T H E S I S L. P. Anderson, M. S. Graduate School Michigan State College of Agriculture and Applied Science 1939 ProQuest Number: 10008248 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest ProQuest 10008248 Published by ProQuest LLC (2016). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code Microform Edition © ProQuest LLC. ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 4 8 1 0 6 - 1346 PENETRATIVE POWERS of DISINFECTANTS iy . .-'{By L. PJ, Anderson A THESIS Submitted to the Graduate School of Michigan State College of Agriculture and Applied Science in partial fulfillment of the requirements for the degree of DOCTOR OP PHILOSOPHY Bacteriology Department East Lansing, Michigan 1939 ^ ACKNOWLEDGEMENTS The writer desires to express his appreciation to Dr. W, L, Mallmann who suggested the subject for investigation and who made many helpful suggestions as the work progressed. The writer is also deeply indebted to Dr, W. L, Chandler for guidance and timely suggestions concerning certain procedures. The writer also wishes to express his appreciation to the other members of the Bacteriology Department of Michigan State College for their many suggestions and hearty cooperation whenever assistance was required. ±27466 INTRODUCTION Many authorities in the field of antiseptics and disinfectants have freely and justifiably criticized and readily altered the only accepted standard method of testing these compounds for their actual value. Since this method does not, obviously, give the user of commercial preparations more than a vague idea of their practical effectiveness in actual use, the attempt has been made to devise a method that will attain this end. It was decided that if any one common characteristic which all compounds must possess to be of practical value could be chosen and a feasible but relatively simple test devised to evaluate this characteristic a step forward would be made. In view of the foregoing it seemed that the one characteristic which must be common to all compounds irrespective of their chemical constitution, is that of penetrative power, since in order to kill quickly they must be able to pass through the wall, or ectoplasm, of the organism and reach the life center. On first consideration it might appear a relatively simple matter to select or devise a test which would evaluate this characteristic, giving the proper evaluation to all compounds to which it was applied. The method so chosen is one to be described later as a speed test, and which in order to withstand critical analyses must have a substantial foundation that will reach beyond mere theoretical considerations. It was deemed advisable to first ascertain, as far as practically -2- possihle, just how a few of the outstanding representatives of the various groups of compounds operated in "bringing ah out destruction of organisms. Therefore, such methods were devised and employed to determine this particular phase hut at the same time keeping in mind the specific item, penetrative power, which theoretical consideration demands must he present. -3- HISTORICAL REVIEW The literature abounds in studies designed to systematize the investigation of the effect of killing agents upon organisms* Only the more important works will he reviewed in order to show the general trend. Robert Koch (32), 1881, started mercury on the road to questionable fame as an excellent bactericidal agent by the use of bacterial impregnated threads. In I8S9-I89I* Geppert (20) proved that the unneutralized sublimate carried by the thread in Koch's method was responsible for the exceptionally high values obtained with mercuric chloride. To eliminate this factor Kronig and Paul (33)*1^97» employed bacterial coated garnets as test objects and in their thorough study formulated tenets which have served as a foundation for subsequently devised methods. Rideal and Walker (39)» L903* started the trend toward the present day phenol coefficient method by devising a test tube method of examining chemicals for their killing action. Chick (10), 1908, did much to ferret out the probable mode of action of killing agents, and also introduced the use of added organic matter (Chick and Martin (ll),1908) in the testing methods. In 1911* Anderson and McClintic (2) published a method designed to eliminate some of the objections! features of the Rideal-Walker method. known as the Hygienic Laboratory Method. This new method was Shippen (HU) combined the best features of the Rideal-Walker and Hygienic Laboratory Method in a test which he put into practice about 1916 and which was published in 1927 by Reddish (37) s-s the !,R-W Modified Method”. Very little change -H- has been made in this test which is known today as the "Food and Drug Administration Phenol Coefficient Method". In I92U Conover and Laird (l*0 published a method utilizing petri-plates instead of seeding tubes. This was designated as a Direct Unit Phenol Coefficient but has received little recognition. Allen (1), 1929, proposed a method for examining antiseptics and disinfectants consisting of direct application of the test solution to the agar slant of a specially prepared culture. In 1933 Jensen and Jensen (23) proposed a modification of the method of Kronig and Paul (33) *>7 using cover glasses instead of garnets. Since that time more attention has been directed towards the toxicity factor of antiseptics and disinfectants in order to give a more practical aspect to the phenol coefficient. This is demonstrated by the work of Salle, McOmie and Shechmeister 1937» employing embryonic chick heart, Iffye (36), 1937» using leucocytes, and Samuels (^-2), 193^, using frog pharyngeal epithelium. All demonstrated that the majority of chemicals ordinarily employed as bacteriostatic and bactericidal agents in the presence of tissue were more toxic for tissue cells than for bacteria. As illustrated by this brief review the bulk of the evolutionary work since the time of Koch has been directed toward introduction of new methods and refinement of the ones existing. Scant attention has been given to the underlying factor of penetration. To avoid a lengthy review only those works unquestionably dealing with penetration will be reported. -5In 1S97 Vincent (^7) examined the ability of various chemicals to sterilize fecal matter pointing out that it was quite difficult to obtain penetration of the organic particles to kill the enclosed bacteria. Claudius (12), 1902, while searching for a method of sterilizing and preserving catgut, obtained penetration with iodine as demonstrated by the death of the organisms enclosed in the minute folds of the tissue. Kendall and Edwards (25), 1911* employed short uniform cylinders of seeded agar from which a small center core was removed at the end of the exposure period to demonstrate the penetrative ability of various substances. Seelig and Gould (U3), 1911* used celloidin capsules and living animal skin to demonstrate the penetration of alcohol and iodine. In 191# the committee on Standard Methods of Examining Disinfectants (13) ln making their recommendations state that HA complete study of a disinfectant must also include its physical and chemical behavior in the medium in which it is employed, as for example, its diffusibility or powers of penetration, and especially its chemical permanence11. Carnot and Dumont (7), 1913, employed seeded agar plates containing a perforated glass cup centrally embedded to determine the penetrative powers of the compounds used in dressing war wounds. Chambers (8), 1922, worked with starfish eggs demonstrating the penetration of their walls by the acid and alkali groups of NaHCO^ and EH^Cl, respectively. Hirschfelder Malmgren and Creavy (2l),1925, produced artificial edema in the dog and observed penetration of an intravenously injected dye from the blood vessels into the edema -6- fluid. Hirschfelder and Wright (22), 1930# ln studying the action of dyes upon proteins, state that an antiseptic acts to "prevent growth of microorganisms hy merely adhering to and altering the “bacterial surface so as to prevent cell division; and it kills them either by altering the surface layer more intensely or by penetrating into the cell body and injuring its internal metabolism