Reprinted from Annals of Ophthalmology and Otology, October, 1896. 
SOLUTIONS DOBELL. 
By Edwin Pynciion, M. 1)., 
OF CHICAGO, 
INSTRUCTOR IN RHINOLOGY AND LARYNGOLOGY, CHICAGO POST-GRADUATE 
MEDICAL SCHOOL; ATTENDING SURGEON FOR DISEASES OF THE 
NOSE AND THROAT, DISPENSARY OF THE ILLINOIS MEDI- 
CAL COLLEGE; ASSISTANT AURAL SURGEON 
ILLINOIS CHARITABLE EYE AND 
EAR INFIRMARY. 
While one eminent rhinologist decries the use of aqueous 
nasal injections, sprays and cleansing solutions, another equally 
eminent and learned will stoutly advocate their employment, 
When doctors thus disagree, Who is to decide? 
Among the advocates, and as a pioneer, may be mentioned Dr. 
Horace Dobell, of London, who, about a quarter of a century 
ago, when at the prime of his professional career, was the author 
of a work entitled, "Lectures on Winter Cough," which soon be- 
came one of the most popular medical works of the then current 
decade. 
In this work was suggested a line of treatment for catarrhal 
coughs, which in the writer's practice had proven highly benefi- 
cial, and prominent among the things advised was the use by 
injection of an alkaline solution Which has ever since been ex- 
tensively prescribed and used under the name of "Dobell's Solu- 
tion." In fact, its popularity became so great that its formula 
was recently incorjxirated in the National Formulary, though 
the original proportions were slightly changed. 
Several years ago I chanced by accident to observe a marked 
difference in the strength of two formulae for this preparation, 
and this gave me a key to the solution of the raison d' etrc for the 
statement made in the opening paragraph. I recently made a 
brief search through several available medical libraries for vari- 2 
ations of the Dobell Solution formula, with the result of un- 
earthing twenty-one different formulae as given by thirty-one 
authorities. As a matter of interest? and to call attention to the 
wide discrepancies to be met with, I will append the result of 
my investigation in tabular form, and, to allow of easy compari- 
son, I have in each case, when necessary, increased or decreased 
the quantity ordered to a uniform or common denominator 
standard of one pint of the finished product and have also dis- 
regarded fractions of a grain. As the borax is the most import- 
ant ingredient I have placed it first and, beginning with the 
weakest, have then arranged the formulae successively as their 
strength increased. No. 14 gives Dr. Dobell's original formula, 
while Nos. 13 and 15 give respectively the metric and troy ren- 
dering of same in the National Formulary. 
Formulae for Dobell's Solution as given by various authori- 
ties: 
- 
- 
- 
- 
Sodae, Bibor. 
Sodae, Bicarb. 
Acid, Carbolic. 
Glycerine. 
W ater. 
~T 
Grs. 30 
Grs. 30 
Grs. 15 
Drin. 4 
Pt.i 
9 
32 
32 
16 
8 
1 
3 
32 
32 
16 
16 
1 
4 
32 
32 
16 
2U 
1 
5 
40 
40 
32 
8 
1 
6 
60 
30 
12 
16 
1 
7 
60 
60 
45 
8 
1 
8 
60 
60 
45 
1 
9 
71 
71 
14 
14 
1 
10 
78 
78 
21 
4 
1 
11 
96 
96 
38 
1 
12 
96 
96 
32 
1 
13 
116 
116 
23 
4| 
1 
14 
120 
120 
48 
i 
15 
120 
120 
24 
4 
1 
1G 
120 
120 
24 
8 
1 
17 
ISO 
120 
24 
1 
18 
127 
127 
27 
61 
1 
19 
240 
240 
80 
14 
1 
20 
210 
240 
120 
14 
1 
21 
480 
480 
180 
29 
• 1 
- 
1. Seiler, Diseases of Throat, Phila., 1889, p. 168; Hare, 
Pract. Therapeut., Phila., 1895, p. 93. 
2. R. W. Seiss in ITare's System of Practical Therapeutics, 
Phila., 1892, Vol. II, p. 417. 3 
3. Ingals, Chest, Throat, etc., N. Y., 1881, p. 402; W. M. 
Carpenter, Index of Prac., N. Y., 1884, p. 52. 
