A Treatise on Regional Iodine Therapy for the Veterinary Clinician

Part 1

A Treatise on Regional Iodine Therapy

for The Veterinary Clinician

by MART R. STEFFEN, M.D.C., V.S.

Author of Special Veterinary Therapy, Special Cattle Therapy, Clinical Diagnosis of Cattle Diseases, Special Equine Therapy, Veterinary Clinical Notes, etc.

1919

Published by PHARMACAL ADVANCE PUBLISHING CO. 168 Duane Street, New York

Copyright 1919 by Pharmacal Advance Publishing Co.

CONTENTS.

I. Introduction.

II. General Considerations of Local Iodine Therapy.

III. Special Considerations of Local Iodine Therapy.

IV. The Selection of Iodine Preparations for Practical Use.

V. Method of using Regional Iodine Therapy in the Correction of Various Pathological Conditions.

Introduction.

In presenting to the veterinary profession this treatise on Regional Iodine Therapy, I do so with the object of bringing into the light certain clinical facts that have to do with the topical application of iodine in veterinary patients, and to discuss, from the standpoint of the clinician, those particular pathological conditions to which these facts apply.

It will be further my purpose to point out to the reader the special indications for topical iodine medication which have, in the past, been overlooked by the practitioner of veterinary medicine.

Throughout the treatise I shall confine myself to the exposition of only such matter as I have found to be compatible with the practical phases of veterinary science in the conduct of my own practice.

M. R. S.

Milwaukee, Wis. March, 1919.

II.

General Considerations of Local Iodine Therapy.

While it is a fact that iodine is one of the most popular of the many medicinal agents used by the practitioner of veterinary medicine and surgery, it also is a fact that iodine--more so than any other agent--is frequently used in pathological conditions and under circumstances that lack every scientific indication for its application. To a certain extent this is true of almost any medicinal agent in common use, even those whose field of applicability is less broad than that of iodine; but it is especially noteworthy in the use of iodine.

Iodine does not differ from any other therapeutic agent with regard to individual indications for its application; it has these as prominently marked as have the alkaloids, physiologically. But it does differ from almost all other therapeutical agents in the fact that, it has such a vast field of applicability in which the indications for its use are supported solely by clinical evidence and in which its action defies all attempts at an explanation of results attained, on a physiological basis.

Although the practitioner may not be able to satisfy his ethical desire to explain the action of preparations of iodine in the latter class of pathological conditions, he soon makes the discovery that these actions and results are, to a very considerable degree, dependent upon more or less well-marked clinical and physical phenomena. In order to be able to give to his use of iodine, in its various forms, even a semblance of ethical practice, and, also, in order to be able to roughly classify and select the conditions in which he may use iodine with some expectation of uniform results, it becomes imperative that the practitioner acquaint himself with these facts and phenomena. Not only this, but he must acquaint himself, as well, with the peculiar and individual effects and actions, in a clinical sense, of the different forms in which iodine is used as a topical or regional application.

What may be an indication for the use of iodine in one form, may lack the requisite pathological status for its application in a successful manner in one of its other forms. Thus, in a given pathological condition, an ointment of iodine may fall far short of the therapeutic power that the practitioner expects it to exert, despite the fact that the case is clearly one for iodine therapy. When, on the other hand, in the same case, use is made of the tincture of iodine, or of an aqueous solution of iodine, the desired results may be obtained with almost amazing promptness. Again, in another class of cases, the reverse may be true.

Although, in a goodly proportion of the cases to be discussed in the following chapters in this treatise, the practitioner must come into direct and frequent clinical contact with the pathological conditions themselves in order to become thoroughly acquainted with the clinical and physical facts referred to, he will derive much benefit from a careful reading of these chapters, to the extent that he will note not only new lines of thought with regard to iodine medication, but he may also lay, in their reading, the foundation for an ethical system of iodine therapy in so far as this is possible in the light of our present acquaintance with the subject.

III.

Special Considerations of Local Iodine Therapy.

Part 2

When we undertake the consideration of those features of iodine therapy which have to do with its adaptability to definite remedial ends, we enter upon a field of thought that may take several forms.

We are concerned, in this treatise, only with matter relating to regional, topical, or local applications of the agent under discussion, and we can well begin the consideration with the identification of the agent itself and the different forms under which it is most commonly used. For all practical purposes, we can confine the discussion of the agent itself to that of the four forms, or preparations, of iodine in almost universal use by practitioners of veterinary medicine and surgery. When, in veterinary medicine, allusion is made to iodine, it is almost, without exception, to one of the following preparations:

1. Tincture of Iodine. 2. Ointment of Iodine. 3. Aqueous solutions of Iodine. 4. Oily solutions or mixtures of Iodine.

Only in rare cases, and then under specific reference, is iodine used in other forms, or in its elemental state, in veterinary medicine. Iodine is a very active agent, chemically as well as therapeutically, and is not readily compatible with other agents. It is for this reason, that combinations of iodine with other drugs and chemicals are not common, and therein lies a distinction for iodine that not many other therapeutic agents can claim; namely, that beneficial effects resulting from iodine medication are almost, without question, due to it alone; it is hardly ever applied in combination with synergists which might obscure the activity of individual ingredients.

This remarkable therapeutic activity of iodine is such that, when properly applied in some of its forms, its presence can be demonstrated in the underlying tissues. After prolonged courses of topical application, its action is occasionally appreciated, both subjectively and objectively, in the evidence of more or less clearly defined constitutional or systemic indications of its presence within the animal organism.

From this, it is apparent that, in iodine preparations of a particular class, we have an agent whose topical remedial effects are, in some slight measure, due to systemic action; in part at least, this action being the effect of great physiological activity exerted in the limited area of its topical application. In some degree this activity of certain preparations of iodine can be explained by reference to the chemical properties inherent in iodine as elemental matter, and in its well-known affinity for certain elemental constituents of the tissues of the animal organism.

The foregoing throws some light on the therapeutic accomplishments of iodine preparations, when topically applied, and, to a certain extent, explains its modus operandi in a physiological sense--an understanding somewhat essential from an ethical standpoint. The old theory, which would ascribe to an increase in function of the regional lymphatic glands all the agreeable therapeutic effects of local iodine applications, does not cover enough ground; it is only when we amplify this theory, with the assumption of the considerations aired in the foregoing paragraphs, that we find it possible to attain a clear understanding of the physiological action of iodine preparations applied regionally.

The Clinical Aims for topical therapy are to be classified as follows:

1. PROPHYLACTIC. 2. AMELIORATIVE. 3. CURATIVE.

Under these three heads, we further sub-classify the actual clinical conditions, which are indicated, into the following:

Under 1. Surgical preparatory technique.

Under 2. Acute pathological conditions, in the corrections of which topical applications of iodine preparations are used as an adjunct to internal medication with other agents.

Under 3. Chronic pathological conditions, in which one or more of various iodine preparations, locally applied, constitutes the entire treatment.

This classification and sub-classification is important and essential when we endeavor to make our use of iodine conform to ethical standards; it is also very essential to the attainment of certain therapeutic ends in actual practice.

1. THE LOCAL APPLICATION OF PREPARATIONS OF IODINE IN THE SENSE OF PROPHYLACTIC AIM IN SURGERY.

The exhaustive pre-operative washing and scrubbing of the integument, that veterinary practitioners applied to their surgical patients in years past, has given way almost entirely to iodine painting. Even those surgeons who still adhere to the scrubbing and washing of the parts about to be incised, complete the process with an application of iodine thereafter.

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