or by both processes simultaneously or successively". In 1930 Knaysi (27-31) published a series of papers on disinfection including an extensive review dealing with the various conflicting theories as to the mode of action of killing agents* Knaysi (30) points out that penetration of the cell wall of bacteria is the one all important factor which has been consistently neglected* Knaysi and Gordon (29), 1930, demonstrated the penetration of yeast cells by iodine and mercuric chloride. Karns (2*0, Karns, Cretcher, and Beal (25), 1932, studied various solutions of iodine using silk and guinea pig skin to demon­ strate the mechanism of penetrative superiority of aqueous-potassium iodide solutions of iodine over alcoholic solution of this element. Biskind (5 , 6), 1932, worked in conjunction with this group but employed frog skin to demonstrate that the aqueous forms of iodine were superior to the alcoholic forms from the standpoint of speed of penetration* Uyiri and Jannitti (35)# 1932, studied the fate of iodine placed upon the unbroken skin of dogs and rabbits. They found that iodine penetrated the live skin in a period of 162 hours but only in the form of its compounds such as KI, and never as free iodine. Mallmann and Chandler (3*0* 1933* found that of a group of recognized disinfectants only colloidal iodine was able to penetrate and render sterile the finely divided particles of avian fecal material* -s Stateraent of the Problem The tendency of the general consumer to employ one disinfectant or antiseptic for a variety of purposes rather than the specific purpose for which it is adaptable necessitated choosing the most severe of all the conditions which compounds must undergo in practical use. These conditions are: (1) Brief contact with the surface to be disinfected, usually under five minutes; (2) organic matter such as blood, serum, pus, dirt, in or beneath which the organisms are located; and (3 ) possible subsequent dilution. Since disinfectants, unlike antiseptics and allied compounds of the bacteriostatic type, must kill rapidly, they are not allowed the privilege of rendering organisms innocuous by interfering with their enzymatic processes thereby leading to gradual extinction, but must reach and destroy the life center of the organism immediately. Therefore, assuming the conditions chosen to be sufficiently severe it was decided that the most important single feature which these compounds must possess (disinfectants primarily, antiseptics to a lesser degree, or not at all) is the ability to penetrate organisms. It is difficult to prove just how a substance kills micro­ organisms and because of their minute size it would be equally as hard to prove that the substance had penetrated the bacterial cell; hence, it was decided to employ methods of a grosser nature and by analogy apply the information obtained to bacteria thereby deriving the single test desired. -9It would be well, "before proceeding further, for the sake of clarity, to draw a line of distinction, even though arbitrary, between the commonly interchanged words antiseptic and disinfectant in order that a consistent meaning may be conveyed in this paper. The term antiseptic will be applied to compounds which render organisms innocuous, or incapable of exhibiting evidence of life, from the moment of contact, but only as long as the two are in contact. The term disinfectant will be used in the sense that the compound employed will kill the organisms during the time of contact implying that its subsequent removal will not result in the organisms exhibiting life. The terms disinfectant, germicide, bactericide, and parasiticide will be used synonymously; and the terms antiseptic, bacteriostat, and parasitistat will be used in like fashion. Further, to avoid confusing terminology, the term compound will be used throughout the work in a general sense to represent the substances used whether they are elements, or compounds. Phenol Coefficients To have information from an accepted standard method with which to compare, several phenol coefficients were run on each compound and the average taken as the basis for comparison with the results of other workers as well as for the experimental methods* to be described below. The method employed was that described in * All media (nutrient broth and nutrient agar) employed throughout this work was prepared according to the specifications given in TJ.S.D.A. Circular Ho. 198. -10- the U.S.D.A. Circular Ho. 198, as "The F.D.A. Method, Staphylococcus aureus, 20°C 11. To avoid inhibitory effects of the compound conveyed to the subculture a second subculture was made into plain broth (Shippen). At the same time that subcultures were made from the test solutions a subculture was also made into a broth containing a substance which stopped the action of the compound that was introduced. The Staphylococcus aureus culture (originally obtained from Food and Drug Administration) used in the phenol coefficient tests as well as throughout the remainder of the work was taken from the stock collection of the Bacteriology Department of Michigan State College and answered all the requirements demanded by the F.D.A. Method. The Bberthella typhosa strain used in one part of the work was likewise obtained from the same source and met standard requirements for this species. Colloidal Iodine* was selected as the chief representative of the halogen group while lugol's solution and Tincture of Iodine (both prepared according to TJ.S.P.X) were included to demonstrate the important role different solvents play in disinfection. Merthiolate was chosen as representative of the newer type of mercurial compounds which are supposed to occupy a more or less intermediate position between the theoretically ideal disinfectant and the theoretically ideal antiseptic. Brilliant green was selected as representative of the dye compounds and as probably the nearest to * Throughout this paper the term colloidal iodine will be used to refer specifically to Iodine Suspensoid Merck according to Dr. W. L. Chandler. -li­ the theoretically ideal antiseptic or bacteriostatic type of compound* Phenol was employed as a reliable standard representative of the coal tar series. Chlorine, though another representative of the halogen group would seem superfluous, was, nevertheless, includ­ ed because of the large variety of agents on the market which have this element as the active ingredient. Two types of such compounds were included, both commercial products, HTH as representative of the inorganic chlorine compounds, and azochloramid as a representa­ tive of the slower acting organic compounds. The data derived (Table 1) show without doubt that elemental iodine is, according to the phenol coefficient test, obviously superior to all the other compounds used. In addition there is no difference between the three forms, colloidal, Lugol's, or tincture, when used in the high dilution necessary for testing, the reason for which will be emphasized later. Chlorine in the hypochlorite form, HTH, is apparently effective when there are 150 p.p.m. available chlorine, yielding a phenol coefficient of 1^.5. However, the stable type compound, azochloramid, in a saturated solution of one (l) part in a thousand could not be tested because it did not yield sufficient chlorine to kill in 15 minutes. It was necessary to extend the time of the test to 50 minutes before sterilization of the seeding was effected, therefore a coefficient is not given. The necessity of the Shippen (*+U) modification is demon­ strated in the results obtained with the two compounds, brilliant -12- TABLE I. - Determination of Phenol Coefficients, Pood and Drag Administration Phenol Coefficient Method, S.aureus 20°C. Compounds Dilutions killing in 10 min, hut not in 5 min. Subcultures in Sodium Plain Broth thiosulphate 1st Broth 2nd Phenol Coefficient Sodium Plain Broth thio2nd sub­ sulphate Broth culture Iodine - Tincture 151^,000 1 :1^,000 1 :1^,000 200 189 Iodine - Lugol's isiM oo 1 :1^,000 1 :1^,000 200 189 Iodine - Colloidal IslH.COO lslH,000 isii+,000 200 189 Merthiolate - Tincture* l: 8,000 is 1,500 is 1,500 21.7 20.2 Merthiolate - Aqueous* 1 : 8,000 IS 1,000 l: 1,000 ii».5 13.5 Azochloramid 11 1,000 is 1,000 