Object: To test the claims of thromboplastic and hemostatic activities.
Claims: Coagulen is alleged to be a “physiological styptic prepared from the natural coagulants of animal food contained in the blood platelets. It has the characteristics of a lipoid.” (If cephalin is meant it is difficult to understand why platelets should be selected in preference to other abundantly supplied organs such as brains).
“Coagulen is indicated in all cases of external and internal hemorrhage due to a deficiency of the coagulating power of the blood: epistaxis, hemophilia, hemorrhage from gastric or duodenal ulcer, melaena neonatorum, hemorrhage from the gums, the lungs, the bladder, the uterus, hemorrhage during or after operations (turbinectomy, tonsillectomy). It has also been used as a prophylactic before operations, likely to produce severe hemorrhage.”
“In cases of true hemophilia one application of 5 grains of coagulen usually suffices to control the hemorrhage.” “In gastric and intestinal hemorrhage the internal administration of coagulen will be found effective.” “In bonegrafting, plastic surgery, dentistry and nose and throat surgery the application of a 10 per cent. solution of Coagulen will be found to be of valuable assistance in controlling hemorrhage and oozing.”
“It is a non-toxic and non-irritating powder to which a certain amount of sugar has been added, with a view to ensuring its prompt solution in water or physiological sodium chloride solution.”
Description: “Coagulen is a yellowish granular powder with but slight odor, a sweet taste and is readily soluble in water or a normal salt solution.” The dry Coagulen obtained corresponds to the description claimed. Old specimens show the presence of dark brown particles. Coagulen is marketed in 3 forms: (1) as dry powder containing lactose, which, it is claimed, facilitates solution in water; (2) as 3 per cent. sterile solution in ampoules;[137] (3) tablets.
Methods of Study: The alleged thromboplastic activity was tested by the method of Howell and a modification of this method by Fenger as described in “New and Nonofficial Remedies.” In the Howell method dog or cat blood is used, while beef blood at body temperature is used in Fenger’s method. In other respects the methods are essentially the same. Briefly these consist of noting the acceleration of coagulation time in a mixture of equal parts of serum and the thromboplastic agent to which about an equal part of oxalate plasma is added. Under these conditions cephalin causes clotting in about 1 minute or even less as compared with 20 to 30 minutes or more of the control.
The effects were compared with freshly prepared cephalin and other thromboplastic agents, using saline (0.9 per cent. NaCl) as control. The effect of different concentrations was also studied.
The literature of the manufacturers claims that Coagulen is harmless. This was tested by making intravenous and subcutaneous injections into guinea-pigs, using saline and cephalin as controls.
Bloods of 4 different species were used, namely, cat, dog, beef and human. Dog’s peptonized blood and plasma were also tried.