4. Roosa, Diseases of Ear, N. Y., 1885, p. 391. 
5. R. W. Seiss in Burnett's Ear, Nose and Throat, Phila., 
1893, Vol. I, p. 646. 
6. Bosworth, Nose and Throat, N. Y., 1889, Vol. I p. 174. 
7. Remington, Prac. of Pharmacy, Phila., 1894, p. 1302. 
8. Parrish's Pharmacy, Phila., 1884, p. 1004. 
9. Loomis, Practical Medicine, N. Y., 1884, p. 11; Hughes' 
Practice of Med., Phila., 1894, p. 242; E. J. Bermingham, Pract. 
Therapeutics, N. Y., 1885, p. 198. 
10. MacDonald, Diseases of Nose, London, 1890, p. 351. 
11. Ball, Nose and Throat, N. Y., 1895, p. 357. 
12. Hall, Nose and Throat, Phila., 1895, pp. 33 and 504. 
13. No. 242 N. F. in Proceedings Amer. Pharm. Ass'n, 
Balt., 1895, p. 90. 
14. Horace Dobell, Coughs, Consumption and Diet, Phila., 
1877, p. 183; Mackenzie, Esophagus, Nose, etc., N. Y., 1884, p. 
380; Lefferts, Pharmacopoeia for Larynx and Nasal Passages, 
N. Y. 1884, p. 11. 
15. No. 235 N. F. in U. S. Dispensatory, 17th. Ed., 1794; 
Clinton Wagner in Burnett's Ear, Nose and Throat, Phila., 1893, 
Vol. I, p. 597; Remington, Prac. of Pharm., Phila., 1894, p. 1279; 
Farquharson, Therapeutics, Phila., 1889, p. 538. 
16. Scoville, Art of Compounding, Phila., 1895, p. 75. 
17. Shoemaker, Mat. Med., Phila., 1895, p. 98. 
18. Hager, Manuel Pharm., Leipzig, 1892, p. 428. 
19. Robinson, Nasal Catarrh, N. Y., 1885, p. 76. 
20. Sajous, Nose and Throat, Phila., 1889, p. 410; Biddle, 
Materia Medica, Phila., 1895, p. 78. 
21. S. O. Potter, Materia Medica, Phila., 1895, p. 476. 
It will be observed that in two cases the glycerine has for 
some reason been omitted, and that in several cases different 
formulae are given at different times and places by the same 
author. The most marked example of this is by Remington, 
whose very dissimilar formulae (Nos. 7 and 15) are only twenty- 
three pages apart. While the variation in the quantity of borax 
and soda called for is remarkable, it is no more so than is the 
varying quantity of carbolic acid employed. With this acid in 
order to get a perceptible antiseptic action in a lotion or douche 
it must be used in a strength of about 1 per cent or say at least 
one drachm to the pint. In quantities much less than this it can 
only be regarded as a flavoring agent and a very poor one at 4 
that. For this latter use I have been in the habit of substituting 
listerine. 
Another variation to be observed is in the quantity of glycerine 
suggested, this ranging from two and one-half to 29 drachms to 
the pint. While this is not as objectionable as in the case of the 
other medical agents, I have by experiment become convinced 
that one ounce or less gives better results than when the one 
ounce is exceeded. For commercial reasons in part, as will be 
later explained, I have arrived at six drams as being the best 
quantity, but this much I do want and have found that without 
the glycerine the solution is less agreeable and herein lies one 
of my chief objections to the use of so-called Nasal Tablets. 