IS 1,000 Pailed Pailed HTH 15 - Aqueous is 1,000 IS 1,000 1 : 1,000 1H .5 13.5 Brilliant Green* 1 :30,000 IS 1,900 Is 8,000 30.0 108.0 Potassium Iodide Solution Ho action Ho action Ho action Alcohol 50$-Acetone 10$ Undiluted Undiluted Undiluted Phenol 1:69 1:69 u fb - 0.0285 - 0.027 - ♦ These are the nearest to killing dilutions; stronger dilutions could not he tested owing to the amount of compound carried over from seeding pots. -13- green and Merthiolate. Brilliant green is a well known bacteriostatic compound and like practically all compounds of this class shows specificity, especially for Gram-positive organisms. It is not surprising to find that it apparently killed in a dilution as high as 1 to 30»000 for the particular stock dye that was employed in this work. However, with the double subculture procedure in use it was found that 1 to 1900 failed to kill in 15 minutes. Che reason that lower dilutions gave negative subcultures, even when double subcultures were made, was due to the amount of compound carried over. This was indicated by the fact that the broth had a strong greenish tinge at a dilution of 1 to 1000 and the color was also perceptible at 1 to 1600. failure of subsequent plantings into these tubes to produce growth provided conclusive evidence that there was an inhibitory amount of compound present even in the second subculture tubes. It is doubtful if the 1 to 1000 concentra­ tion killed within 15 minutes. Merthiolate, in both aqueous and tincture (solvent; alcohol 50 percent, acetone 10 percent, water Ho percent) solutions, showed much the same picture as brilliant green. The 1 to 1000 aqueous solution failed to kill in 15 minutes whereas the 1 to 1000 stock solution of tincture did kill in 5 minutes. This was evidently due to the alcohol concentration since dilution up to 1 to 1500, lowering the alcohol concentration to 30 percent, failed to kill in 15 minutes. This information, of course, was obtained by using the Shippen (U4) double subculture technique. Phenol coefficients of the -1U- nearest estimated or strongest dilutions used were calculated and placed in the table. The few items given in the above paragraphs illustrate some of the weaknesses of the test even when it is uncomplicated by additional factors such as added organic matter of various types or definite particle size as suggested by Garrod (19)» 1935* These items illustrate why Reddish (38), 1937* ks-3 30 strongly emphasized the fact that the test has been badly misused in expecting it to yield any, let alone equally as much, information for antiseptics. For, no matter what other arguments may be offered the paramount one is that the test has been designed for disinfectants only. In addition there is the potential possibility of misinterpretation depending upon the viewpoint of the investigator. Reddish (38) illustrates by giving the phenol coefficient of a certain percentage of carbolic acid which is straining the interpretation slightly since comparison is based on this compound and any strength compared to it should always be unity. In other words, comparing a yardstick with itself accomplishes very little. Another type of interpretation aptly illustrated by Dunn (15)* 1937* is to give the phenol coefficient on the basis of solid substance or dry powder resulting in a very large figure which is definitely misleading if the compound is insoluble at high concentrations or so toxic that to be usable it must be diluted to such a weak concentration that the phenol coefficient of the usable dilution may be even less than unity. -15- Salle and Lazarus* et. al., (1935-37) utilizing a tissue culture technique in conjunction with the regular phenol coefficient method devised a toxicity test for evaluating disinfectants which Salle, McGmie, Shechmeister and Foord (Hi), 193&» found needed revision in the form of added organic matter. The incorporation of horse serum, however, did not seriously alter the results hut merely lowered the figures for all compounds. They showed by their first technique that Merthiolate, with a rather high toxicity index, had a phenol coefficient of 70. let when their test was revised adding the horse serum factor and taking into account the marked inhibitory properties of Merthiolate, they found that a H percent solution, the strongest that could be prepared, failed to kill S. aureus in 10 minutes. The well known dye, mer euro chrome, which had by their first test a phenol coefficient of 0.6 (killing in a dilution of 1 to Ho) was found by the modified (bacteriostatic determination) method to fail to kill the same organism in an 85 percent solution, the strongest solution they could prepare. On the other hand they found iodine (Lugol*s solution) by their first technique to have a phenol coefficient of 308 or killing in a dilution of 1 to 20,000. By the revised technique the killing dilution was 1 to 3520, Just a little less than a saturated water solution of iodine. * Series of articles published in Proc. Soc. Exper. Biol, and Med. were condensed and published with complete description of test by Salle, McOmie and Shechmeister (Ho), 1937- -l6- These facts are presented to illustrate how closely the findings in this work parallel those of these investigators* Agar Cup Plate The next method employed was the first step in demonstrat­ ing that penetrative power (assuming all other factors such as medicinal-organism contact, constant) was the chief factor responsible in the ultimate rapid destruction of organisms. method is presented in U.S.D.A. circular 198. This It has been credited to Dr. L. C. Himebaugih by Reddish but apparently was originated in 1918 by Carnot and Dumont (7) and known today as the agar cup plate method. Preliminary trial runs indicated that the chief objections to this method are: (l) The phenomenon observed is evidently more that of diffusibility than penetration and (2) volatile compounds will give a false picture, even of diffusibility. The latter is accomplished by saturating the atmosphere immediately above the agar, redissolving in the moisture of the surface diffusing downward over the entire area at the same time the compound is diffusing outward from the center. This last objection was easily eliminated by covering the agar with a layer of paraffin prior to cutting out the center portion with a cork borer. Repair of the center cup so produced was accomplished by filling with agar level with the paraffin and again -17- cutting out the center portion with a smaller cork borer leaving a wall or collar of agar. This formed a seal over the opening existing between the agar and the paraffin layer thereby preventing any of the compound subsequently placed in the cup from seeping out between the layers of capillary action. The bottom of the cup was repaired by a drop of agar to prevent capillary seepage between the agar and glass. Employing 0.1 percent soluble starch and 0.1 percent potassium iodide as an indicator in the agar, data were obtained for iodine and chlorine (Table Z) which show that these volatile compounds gave fairly consistent readings, i.e., diffusing outward from the center of the plate a definite distance. On the other hand the data on uncovered agar plates (Table 2) appear to show that the iodine containing compounds (according to the starchpotassium iodide indicator) had, within the limits of reading time, 2b hours, diffused out to the periphery of the plate. After noting some of these peculiarities of agar cup procedure a series of agar cup plates was set up using the test organisms, E. typhosa and S. aureus, for indicators rather than starch and potassium iodide. This change was necessary as the majority of the compounds listed were employed, and two, aqueous merthiolate and tincture of merthiolate, cannot be tested by color indicators. The plates were observed at IS and 2U hours and readings made at US hours* -1S- TJiBLE 2. - Determination of Penetration, Agar Cup Plate Method ** Temperature 2^C Inhibition Zone width* in cm. Nutrienlb Agar Plain Agar Paraffin Paraffin Uncovered Uncovered Top Top Compound Concentration Iodine - Tincture 1:20 *+.0 l.ZS 2.07 i*.e Iodine - Lugol's 1:20 Iko 1.5 2 .1*5 !