Tuesday, November 11, 2014

Historical Contribution: 1923, Young & Hill,Mercurochrome & Gentian Violet

1923
HH Young, Hill JA. The Treatment of Septicemia and Local Infections By Intravenous Injection of Mercurochrome 220 Soluble and of Gentian Violet. JAMA. 1924;82:669-75.


 

In 1919, Hugh Hampton Young published the first report of mercurochrome-220 to sterilize the bladder in the Journal of the American Medical Association (JAMA) (click here for link to Historical Contribution: 1919). Four years later, he writes the follow-up manuscript demonstrating the effectiveness of mercurochrome in the treatment of a variety of bacterial infections. In addition, he describes the use of gentian violet, a potent antimicrobial for gram-positive staphylococci. After proving intravenous instillation of gentian violet in rabbits is safe – Young endeavors on human treatment with the medication.

In total, Young presents 12 cases treated and cured with mercurochrome – the first one in 1922. In patients 1-7, Young meticulously details the tenuous clinical course of patients afflicted with septicemia, retroperitoneal and abdominal abscesses, kidney and bladder infections treated by intravenous mercurochrome.




In patients 8-12, Young describes the use of intravenous gentian violet. The first intravenous dose of gentian violet was given July 12, 1923 to a patient with staphylococcus aureus urinary tract infection related to a ureteral calculus. The remaining cases demonstrated cure of systemic staphylococcal infections including those stemming from complications of diabetes, osteomyelitis, urinary system infections. Importantly, gentian violet cleared the source of infection, improved systemic infection, and cleared sequealae of the systemic infection (i.e. abscesses).
In his typical fashion, Young took meticulous notes regarding the clinical course and laboratory values associated with each patient. Not only was the defervescence and normalization of vital signs in septic patients impressive, but the hourly documentation of blood and urine cultures demonstrating true sterilization of the infection.

 

To summarize, in the early 1900's, septicemia was almost universally fatal and mercurochrome ushered in a new era of antimicrobial treatment and hope for the treatment of infectious disease. Patients in this series were described as "desperate cases" – in which experimental antimicrobial treatments were justified. Young was extremely pleased with the results; he describes the sure and sterilization of the blood by intravenous mercurochrome "miraculous" and goes on to say,
"In these cases we have the first demonstration that gentian violet may be used intravenously to combat general septicemia or local infections, and with remarkable success in the case of gram-positive staphylococci. Coupled with the equally amazing results obtained by mercurochrome, these cases represent a splendid therapeutic achievement, and one is tempted to soar into realms of fancy and see a great variety of infectious processes treated and cured intravenously;"
Read more about mercurochrome in publications by Hugh Hampton Young by clicking on the following links:
Historical Contribution, 1919
Historical Contribution, 1925

To read the entire manuscript: follow the link above, visit the Centennial Website or click here.

HISTORICAL CONTRIBUTIONS highlight the greatest academic manuscripts from the Brady Urological Institute over the past 100 years.  As the Brady Urological Institute approaches its centennial, we will present a HISTORICAL CONTRIBUTION from each of the past 100 years.  In the most recent experience, the most highly cited article from each year is selected; older manuscripts were selected based on their perceived impact on the field.  We hope you enjoy! 

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