In my experiments I found the weakest solution given to be 
the most satisfactory, it containing one drachm,of the combined 
salts to the pint, which I have generally found to be as strong as 
is agreeable to the nasal mucous membrane. In the employment 
of nasal douches (indicated only in atrophic conditions) one 
drachm of salt to the pint of luke-warm water is the strength 
most advisable. This makes a fluid of about the same 
specific gravity as the normal blood serum. (Seiler, 
Phila., 1889, p. 2G8.) I have found the same rule holds 
good, though to even a more marked degree, in hy- 
pertrophic conditions. The greater strength so often em- 
ployed will, in part, explain the unsatisfactory results which have 
so often been met with. While in purely atrophic conditions a 
large quantity-a pint or more-of an aqueous solution of proper 
strength and temperature can, in my opinion, under proper re- 
strictions, be safely employed, in the usual or hypertrophic form 
of nasal trouble, I have found that a small quantity, one drachm 
or less, simultaneously sniffed in both nostrils, and frequently re- 
peated, gives the best results, and hence my belief that a second 
reason why some have found such treatment unsatisfactory is 
because too great a quantity was each time employed, and possi- 
bly not at all heat xl; so, to recapitulate, I have learned that suc- 
cess in using aqueous solutions in hypertrophic conditions, 
hinges largely upon the method adopted in the same way as is 
necessary a correct method in the safe use of the nasal douche; 
that the strength of the solution should not exceed one drachm 
of salts to the pint; that the quantity each time employed must 
not exceed one drachm, and, on the line of the utility of the small 
dose, frequently repeated, it must be sniffed several times daily, 
preferably from the palm of the hand, thereby becoming suffi- 
ciently warmed, as the quantity is so small. 5 
Having decided to employ such solution as has been described, 
I ran up against a stumbling block of no mean proportions. I 
allude to the method of American druggists of basing their 
charge more upon the quantity ordered-the size of the bottle, 
if you please-than upon the value of the ingredients prescribed. 
When among the Romans we are advised to do as the Romans 
do; so I began experimenting, with the object of pleasing all 
parties concerned, so that the patient could have the medicine 
ordered at a reasonable expense, and still comply with the pop- 
ular pharmaceutical requirements. My solution of the problem 
was to have compounded together the active agents, and let the 
patient furnish the pint bottle, the water, and make the required 
dilution. I have found this method, without exception, to be 
highly satisfactory, and additional advantages have been attained 
beyond the primary object. In this way my druggist makes up 
one quart at a time; I am assured of the purity of the component 
parts, and the invariable uniformity of the medicine the patient 
receives, as only the best chemicals are used. I will now give 
the formula and process, and take the privilege of giving the 
compound a name which seems to be the most fully descriptive: 
MIXTURE DOBHLL-PYNCHON. 
1$ Soda' Bicarb. Merck, C. P. 
Sodaj Bibor. Squibbaa gii 
ListerineOss 
Glycerine, C. POiss 
First mix and triturate the two salts and place same in a one- 
gallon bottle, adding one-half of the quantity of glycerine; then 
let stand 24 hours uncorked, with frequent agitations. Next add 
the remainder of the glycerine and continue agitations for an- 
other 24 hours, with bottle uncorked, as before. Lastly, add the 
listerine and let stand 24 hours longer, when it is ready for use. 
By the admixture of the glycerine with the salts, a "foaming" is 
produced, which means a liberation of carbonic acid gas, and the 
production of a glycerole. In its use, it is designed that each 
ounce of this mixture shall be diluted with water to one pint, 
which will then contain 30 grains each of borax and soda; Lis- 
terine, two drachms, and glycerine, six drachms, making a bland 
and pleasant solution, with a specific gravity of 1015°. For of- 
fice use it is my standard alkaline spray, though for use as a spray, 
I am particular to dilute with distilled water. 
It is not expected that the small amount of listerine added will 
give any particular degree of antiseptic property. It is used prin- 
cipally as a flavor, and to increase the quantity above the six 
drachms of glycerine to one ounce. Listerine is the best flavor- 6 
ing agent I can find, and it is a handsome tribute to its valuable 
aromatic and pungent properties, when so small a quantity as 
two drachms will, to an appreciable degree, flavor one pint. 
In writing the prescription for the patient, instead of taking the 
time and trouble to write out the entire formula, I simply order 
the mixture by name, thus saving for myself much time. The 
patient, likewise, is a saver of time, as it takes but a moment or 
two for the druggist to fill the prescription; while if extempor- 
aneously prepared, an half hour or more would be required. I 
write as follows: 
ft Mxt. D-P 
S.-Add to aqua Oi, then sniff 3i 
every hour. 