*.0 Iodine - Colloidal 1:20 U.O 1.0 2.0 **.0 HTH 15 150 p.p.m. - 0.1 0 .1* - * The average distance of all the plates used from the edge of the cup to the periphery of the plate was 1*.0 cm. Hence, this figure denotes penetration of entire plate. ** Starch and potassium iodide used as indicators. -19- As was expected from the preliminary observations the 5 percent solutions of tincture of iodine and Lugol's iodine gave sterile plates in all seventeen trials (Table 3)* ®he 5 percent suspension of colloidal iodine gave only two sterile plates out of the series, the remaining fifteen plates having well marked zones. The apparently larger zones given by colloidal iodine against E. typhosa was due to the two sterile plates occurring in this series, thereby raising the average. The 0.1 percent concentrations of Merthiolate, aqueous and tincture, gave identical results against E. typhosa and also S. aureus. These two solutions were apparently slightly more specific for the Oram-positive organism than the Oramnegative organism. HTH 15 in a concentration of 150 p.p.m. available chlorine gave the smallest inhibition zones obtained but was equally effective against both organisms. The more stable chlorine compound, azochloramid, in a saturated aqueous solution of 1 part in 1000 parts of water gave inhibition zones comparable with the Merthiolate solutions but showing slightly more activity against E . typhosa than S. aureus. Since extent of penetration varies with the time, it was thought more definite information might be obtained about the relative penetrative power of the three iodine preparations, alcohol solution, potassium iodide solution, and aqueous iodine (colloidal suspension). clearly shown. Conversely the faults of the method would be more To observe relative penetrative power a third series -20- TABLE 3 . - Determination of Penetration. Agar Cup Plate Method __________________________________ Temperature 37°C Compound Concentration Inhibition Zone, width* in cm. Indicators** E . typho sa S. aureus Iodine - Tincture 1:20 **.0 k.O Iodine - Lugol's 1:20 k.O k.O Iodine - Colloidal 1:20 2.9 2.3 Merthiolate - Tincture 1:1000 1.7 2.0 Merthiolate - Aqueous 1:1000 1.7 2.0 Azochloramid 1:1000 2.0 1.6 HTH 15 150 p.p.m. 0.7 O.S * Prom the edge of the cup to the periphery of the plate the average distance for all the plates used was ^.0 cm., hence, complete penetration is denoted. ** Average of ten trials using E.typhosa, and seven trials using S.aureus. -21- of agar cup plates with paraffin tops were prepared and readings made at frequent intervals up to progress of diffusion. hours to detect variation in From Table ^ and the companion graph (Fig.l) it appears evident that by this method Lugol's and tincture of iodine penetrate or diffuse much more rapidly than does colloidal iodine. This is explained by the fact that the particles which represent the reservoir in colloidal iodine settle down to the bottom of the cup so they do not exert the full vapor pressure force evenly throughout the suspension as does occur when the suspension is kept agitated during short time contact. This last item, as will be further clarified by following tests, rather clearly demonstrates one of the definite objections to this method. The necessary lgpse of time before reading the plates is so great that the worker has very little chance to place a correct interpretation upon his findings, which can be just as readily called diffusibility as penetrative power, since it is frequently necessary for hg hours to lapse before reading the results. Reiterating, the most superficial reasoning would demand that, to be effective, compounds should have the ability to penetrate within a very short space of time. In a test of this sort where there is no way of knowing what might be taking place up to 2h hours (when the very first evidence of growth is detectable) about the most valuable information that can be obtained from it is whether or not a compound will yield any zone of inhibition. The size of the -22- TABLB - Determination of Penetration. Method Using Paraffin Tops. * ________________ Tim© from filling, in hours. Agar Cup Plate Temperature 25°0 Inhibition Zone, width in cm. Tincture Lugol1s Colloidal of Iodine Solution Iodine 00:30 0.25 0 .*+ 0 .1 00:60 0.37 0 .6 0 .2 1:30 0 .H5 0.7 0.25 2:00 0 .6 0.85 0.33 2 iko 0.7 0.95 0.3 8 U:U0 0 .9 2 1.11 0A 6 10:00 1.3 1 .6 0.55 13:00 1 .U5 1.76 0.5 8 2^:00 1.95 2.15 0.6 5 38:00 2 .2 2.3 0 .7 * Efutrient agar containing 0.1 percent soluble starch. Pig. 1. - Comparative Rates of Penetration of Tincture (A), Lugol*s (B) and Colloidal Iodine (C) in Paraffin Covered Agar, Distance penetrated in * 5 3 z / 0 4- Q /Z /£> ZO Z4- Time of Action in Hours ZQ 3Z 3i> 4G -23- zone produced is definitely misleading as will "be shown in the next section. Tor example, Merthiolate frequently gave plates that were entirely sterile as did some of the iodine preparations acting on uncovered plates. Tet when these two compounds were confined within an object that they had to penetrate in order to give any zone in the agar, the areas of the zones were surprisingly similar. One other minor objection to this method is that special porous plate tops must be employed to permit evaporation of moisture produced by bacterial metabolism. In addition considerable care must be exercised to prevent slopping of the compounds over the edges of the cup, particularly tinctures which have a tendency to "crawl". Those objections are readily eliminated by the technique employed in the next section. Modified Agar Cup Plate. As a result of the series cited, it was thought that an alteration mi^it be made in the procedure which would show, without question, that penetration had been accomplished and that diffusibility had been entirely eliminated. The technique was as follows: (1) A freshly collected length of adult chicken intestine with a fairly constant diameter and thickness was washed in Locke's solution, (2) Cut in k cm. lengths, tied at one end with a loop of No. UO thread, -2U- (3) ^b® section was filled with 1 ml. of compound and the open end tied with a loop of thread, (b) The tied section was washed by dipping into a neutral­ izing solution and thence into two changes of distilled water, (5) It was now placed in the center of a petri-dish, (6) Agar seeded with S. aureus was poured in a thin layer into the petri-dish and allowed to set (this prevented floating), (7) Additional seeded agar was poured to cover the tissue, (S) The plates were incubated at 37°C. and, (9 ) Readings were made at 2b and bS hours, noting the size of the inhibitory zone obtained around the tubular section of tissue. Employing this procedure the area of the zone need not bear the brunt of interpretation as to the penetrative power of the compound involved but rather serve as a crude yet definite indication that the compound had penetrated the tissue* Table 5 shows the relative penetrative power of the compounds employed given in actual measurements obtained direct from the plates. It is to be borne in mind that while the elliptical zone sizes given in cm. (length and breadth measurements) represent the total area of inhibition minus the size of the tissue, the size of these areas are not to be interpreted in the sense that one compound is better than another simply because the zone is bigger. In fact, the tables show that the majority of the zones are of very nearly the same area. Several observations were made which are -25- TABLE 5* - Determination of Penetration. Compound Concentration Adult Chicken Intestine Test.* Ho. of trials Average size of zone in cm. Average area of zone in cm. 4 Iodine - Tincture 1:20 22 3.65 x 2.57 9.28 Iodine - Logoi's 1:20 23 3.25 x 2.1* 7 .so Iodine - Colloidal 1:20 23 2.3 5 x l M 3.3S Merthiolate - Tincture 1:1000 17 2.77 x 1.86 5.15 Merthiolate - Aqueous 1:1000 20 3.00 x 2.16 6 .1*8 Azochloramid 1:1000 12 0.85 * 0.15 0.13 32,500 p.p.m. 2 3.1* X 2.3 7.82 HTH 65 Brilliant Green 1:20 2 3 .9 X 2.8 . 