organisms. Apparently, he was so convinced of the truth of the opinion that my reasons for the injection of the hydrochloric acid were figments of fancy that he would preserve his repute by neither giving nor taking this dangerous acid. During the winter 1934-1935, I saw him rarely, but when I did see him, there were always evidences that he was still the host of germs.

To my utter surprise, he came to the office on April 3, 1935: a sick man, 58 years of age, weak and dispirited. He told me that the day before, Dr. J. P. McQueen had told him of unusually satisfactory results in his treatment of salpingitis by the intravenous injection of solutions of hydrochloric acid. He was so impressed that he at once determined to come to me, as the sinus infection was in such a state of activity that a good night's rest was impossible, bleeding was growing worse, and the exudate of pus was most annoying night and day. The right eye was much reddened; apparently, again the iris, retina, and choroid were involved.

My confrere said he wanted 1-200 hydrochloric acid. I asked if he did not think this was a bit strong for the first injection. I told him that, in my opinion, this strength of the acid would give him a vivid illustration of the phenomena of the inflammatory reaction, nature's own response, to infective diseases, and that the essential factor in the reaction, the following leukocytosis, would be most helpful, if he did not mind the fever.

The intravenous injection of 1-200 was given, and he returned to his office. From his cot I had hourly reports of fever – 101°, 102°, and in four hours 104° F. I assured him he would not die and that he could rest assured he would be better when the reaction had passed, as he had had the fever that is said to destroy micro-organisms, a great increase in phagocytic activity, and that his red cells had twice as much oxygen as at the time the injection had been given. In spite of these assurances, my good friend was not altogether satisfied.

However, the next morning he came in with the report of the first good night's rest he had had for months, having awakened to clear the nasal passages only once. It was amusing to see that he brought with him a box of 25 ampoules of 1-1000 hydrochloric acid for further use. Nothing I could say would induce him to consider another injection of the stronger solution. Exudate from the nose was still stained with red cells. So I was forced to tell him that, since he seemed determined not to take the acid which he seemed to like so much the day before, I should be forced to add its germicidal qualities to the intravenous injection by its injection into the infected area by a spray. This was done with a hand spray of a solution 1-500 hydrochloric acid. Of course, a sharp stinging in the nasal passages was felt, but there was an immediate effect in the contraction of the swollen capillaries and the consequent freedom of the passage of air -- altogether the same clinical phenomena that follow the direct application of solution of cocaine or Novocain to these membranes.

During the month of April, the intravenous injection of the acid, 1-1000, was given six days in the week, along with the nasal spray twice as strong. Improvement was steady. In the first week, the exudate on handkerchiefs was no longer stained with red cells; the gain in weight was regular from 160 to 169 pounds. So great was the improvement that the visits were made in May with much less regularity. There was a total number of 35 visits, on each of which the nasal spray as described was used – altogether, 25 injections of the intravenous solution. He has not been in the office for a week, and yesterday, he told me on the street that he had not been to see me because there was no need for my services.

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