398 
Carrel-Dakin  Solution. 
|  Am.  Jour.  Pharm. 
^    September,  1917. 
obvious.  The  various  hypochlorite  solutions  are  all  more  or  less 
unstable  as  to  chlorine  content  and,  while  they  can  be  made  more 
stable  by  making  them  more  alkaline,  this  militates  against  their  use 
on  the  tissues. 
The  first  practical  application  of  chlorine  in  surgical  procedure 
for  the  eradication  and  control  of  infection  was  undertaken  by  Brit- 
ish surgeons  shortly  after  the  beginning  of  the  great  war.  They  im- 
mediately recognized  their  helplessness  when  the  large  number  of 
wounded  began  to  arrive  from  the  front  with  wounds  of  every  de- 
scription and  all  terribly  infected.  They  worked  with  hypochlorous 
acid  in  one-half  per  cent,  aqueous  solution,  made  by  adding  12.5 
grammes  of  chlorinated  lime  and  the  same  quantity  of  boric  acid  to 
a  liter  of  distilled  water  and  allowing  the  mixture  to  stand  over 
night.  This  was  then  filtered  and  used  as  a  surgical  dressing.  In 
the  British  Medical  Journal,  July  24,  191 5,  p.  129,  they  give  their 
results ;  while  these  are  good,  other  workers  seem  to  have  been  un- 
able to  duplicate  them. 
In  their  experiments  they  failed  to  take  into  account  the  extreme 
variability  of  chlorinated  lime  and  this  may  be  the  main  reason 
why  results  have  been  unsatisfactory  in  different  workers'  hands. 
Dakin's  solution  then  made  its  appearence.  This  is  now  re- 
ferred to  as  Dakin's  Original  Solution.  This  solution  is  very  easily 
made :  140  grammes  of  dried  sodium  carbonate  are  dissolved  in  10 
liters  of  water,  and  200  grammes  of  chlorinated  lime  are  added; 
the  mixture  is  well  shaken  at  intervals  during  one  hour ;  the  super- 
natant liquid  is  then  siphoned  off  and  filtered,  preferably  through 
paper.  This  solution  is  somewhat  alkaline,  but  this  alkalinity  is 
modified  by  the  addition  of  40  grammes  of  boric  acid.  This  prepa- 
ration however,  did  not  prove  altogether  satisfactory.  Sometimes 
it  worked  admirably  and  at  other  times  not.  There  were  times  that 
patients  complained  that  the  solution  was  very  irritating  and  painful, 
although  the  original  technic  followed  in  its  manufacture  was 
always  scrupulously  duplicated.  Of  course,  the  fault  laid  with  the 
chlorinated  lime.  While  the  formula  was  always  rigidly  adhered 
to,  the  chlorinated  lime  seldom  had  the  25  per  cent,  chlorine  content 
that  was  required  to  make  a  0.5  per  cent,  solution.  When  one  re- 
members that  the  different  brands  of  chlorinated  lime  available  in 
the  open  market  vary  considerably,  and  that  even  different  packages 
of  the  same  brand  will  run  all  the  way  from  25  to  35  per  cent,  in 
available  chlorine  content  (at  least  that  was  the  range  found  by  us 