10.92 Brilliant Green 1:100 1 3.8 x 1.9 7.22 Phenol 1:20 0.87 x 0.32 0.28 10 * 1 ml. of compound placed in 3 x 1 cm. length of intestine and embedded in s« aureus seeded agar. Clear zone produced by compound diffusing into the agar read at 1*8 hours. -26- cons idered worthy of inclusion here because of the bearing they have on the subsequent data. In addition these facts are more valuable in this interpretation than the actual measurements recorded. The chlorine compound, HTH 15, employed in previous tests in a dilution containing 150 p.p.m. available chlorine (l part powder - 1000 parts of water) had given such consistent negative results that a stronger solution of HTH 65 was prepared (5 percent solution of the powder) containing approximately 32*500 p.p.m. available chlorine which did give a zone of inhibition in this test but only after it had MeatenM its way throu^t the tissue. The three forms of iodine employed while giving variable size zones, but within the limits of technical error, never failed to render sterile the tissue section in which they had been placed* On the other hand the two solutions of Merthiolate used while also giving a variable but frequently good sized zone in the seeded agar consistently failed to sterilize all parts of This failure the tissue section. was noted at the ends of the section where the tie off was made indicating that the mechanically produced added thickness of the tissue at this point slowed the penetration of the compounds sufficientlyto allow development of the organisms present on the washed intestines. normally These organisms, as a group, are predominately Gram-negative and less susceptible to these compounds than the S. aureus used as the indicator. The interpretation that -27- penetration was retarded is based upon the fact that subculture from these hazy zones at the ends of the tissue section gave no growth, nor would these subcultures support growth upon subsequent seeding. This was due to the amount of compound carried to the tube of broth in the small loop of fished agar, indicating that while the myriads of colonies had time to develop partially they were killed within the ty-S hour time limit. This is a notable contrast to the sections containing iodine which invariably had a cleared zone all the way around the tissue that upon subculture was always negative and yet the subcultures would support growth upon subsequent seedings. The slow acting chlorine compound, azochloramid, which In comparison with the more commonly known brands of chlorine compounds, is very stable in the presence of organic matter, gave a zone indicative of just bare penetration of the tissue as the zone rarely ever encompassed the whole tissue section. In other words only partial sterilization of the tissue section was obtained. This was also true of 5 percent phenol which was carried along in this series of experiments as the representative of the coal tar group of compounds. The tissue section filled with phenol was usually, but not always, surrounded by a visibly cleared zone of inhibition. Brilliant green, when employed in a concentration of 1 to 1000 utterly failed to penetrate in a number of trials. Stronger concentrations of 1 to 100 and 1 to 20 were prepared and penetration was obtained* The zone sizes given in the tables for -28- these latter concentrations of the dye are the measurements of the area of dyed agar, and not a readable zone of inhibition, since the dye did not penetrate soon enough with the 1 to 100 concentration to prevent development of colonies within the zone covered by the dye in the 4-8 hour reading time. In both trials with the 5 percent concentration of the dye the penetration of the tissue was fairly rapid occurring shortly after pouring the agar, but not in sufficient concentration to give rapid diffusion into the agar so as to prevent the development of all colonies within the dyed area. Penetration of Adult Chicken Ceca The above findings led to the following experiment to determine the relative time necessary for these compounds to penetrate tissue of a slightly different type. The technique was as follows: (1) Adult chicken ceca were obtained, washed in Locke's solution and filled with 10 ml. of compound, (2 ) The open end tied with No. 40 thread, (3 ) Washed by dipping in neutralizing agents and two changes of distilled water, (4 ) Placed in a flask containing 100 ml. of a 24 hour broth culture of S . aureus, (5) Shaken at intervals, and (6) Subcultures made frequently to determine when the compound had penetrated the tissue as indicated by death of the bacteria in the surrounding medium. -29- To eliminate the possibility of variation in the structure of the ceca from "bird to bird, pairs of ceca were obtained from two birds> one of each pair being used for colloidal iodine and the other of each pair being used for Lugol's iodine and tincture of iodine respectively, The findings recorded in Table 6 are in reasonable accord with assumptions made in the preceding section* Lugol's solution proved to be the most rapid, in fact penetrating in just a few minutes whereas tincture of iodine required 39 minutes and colloidal iodine needed 5 hours to penetrate the tissue. Both Merthiolate solutions penetrated this type of tissue in 6 1/2 hours while phenol required approximately 33 hours to sterilise the culture. All the other compounds, 1 to 1000 concentrations of HTH 1 5 , azochloramid and brilliant green failed to sterilize the S. aureus culture or tissue in Wk days. At this time equal size portions of the negative cecal tissue were snipped from the terminal ends of the respective ceca, washed and embedded in S. aureus seeded agar to ascertain if there were any residual compound in the tissue. All compounds (but phenol), Lugol's, tincture, and colloidal iodine, aqueous and tincture of Merthiolate, showed inhibitory zones. The latter two zones being somewhat larger than those produced by the iodized tissue sections. -30- TABLE 6, — Penetration of Adult Chicken Ceca . ______ ______________ ________________Temperature 20°C. Compound Concentration Time when 1st subculture became negative Inhibition zone of plated tissue cm. Iodine - Tincture 1:20 39 min. Iodine - Lugol's 1:20 6 min. 0.1 Iodine - Colloidal 1:20 5 hrs. 0.1 Merthiolate - Tincture 1:1000 6i hrs. 2.2 Merthiolate - Aqueous 1:1000 6J hrs. 2 .4 HTH 15 150 p.p.m. 44 days positive - Azochloramid 1:1000 *44 days positive - Brilliant Green 1:1000 44 days positive - Phenol 1:20 33j hrs. 0 0 .0 5 -31Penetration of Microscopic Living Units Having determined that dead tissue could "be readily penetrated by the compounds in use and having in a measure determined some of their limitations it was decided to conduct further tests upon living objects of sufficient size to make the end point visible with the aid of a microscope. Coccidia from fresh acute cases of fowl coccidiosis and freshly hatched long-tailed strongylid larvae of horses were chosen for these tests. These two organisms were selected because in both instances there exists a very definite membrane which must be penetrated before the life center is reached with ensuing death, namely the wall of the oocyst or the protective cuticle of the larvae. Penetration of Coccidlal Oocysts. The selection of coccidial oocysts to meet the investigative purpose of this paper was based upon the evidence accumulated by Chandler (9), Becker (4 ), Pish (IS) and others that the shell or wall of the oocyst is a membrane extremely difficult for compounds to penetrate. Chandler and Schalm * have demonstrated (with another objective in view, i.e., death of the organism) that a distinct differ­ ence exists between the three iodine preparations employed here, finding that, under constant controlled conditions, they kill the oocysts in the following order* (l) axjueous solution of iodine * Unpublished data. -32- suspensoid, (2 ) Lugol's solution, and (3 ) tincture of iodine. It is well to toear in mind that thus fax the tests made on agar cup plates and dead tissue have indicated that, if these tests are fair measures of penetrative power, that the atoove order should toe (2), (3), (l). The technique employed toy Chandler and Schalm was modified slightly for this determination of penetrative power, which, as previously stated, varies only as the time of contact. In order to ascertain this end-point the following method was used: (1) 0.25 ml, of a suspension of freshly collected, washed, coccidial oocysts was placed in U.75 nil* of compound, (2) Thoroughly shaken at intervals, (3 ) At definite