AN EXPERIMENTAL INVESTIGATION OF THE VALUE OF HEXAMETHYLENAMIN AND ALLIED COMPOUNDS

CURTIS F. BURNAM
1912 Archives of Internal Medicine  
This study was undertaken to determine the capacity of infected kidneys to excrete hexamethylenamin. We had just had a small series of unilateral kidney infections in which large doses of hexamethylenamin had failed to be of any benefit. The frequent clinical failure of the drug it was felt might depend on its inability to pass through such impaired organs. At the outset, full credence was placed in the generally current valuation set on hexamethylenamin, i. e., when taken by mouth, it is
more » ... ed in the urine, bile, pancreatic, synovial and cerebrospinal fluids in sufficient quantities to be of marked bactericidal value. This confidence, however, was not strengthened by a rather thorough review of its extensive literature, and personal experimental results which quickly developed gave still greater uncertainty. Ever since Nicolaier introduced it into medicine, nearly twenty years ago, the efficiency of the drug has been ascribed to its decomposition into formaldehyd. The authors, however, are quite vague, using such adjectives as, a little, partial and almost complete, in describing the extent of this decomposition, and not a few hold that hexamethylenamin is antiseptic itself independent of the formation of formaldehyd. Nowhere has there been serious endeavor to ascertain how much hexamethylenamin or formaldehyd are present in the fluids of the body after giving the drug by mouth. Its accredited efficiency in the body fluids where it has been described, rests, first, on a demonstration of the existence of either hexamethylenamin or formaldehyd in the fluid; second, on clinical improvement, and third, on the reduction in the number of bacteria as shown by the plate-culture methods after its use. In my personal studies, the seemingly necessary steps were, first, a quantitative determination of the amount of hexamethylenamin excreted in the urine after giving known quantities by mouth; second, a quantitative estimation of the amount of free formaldehyd present; third, determination of the bactericidal power of hexamethylenamin; fourth, determination of the bactericidal power of formaldehyd; fifth, determination of the strongest solutions of hexamethylenamin and of formaldehyd which can be tolerated by the kidneys and other urinary organs; sixth, a comparison of the chemical and clinical findings.
doi:10.1001/archinte.1912.00060220029004 fatcat:b3hgtpalarabflics65lwdhwwy