Am.  Jour.  Pharm.  \ 
September,  19 17.  -* 
Carrel-Dakin  Solution. 
399 
of  packages  put  up  in  this  country,  and  in  Europe  it  must  be  greater, 
as  the  range  of  chlorine  content  of  packages  bought  on  the  open 
market  there  run  all  the  way  from  20  to  37  per  cent.),  it  is  perfectly 
obvious  as  to  why  results  should  be  so  variable  in  different  surgeons' 
hands. 
Now  Dr.  Carrel's  method  for  combating  infection  is  simply  a 
more  or  less  continuous  irrigation  of  the  wounds  with  a  modification 
of  Dakin's  solution,  or,  to  be  more  exact,  a  modification  of  the  well- 
known  Labarrque's  solution,  officially  known  as  Liquor  S.odce  Chlori- 
nate?. This  official  solution  of  sodium  hypochlorite  contains  2.5  per 
cent,  of  available  chlorine  and  is  markedly  alkaline.  This  makes 
its  use  as  a  dressing  for  infected  wounds  prohibitive,  it  being  ex- 
ceedingly irritating  and  painful.  Dilution  of  this  solution  with 
water  to  reduce  it  to  0.5  per  cent,  of  available  chlorine  (the  strength 
of  the  Carrel-Dakin  solution)  is  impracticable,  as  it  is  still  too  alka- 
line. Such  a  diluted  solution,  first  neutralized  by  the  addition  of 
boric  acid,  has  been  used  but  with  very  unsatisfactory  results,  it 
rapidly  losing  its  chlorine,  and  proving  otherwise  objectionable. 
Of  course,  making  the  preparation  in  this  manner  simplifies 
matters  very  much  and  also  saves  time,  a  factor  of  some  importance 
where  large  quantities  must  always  be  available.  It  was  Daufresne 
who  pointed  out  the  disadvantages  of  neutralization  with  boric  acid, 
to  which  he  attributed  much  of  the  irritation  and  painfulness,  and 
the  extreme  variability  of  the  chlorinated  lime  was  also  noted  by 
the  same  observer. 
Naturally,  this  illuminating  fact  put  an  entirely  new  aspect  on 
the  matter  and  brought  forcibly  to  mind  that  estimation  of  the 
chlorine  content  of  each  new  lot  of  chlorinated  lime  was  absolutely 
essential  before  concordant  results  could  follow. 
Accordingly  Daufresne  evolved  the  following  technic  for  making 
this  preparation,  and  this  only,  and  no  other,  should  be  used  when 
Dakin's  or  Carrel-Dakin  solution  is  called  for : 
Chlorinated  lime  (25  per  cent,  chlorine) 
Sodium  carbonate,  dried   
Sodium  bicarbonate   
184  Gm. 
92  Gm. 
76  Gm. 
Into  a  12-liter  bottle  put  the  chlorinated  lime  and  five  liters  of  water 
and  shake  frequently  during  a  period  of  six  hours ;  dissolve  the  two 
sodium  salts  in  five  liters  of  water  and  after  six  hours  add  this 
solution  to  the  mixture  of  chlorinated  lime  and  water  and  shake 