periods 0 *5 ®1 * of the suspension was placed in H.5 ml. of "brilliant green-sodium thiosulphate and allowed to sporulate at room temperature. This procedure sufficed for all iodine and chlorine containing compounds, (H) For the merthiolate preparations the sample of oocysts prior to placing for sporulation were first washed in saturated H^S water then three washes of tap water toy centrifugation, (5) For phenol, "brilliant green, and the acetone-alcohol mixture three washes with tap water sufficed, (6) At the end of Ug hours the greater portion of super­ natant liquid was drawn off and a drop of the sediment placed on a slide under a cover glass, (7) Handom fields were counted until a total of one hundred -33- oocysts had "been observed, noting those that were sporulated, non-sporulated and fragmented, (8 ) Control samples were sporulated at the same time, (9) 2?he total sporalation for the control samples which averaged 95 Per hundred oocysts was taken as the 100 percent base upon which the percentages shown in the table were calculated for the test samples, and (1 0 ) The recognized sporulation medium, 2 percent potassium dichrornate was also used to show that the brilliant green-sodium thiosulphate medium produced maximum sporulation. Of the rapid acting compounds (Table 7 ) It caja seen that colloidal iodine was the most rapid of all compounds in penetrating. Observation showed that it actually entered and stained the cytoplasm of the organism in less than 5 minutes. The time for Lugol's solution to enter and kill was over 15 minutes while 5 percent phenol needed approximately h hours and the 5 percent HTH65 solution (32,500 p,p,m. available ehlorine) required better than 7 hours to give complete mortality. From Table 8 it can be readily seen that the compounds which under other penetrative conditions (cf, agar plate methods) appeared possibly superior to colloidal iodine are in the light of these data actually inferior. Five percent tincture of iodine killed only 28 percent of the oocysts in 12 hours. Aqueous Merthiolate in the three concentrations 0 .1 , 1 *0 , and *K0 percent was sli^itly better. -3'4- 30 st* CO O o 69 OiH HI O o 0 Pi1 •d ° o © _ rt o rl *rl ft 4J H •H O » O •d Q © H H ♦H M 'd H O rt to 4> Cl & o o ■3 •H O o o o § S o to ft O'! s [3 •H o o o o «oH O o £d* o o o o o m 8 8 in 4> r-H tO 8 tn id ) o M © At B rd © 3 43 Pi 43 •H 03 ■£ a\ 0 S «H tn 2 B o *H o o o a o •H © ® PL| © o *H O 43 43 eo Pt o a ft •p 42 rl (3 43 *d o © *d PScfl o* © •H © W o © © o o o o CM VO <3 Pi 43 cm © © PL, to 0 O • •H 4» a (3 h 4* 8 8 r—1 EH > o o o rt •H »d •H o O O o CT\ P-l 43 . oo c w * % © i rt o *d o © rt § o o o K\ CM rH rH •H 43 OJ s IT\ .rt* •H O o o o o CO O OJ OJ o rt a rH © rt g © ft rt u o o .rt *H o 43 43 CO rt rt* O 9 43 ft ■h d 4 3 »d o © *d d B rt cr* © •H r ot •H 43 © rt 43 rt © o rt o o 0 CM »♦ rH © »d 0 O & o o 0 CM *• rH 0 rH 4> © rt «H E4 rt trt •H O 1 — 1 rH O O ! I 1 © rt ♦H *d © rt •H *d © rt •d 0 0 0 J-4 H4 H4 © W 3 1 .rt • — fto © H O •d d oj rt © CM d o o © rt e 43 rt o o a rt rt © •r ft H & 4©3 «§ § § O PH r © t r t © 43 43 rt § 43 *h nd WHO h H +> o -h q o rt rt o 1© *d ft CM © rH O rt .ft .p d CQ nd *H O © © Q d o t§ O O *d © 4§ IrS d p © d © pH *H & j§ p M m p *H O & S2i I d O © a •H £ d o d *rH d *H d •rl a a g O"S d »H © O O © o rH P © to o P C5 M d •H P CJ -3 o» is? p •rl • 3 EH © a a o o „.r\_ KV d •H d •rl a o ...K\ . a o rfx- g •H P Oi d P & EH a EH CO id U o «to O d *rl d © o d O O s m ro ©0 o rH rH o o OJ © rH g g © EH rH O M 1 & o o d *H 1 d © © © ciJ d ■ — i p •H ■S' O rH rH O O 1 1 © d © d u P o •d *d •H ,d p d n M s •H o •H o © p X 4-3 o s© LO P W P P5 -51* 43 © S d ih © rQ © © * H ft O ft d © »d sa *s d © 4* A © O •H 43 *H O C O d _d © u • •h *d •d § d 0 43 43 •H O rQ d •H O O © az d o •H * 4» ♦H © rO H *H o s-a a . ir; 3 U © C O Sm O fth0 o d O *H *d 4* © *rl 4= .O in o to »d 4©3 © © Eh 43 m,S «H © O PI © (6 W) d «h © o © d f t *rl .& TO © d o • © © cfl d rH © ft *rl •d ft 43 S 43 •d M + + 3 O ,Q 3© 3 • d £3 •H O "S r4 a to S3 •a'S «d © «d co © © -d" © d IH J 8 •P m of g •d © ■a > CO o © .H a a 0© *H © r— EH PI r*- a a a § d d © o d o o TO si O O d © o d 43 0 0 o C V J O C V J 8 rH rH »H in cm a« p! o o in OJ m 8 © o I H I © •dH *d o r4 O O © d 3 o •H d 0 © ft S* *H O © O o d d 3 *H d «H d © © d ciJ © ■§ 43 si in vo u © a s d d st 43 d 3 43 d © o »d g § © *d © 43 © o 5 ft rH 9 o g1 O •H © d 43 > d o ♦H "d d 4» EH O -52- © * d49 TABLE 15. - Penetration of Rabbit Skin by Selected Compounds Acting 5 1 /2 Hours Before and an Additional 5 Hours After Death of the Rabbit. 00 I N fi ,*H ©49 o o & © d © •H M 0*H 0«d © d Ah*h © C/3 *d © •5 © © •H «H O •H i© • © S 49 © © 'd S t 0 iH♦ O ^• 2 d © rH 0 © 1 d o o S *H ■S & O 4o9 O0 d m tO VO O VO O O O rH in |" - o O d •H © 'd d 05 *r4 ©M *d to Eh rd O to a 0 0 je! Jcj jci J$ in in in in CO u O G O 0 in § © 1% 0 •a d ,d •H .d to JH rC3 h| w H|W 0 jh in o OJ in 8 «H 09 hJ w in 8 r4 0 OQ 09 m S hI w in j© hI w in h |n in in C• VJ » rH t3 to •d JP® d S © *H 8 in * CVJ m fH rH 49 © +9 o cj 49 49 i & o o 1 rH O t© d *3 • 1 © d •rH »d © d •rH *d © d •rH Eh ,o © »H 0 8-H o 0 HH O O 0 © •H © Ho u. c +©» d *d 49 d ra co 8 1 © d •rH »d O H d *i-f d *d •H O t~\ 1— ! .d + 9 in vo fH © s m 3 49 rtH 49 0 ?) © • © 'd Pi *H P g-g »d * •§ § in o vo e© o *§ pf § *H 4» © fn 49 Pi'd in C/3 O o M a t> £ 3# 1 0 1 © 5 © J j 1 49 h © O d o O © •rH a. jsj o $ £ 1 | © w) 1=1 © *d © •H JS 'd 0 in *h vo a i •dP W •H •d © § © P rH 49 O d d © © P P Ah £ * * through to the fascia no inhibitory O !Z3 0 •H 0 O d O © digestion of the epidermis but not completely zone was expected of the fascia. IT\ PI © u 0 m LTV rH + KV p O •H O 1 + © CM B •H EH O rH + .H + enssfa t © Pi •3 ■p 0 w 1 + & tJ •a© © •H ■P © + + © © Pi © © Pt < D + i + o u ? o 1 + l 1 l je © H I (0 o •p © o * O & Skin** stretched over short tubes 1 ml. culture inside. Subcultures at -53- -5^- abl© fashion the length of time required for these compounds to penetrate both live and dead skin. The term wlive skin8 will he used in referring to the skin when it is on the intact, anesthesized animal with circulation unimpaired. employed in referring The term Bdead skin'* will he to the skin from the moment when the animal has heen sacrificed and the general circulation stopped irrespective of whether or not the skin is used on the animal or removed immediately at death for test tuhe work. In each test the animal was sacrificed as indicated hy the termination of the experiments on live skin, Tables 1*4- 1 9 . The cups were emptied and the interior washed with a neutralizing agent and several changes of distilled water followed hy swabbing dry, then cups were removed. The circular area of epidermis covered by each cup was removed as was the underlying areolar tissue and first layer of muscle, except where inflammatory reactions had occurred to such a degree that the fascia was more or less adherent to the skin. These bits of tissue averaging 1 .3 cm. in diameter were placed upon a previously poured thin layer of S. aureus seeded agar, and covered with another layer of seeded agar. Incubation was carried out the usual *+8 hours to allow a dense growth to clearly outline the area around the tissue where the compound had diffused into the agar, killing or inhibiting the colonies. Inspection of Tables lU-1 9 show that the compounds to which definite killing action had been previously assigned were capable of -55- penetrating the skin, the areolar tissue, and into the muscle layers if certain conditions obtained. in more detail later* (These conditions will "be described Babbit Ho* ty, Table 1^, was sacrificed immediately after the suspension of S . aureus was placed in the pockets so that insight might be gained as to whether or not the failure to sterilize the inoculum through, live skin was due to factors beyond reasonable control* This was evidently the case since positive subcultures were obtained even though the iodine compounds had macroscopically penetrated* Inspection of Table l4 shows that ¥ percent aqueous Merthiolate and the three 5 percent iodine compounds penetrated the epidermis of the dead animal in some time under 7 hours since tissue plating demonstrated they were present in the first layer of abdominal