I am careful to give patients directions as to its use, as follows: 
"While standing, pour not to exceed one teaspoon ful of the 
"dilution in the palm of the hand. Next, hold hand about two 
"feet above floor, and stoop until medicine can be sniffed in both 
"nostrils at the same time. After this, use handkerchief, but blow 
"very gently." 
After the use of the nasal solution, I direct them to gargle the 
throat, generally with a weak solution of the chlorate of potash, 
and to thus repeat the solution and gargle every hour. I pre- 
scribe this as a routine treatment for home use, the patient mean- 
time being made to understand that this gives only temporary 
relief while being used, and that its object is chiefly to prepare the 
nasal passages for the surgical steps which must follow from 
time to time, and upon which the only hope for cure can be 
placed. During the entire course of treatment the patient is di- 
rected to continue the sniffing and gargling every hour or two, 
which, by the way, is equally as effective in controlling inflamma- 
tion after operations, as in preparing the passages at first. By 
stooping well forward and sniffing as directed, the solution en- 
ters all three of the meatuses and thus has a beneficial effect upon 
the entire Schneiderian membrane, while, owing to the small 
quantity each time employed, there is no danger of its entering 
the eustachian tubes. In a large experience for the past seven 
years, in both clinical and private practice, with this method of 
treatment I have invariably met with favorable results, but I 
insist upon the exact following of directions. I greatly prefer 
the sniffing as described, to the use of an atomizer, and reserve 
this instrument exclusively for medicated alboline sprays. 7 
The advantage of stooping has been emphasized by T. F. 
Rumbold,* of St. Louis, he having recommended the use of a so- 
lution of common salt, one drachm to the pint of warm water, of 
which "one to three 'handfuls" were to be sniffed several times 
a day. I can easily appreciate a danger in using so large a quan- 
tity, and my experience with salt in hypertrophic conditions, has 
not been favorable. 
Other great advantages in the concentration for patients who 
are travelling, are its compactness and portability, and the fact 
that as small a quantity as is desired can be prepared; for exam- 
ple, half a drachm of the mixture to one ounce of water. 
While in hypertrophic conditions the intention is to add one 
ounce of the mixture to a pint of water, in some cases, when be- 
ginning treatment, owing to hypersensitiveness, I direct a still 
greater dilution to a point of perfect tolerance. In atrophic 
forms of nasal trouble, or if ozena be present, I add to the mix- 
ture a proper amount of carbolic acid, and sometimes, for a short 
time, to secure greater stimulation, increase the strength by add- 
ing more than one ounce of the mixture to the pint of water. For 
example: 
PhenolSiss 
Mxt. D-Pad §ii 
M. 
S.-Add to aqua Oi and sniff 
3i-3ii every hour. 
In the atrophic form more than one drachm may be safely ad- 
vised. After a very short time, the phenol can be dispensed with, 
and the strength reduced to the usual amount of one ounce to 
the pint. 
The practicability and convenience of this mixture will appeal 
to the country practitioner or to the physician to whom a drug 
store is not conveniently near. 
Having on hand a mixture so valuable as this, it is not at all 
strange that I should have discovered other methods for its em- 
ployment, and no doubt the list could be easily extended. 
In the treatment of hardened cerumen, I have found it admir- 
able as a softening agent. Directions are given that 15 or 20 
minims be dropped in the auditory canal at night, and then the 
meatus plugged with cotton made dense with mutton tallow, or 
what is still more elegant, when obtainable, Hageman's camphor 
ice. This is repeated for three or four nights in succession, after 
which the cerumen is easily dislodged by a warm water injection. 
♦Hygienic and Sanative Measures for Chronic Catarrhal Inflam- 
mation of the Nose, Throat and Ears, St. Louis, 1SSO, Vol. I, pp. 
68-76. 7 
Another use to whidh I have put this mixture is as a lotion for 
chapped hands. At night, after a thorough soap and hot water 
washing, a teaspoonful is applied to the hands and well rubbed* 
in, following which an old pair of kid gloves are worn till morn- 
ing. After two or three nights the trouble will be corrected as 
well as, or better, than when any of the popularly advertised 
chapped hand lotions are employed. 
Diluted in the proportion of about two ounces to the pint of 
water, it will be found to be an efficient and agreeable gargle; 
sometimes better hot than cold. 
Columbus Memorial Building.