620 GENERAL THERAPEUTIC MEASURES 



in cases not so urgent as to demand intravenous saline infusion or hypo- 

 dermoclysisj more especially moderate degrees of hemorrhage, shock, col- 

 lapse and circulatory depression, when the intrinsic heat of the injection 

 is valuable in restoring the normal bodily temperature. 



Uses. 



INDICATIONS FOR SALINE INFUSIONS. 



Grave hemorrhage. Purpura hemorrhagica. 



Shock, traumatic, operative, and elec- Aside from hemorrhage, in collapse or 



trie. shock from any cause. Give a small 



Suppression of urine. infusion of adrenalin. A large injec- 



Severe diarrhea. tion of saline in such cases may lead 



Eclampsia. (Venesection most sue- to edema of the lungs and body. 



cessful.) 



Hypodermoclysis, or the intravenous injection of saline infusions, 

 finds its greatest usefulness as a life-saving measure in severe hemor- 

 rhage. The indications, follovsring hemorrhage, are to fill up the vessels 

 and to restore vascular tension, since danger is imminent, not from loss 

 of blood corpuscles, but from lack of a circulating medium. There is a 

 sufficient number of red corpuscles to carry on the respiratory and oxygen- 

 bearing functions even after the greatest loss of blood possible from ordi- 

 nary causes. In fact, respiration is but slightly impaired in human sub- 

 jects suffering from pernicious anemia, when there is an 80 per cent, 

 reduction in the normal red corpuscles, and one-half of the blood may be 

 '^withdrawn from animals and replaced with normal salt solutions without 

 serious damage resulting. Notwithstanding the great value of salines in 

 hemorrhage, the transfusion of blood is unquestionably more efficient. 

 Levin found that dogs die from a loss of blood equal to 4.5-5.5% of their 

 body weight. The heart would stop but would start up again shortly 

 with saline infusion. But by replacing the blood lost with blood trans- 

 fused the animal would.be as well as ever within a few minutes. Saline 

 infusions greatly dilute the blood — and, therefore, poisons in the blood — • 

 in toxemia, while they increase the activity of the kidneys and elimination 

 of toxins. The restoration of vascular tension is believed to assist the 

 natural bodily resistance of the patient. 



A great variety of disorders have been treated successfully in human 

 medicine with saline infusions, on this basis, including: septicemia, pneu- 

 monia, uremia, diabetic coma, purpura hemorrhagica,* tetanus, ulcerative 

 endocarditis, pyelitis ; acute alcohol, ether, chloroform, carbonic monoxide, 

 arsenic and mushroom poisoning; and toxemias resulting from acute in- 

 fectious disorders. The same treatment may be applied to hemoglobinuria 

 and other toxemias peculiar to the domestic animals. Venesection for the 

 purpose of removing the poisoned blood may be resorted to prior to prac- 



*G. W. Dunphy (Amer. Vet. Beview, June, 1905) writes that he treated two 

 cases of purpura hemorrhagica in the horse by injection of 6 liters of normal salt 

 solution following the removal of 5 liters of blood from the jugular (by means of 

 a trocar and canula), and, at the end of twenty-four hours, bled 2 more liters 

 and injected 3 more liters of salt solution with very happy results. He also dem- 

 onstrates the wonderful life-saving influence of intravenous saline infusion after 

 the loss (by a horse) of 25 liters of blood. 



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