muscle* Brom Table 15 it can be seen that these same compounds were barely able to penetrate the dead skin in 5 hours, even though they had acted on the live skin 5 V 2 Iwmrs before the animal was sacrificed, a total of 10 1 /2 hours action upon the epidermis. Incidentally, the stronger solution of aqueous HTH 65 used, (32,500 p.p.m. available chlorine) showed why it was virtually impossible of demonstration in the subcutaneous tissue by this technique. Since HTH penetrated by oxidation, causing necrosis and digesting the tissue as it went deeper, the compound itself was used up in the procedure. Therefore, insufficient residual compound was present in the tissue to be demonstrable when the epidermal layer was plated. -56- At the time the animal was sacrificed (5 1 /2 hours) the skin was dissected loose from the muscle and the under side examined for macroscopic evidence of any of the iodine compounds* Hone were visible until 5 hours later, but edematous reactions in the areolar tissue were evident under all cups except b- percent Merthlolate, Brilliant green was omitted because of the obvious length of time (by observation) necessary to penetrate the epidermis, while aqueous HTH and phenol were dropped (Tables lH and 15 ) from further consider­ ation because the amounts penetrating were apparently used up or bound by the epidermal cells so that no residual could be demonstra­ ted by plating the washed epidermis* Considering Table l6 next, it is readily seen that aqueous Merthiolate and the three iodine compounds penetrated the epidermis and the areolar tissue in 11 hours. In this test the compounds acted on the skin of a live animal the first 6 1/2 hours and on a dead animal the last b 1/2 hours. To distinquish between the compounds from the standpoint of speed, a section of the unused epidermal layer was removed at death, cut into sections an inch square and stretched over one end of a sterile two inch length of test tube. A ml. of a saline suspension of S» aureus was placed therein and the skin end of the tube then immersed beneath the surface of a compound. Subcultures from the inside at intervals proved colloidal iodine to be the most rapid, penetrating the skin in something less than two hours while over -57- three hours were required for tincture of iodine. The 4 percent aqueous solution of Merthiolate did not penetrate in sufficient amounts to sterilize the seeding in 20 hours. However, the compound had penetrated in sufficient quantity "by this time such that the Shippen procedure, i.e., a double subculture, gave no growth in the first tube but excellent growth in the second broth tube. The next two experiments (Tables 17 and IS) were designed to explode the myth of easy penetration of live skin. In these two tests a run was performed with the cups set up on one side of the mid-line of the abdomen with the animal alive. Duplicate cups were set-up on the other side of the mid-line and filled just as the animal was sacrificed. the tissues plated. manner. The first set of cups was then removed and The second set of cups was treated in the same The only variable introduced was time, the compounds being allowed to act upon the live skin longer than upon the dead skin. Acting upon dead skin 7 3/^ hours (Table 17) all of the compounds employed (l and h percent aqueous Merthiolate; 5 percent tincture, Lugol's and colloidal iodine) penetrated the areolar tissue in sufficient concentration to give definite zones on plating. Whereas, acting upon live skin almost an hour longer k percent aqueous Merthiolate was the only member of the group apparently able to penetrate the epidermis. It is evident from the areolar tissue zones and the relative size of the epidermal tissue zones produced by the 1 percent aqueous Merthiolate and the three 5 percent concentrations -58- * * CM • O 525 ©

•H d td © Rl • VO ITi • I— rl • h— 0 > • K"\ tf « , M d CO s t© «5 •rl B o d 5 S S «[N< ©JiT rj£f o a ocj o o *H 43 d q o> <*5 +» o co © CO *H O \ 43 *H *H d o C VJ © © 43 * 01 43 rQ rt © H • CO • OV , • * KV • O O rH I— rH JS % h |3 r© ■\ — 1 1J i 0 EH h CM o © • W > $4 *4 o © *H O 43 £# LTV © • r© •H O 8 •rl 43 09 © 'S l> *H d © o CO * *h- 1*1 44 m ft? TABIU ■P VO »d I& o o $ CD •rH rH O 0 •dH Eh rH ■— I 1 O © I © o o i © "§ rH © d d d 3 o 3 o »d o O a •p fH © S © a • d d •H fH 43 o 41 © ■P to © 44* fH -p d © fH d o © s © © d o ,d © •H -P © -P © I— I o 44 Pi fH • •p © o -P © a •H -P © © d o N d o I o © © -P fH •op fn •H © •H d M © fH d ■P O idH -P © d *** Sterile plate CO ,9 59- -6o- of iodine that the dead epidermal layer was much easier to penetrate than that of live skin* The aqueous forms of iodine, Lugol's and colloidal, show some superiority over the same strength of tincture of iodine hy penetrating the first layer of abdominal muscle while the latter compound reached only as far as the areolar tissue within the allotted time period. The 4 percent aqueous concentration of Merthiolate showed similar superiority over the 1 percent concentra­ tion by penetrating the dead epidermis, areolar tissue and into the abdominal muscle while the weaker concentration failed to penetrate the muscle. In the second experiment of this type (Table 18) the allotted time for penetration of the live and dead skin was shortened 2 1/2 and 3 1 /b ^ours respectively. distinction between the compounds. This served to give a clearer Acting upon live skin 6 hours none of the compounds penetrated the epidermis whereas acting upon dead skin b 1/2 hours three of the group, Lugol's iodine, colloidal iodine and k percent Merthiolate penetrated the epidermis as demonstrated by their presence in the areolar tissue. It is noteworthy that with these shorter time periods smaller amounts of the compounds were present in the epidermal tissue as demonstrated by the relatively smaller inhibitory zones when compared with those obtained on dead skin in the previous experiment (Table 17). Prom observations made upon the plated tissues given in Tables 1^ to 18 it was noted that the zones given by the areolar -61- tie sue under the b percent Merthiolate cups were barely evident. It is felt that the evidence of penetration given by these zones is false. It is possible that these zones were due to contamination of the areolar tissue by the Merthiolate when the epidermal layer was being cut from the skin. Even after most careful neutralization and thorou^i washing of the epidermal layer under the b percent Merthiolate cups there was considerable residual compound in this layer as demon­ strated by the majority of plates being sterile or almost so. In view of this fact it was felt that if true penetration had occurred then the areolar tissue and muscle tissue layers would have enough compound to produce much more definite, distinct zones than were obtained. In this connection it is well to remember that the bacteriostatic properties of mercury are high and not easily inacti­ vated by nutrient media, hence even a minute amount of the compound carried from epidermal layer to the subcutaneous layers by the instruments at time of dissection could easily account for the results. Before proceeding to the final table of this series, it would be well again to call attention to the more obvious differences among the three iodine compounds employed. Whether acting on live or dead skin, colloidal iodine penetrated faster and deeper than did Lugol's iodine. The platings of surface skin, areolar and muscle tissue from colloidal iodine cups gave much larger inhibition zones than the Lugol's, indicating that more iodine was taken up by the tissue from the colloidal iodine. The same concentration of tincture -62- of iodine was an outstanding failure, in several instances not even penetrating the epidermal layer of tissue. The data given in the final Table of this series (19) were obtained by the same procedure as used in Table l6 , i.e., tying the skin over the open end of a short sterile test tube and placing a ml. of a saline suspension of S. aureus on the inside, replacing the cotton plug and inserting the skin end of the tube in the compound allowing it to float undisturbed, except to subculture at intervals. Using the Sfcippen subculture procedure with Merthiolate and brilliant green it was possible in this lengthy test to demon­ strate that the dye could penetrate dead skin but required even to tint the saline suspension inside the tube and 99 66 hours hours to reach sufficient concentration to produce a negative subculture. The b percent concentration of aqueous Merthiolate required less than 37 hours to give a negative subculture but the 1 percent solution of Merthiolate needed something over 60 1/2 hours to give negative sub­ cultures with the 0 .1 between hours. ^7 und 60 percent tincture yielding negative subcultures The iodine group was again obviously superior. iodine penetrated in 15 2 Colloidal 3 /k hours while Lugol*s solution required minutes longer to render the seeding sterile. Tincture of iodine was 3jnost as slow as the strongest solution of aqueous Merthiolate, requiring 1^- to 17 hours to penetrate. Here, too, is strikingly shown why, in practical use, tincture of iodine is of little value -63- « +» •H X X & 0 0 :6 6 I t I I IJ H- I 0 0 :1 2 f 1 I II l+ + TABLE I + + Hi m IH •H 0 O 09 I I 0 1+ Og:l£ l + l 0 Q:1 t + + H* I H- I + + + + It I I I t + + Vl ++ tt 0 0 :^ 1 w1 0 0 :SI ++ 00:6 •H Eh t I 0 £:s + + 0 0 J2 + + Hi H» rd ++ d Hi d o o •H CO d §£ ++ © © d © «H © d © Hi ++ ++ ■§3 + + + + ++ ++ H» © rH rH U Hi •H CO IH Hi P- 2 »rl rd + + ++ © + + + + © © © © Hi Hi d X©I tvD d o u © Hi d d © d Hi § u © © d u d © o © © •H d © d rH © d © IH © O JU u ft ■P P H d d o © H O d d *d o 10 ++ + + Ih * ,d © Hi © © d d d PM w + + I + o © d rd . + + + + OO: £ Hi Hi d © 6 X© % n * *2 X © d Hi d CO d 03 d 0 IH © 0£:i X rH_$VJ d O d o •rl CVJ rH CVJ CVJ •H ICM "8 u +> d © o d o o o cv O CM O CVJ o rH P & -P 19. - Relative Penetrative Time of Selected Compounds Acting Tissue Stretched over One End of a Class Tube* on Epidermal cr> 0 d § o & o o 1 0 d d Q -P •P d rH d X ■P •H rd P 0 I § 1 © EH 1 — d— £ d © © £ rH O O © CVS © © 3 O EH IT\ © 3 E $ t © d d •rl © 1 Hi •H O O +» 5 o IH © 53 U © H rH rH •rl IH W iH O M -P • © § & e)VD hH d d •H © V£» Hi • d •rl —1 © d © 09 1 *H d •rl O © <1-1 ft O Hi d © © 0 A •rH • d © 0 +> +> © •H d Ih © d d d ft © H» .d « -= r > d C VJ ft © d © Hi d *H © © d Q d d *H 3 © © s •H rH £ d © t H IH © d •rl © Hi © Hi •a © d © 4 •H rd © O Hi d d d H> •H & •d P P © 53 3 0 M © «5 ■ — l © d © © P & c! j p p p •rl .d p P © S d d *H rH ■ — I •rl P fd d 03 •rl rH rH *H P m -73- the preceding sections it was decided to employ only iodine, Merthiolate and "brilliant green for this test. It was felt that in the selection of these three compounds the entire range of rapid — moderate — extremely slow penetration would be best demonstrated by iodine, Merthiolate and brilliant green, respectively. i The data obtained (Table 20) are in harmony with the accumulated data of the preceding tests* tion of 1 to 1 ,0 0 0 , 0 0 0 while a 1 to 1 0 0 ,0 0 0 Elemental iodine in a dilu­ penetrated and killed the bacteria in dilution sterilized the seeding within 2 30 minutes seconds. These results occurred consistently irrespective of whether tincture, Lugol's or colloidal iodine was the stock solution used. Merthiolate in a dilution of 1 to 10,000 effected a 75 Per­ cent reduction of the initial seeding within minutes with little 20 additional effectiveness noted up to 30 minutes. dilution of 1 to 5 ,0 0 0 was obtained within in 30 15 a 95 When used in a percent reduction in the initial seeding minutes but complete sterility did not result minutes. Brilliant green employed in a dilution of 1 to 10,000 was as efficient as Merthiolate at the same concentration reducing the initial seeding by 77 percent within 20 minutes. concentration was cut in half (l to 2 0 ,0 0 0 ) However, when this this compound failed to give any reduction in the initial seeding within 30 minutes. That the compound was definitely bacteriostatic was proved by the observa­ tion that of the two series of broth tubes used as dilution blanks in which the concentration of the compound was 2 ,0 0 0 , 0 0 0 1 to 2 0 0 ,0 0 0 and respectively none of the tubes showed any evidence of 1 to -71*- growth even after extending the incubation period from Ug hours to 96 hours. It was found necessary to use four broth tubes instead of two asdilution blanks for each time interval when the stronger concentrations of Merthiolate (l to (l to 10,000) were tested. 5 ,0 0 0 ) and brilliant green When only two dilution blanks were employed sterile plates resulted. These results explain some of the points emphasized in the preceding sections and support the contention held that in order for a given compound to be an effective germicide it must possess the power to penetrate bacteria rapidly. It is to be noted that no organic matter was employed in this test. Organic matter was omitted because true penetration of the bacteria was desired without confusing side reactions to consider. For organic matter to be of any value in this particular test the organisms would have to be enclosed by the particles i.e., grown within the particles so that the compound would have to penetrate the organic coating before reaching the organism. To employ any particular organic matter even of uniform size as suggested by Garrod (19), 1935* would merely serve to introduce another variable into the test. Those compounds that penetrate rapidly would enter organic matter and bacteria alike, being removed from the solution in the procedure. Consequently, stronger solutions of such compounds are required to effect sterilization. Compounds which penetrate -75- bacteria slowly would also penetrate organic matter slowly* This virtue of slowness enable weak dilutions of slow penetrating compounds to do the same total work that requires, comparatively, much stronger dilutions of the rapid acting compounds to accomplish* This comparison of the slow penetrating compound with the rapid penetrating compound under conditions of organic matter testing would make the former stand out as the superior bactericidal agent which is the reverse of the true state of affairs as demonstrated by this work* -76- SUMMAHT The compounds employed in this work are summarized in Table 22 under each test used according to their relative effective­ ness. In arranging this table* the factors of temperature, substrate, concentration, quantity, and time of action were all considered. The information embodied in this table may be condensed by arranging these compounds in the order of their penetrative ability: 1 . Iodine - Colloidal 2 . Iodine - Lugol's 3. Iodine - Tincture h. Merthiolate - Aqueous 5* Merthiolate - Tincture 6 . Phenol 7. H T H g. Brilliant Green 9* Azochloramid The phenol coefficients of a group of selected disinfectants and antiseptics were found. The mechanism of the agar cup plate method was shown to demonstrate diffusibility rather than penetrative ability. Modification of the agar cup plate method was accomplished and the penetrative powers of the iodines, Merthiolate, brilliant green, azochloramid and phenol unequivocally established. 1—1 OJ m © u °H »d r rd *H o e o © P © rH o •H .d pd © S in vx> W d O © d* g © i in rH id EH id in rH id id eh r— Azochlor­ amid Brilliant green * in rH W EH id Brilliant green * i Azochlor­ amid !Brilliant green © 3 *H P& ^ p 2d d ©i pH S I to , rH *d % o i 3 i Brilliant green Merthiolate 1 i 1 * * in VD id Eh w * * rH O d © ,d Pi i i CO cn results. Merthiolate -tincture "8 Azochlor­ amid 1 ■■ 1■ ■■11 ■ © . © p§ d o •h d »d *h OP HH ; Merthiolate -aqueous Penetration of bacteria i n i t ! * Failed ** Hot demonstrable by technique employed *** Tincture, Lugol's, and Colloidal Iodine gave identical H *d •8 t o N 3 Phenol in IX) W EH W 1 eh 10 d O © d d © i Phenol id •©p r©H o *H . pd U © X Merthiolate -tincture in VJD m ■—i o d ID £ Phenol © Merthiolate -aqueous in IJD w Eh tn Brilliant green__ CO d O 0) 0 O' © l Merthiolate j I -tincture | Iodine ;-tincture Iodine i-Lugol's Iodine -colloidal rH •oH ,d P ^ id S Merthiolate| Brilliant -aqueous 1 green Iodine -tincture Iodine ( -Lugol's Iodine -colloidal ... Penetration of rabbit skin "8 Merthiolate -tincture •od d H l 1Phenol to ID r-l * * * ID d •H o Merthiolate -tincture n Iodine -colloidal Iodine -colloidal } © d © © S I Iodine -Lugol's j Penetration of strongylid larval cuticle * * * © d -rl o h-t Brilliant green * * *