As with any injection which pierces the skin, there is a risk of infection from bacteria or other organisms present in the environment or on the skin prior to the injection. This risk is lessened with proper aseptic technique and cleansing of the area prior to administration. Intramuscular injections may also cause an abscess or gangrene at the injection site, depending on the specific medication and amount administered. There is also a risk of nerve or vascular injury if a nerve or blood vessel is inadvertently hit during injection. If single-use or sterilized equipment is not used, there is the risk of transmission of infectious disease between users.
Risks and complications
Intramuscular injection
Intramuscular injection | Risks and complications
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the three most commonly used sites for intramuscular injections are
user
The deltoid muscle of the upper arm, the gluteal muscle of the buttock, in infants, the vastus lateralis muscle of the thigh
assistant
does this have any complications?
user
Yes, the most frequent complications of a deltoid injection include pain, redness, and inflammation around the injection site, which are almost always mild and last only a few days at most.
assistant
why is it taken?
user
In medicine, it is one of several methods for parenteral administration of medications.
assistant
is it meant for any specific populations?
user
In some populations, a change in injection site, needle length, or technique is necessary; for  example, in very young people or frail elderly people, a normal length needle may be too long to safely inject in the desired muscle
assistant
which country was it used first?
user
Sorry. I cannot find the answer based on the context.
assistant
can you list some of it's uses?
user
Intramuscular injection is commonly used for medication administration, such as, vaccination
assistant
what technique is used for it?
user
The injection site is first cleaned using an antimicrobial and allowed to dry, it is performed in a quick, darting motion perpendicular to the skin, at an angle between 72 and 90 degrees.
assistant
when was it first used?
user
Injections into muscular tissue may have taken place as early as the year 500, but, by 1961 they had "essentially taken over the procedure"
assistant
does it have any side effects?
user
No, but, there is a risk of infection from bacteria or other organisms present in the environment or on the skin prior to the injection.
assistant
who discovered it?
user
Intramuscular injections began to be used for administration of vaccines for diphtheria in 1923, whooping cough in 1926, and tetanus in 1927. By the 1970s, researchers and instructors began forming guidance on injection site and technique to reduce the risk of injection complications and side effects such as pain. Also in the early 1970s, botulinum toxin began to be injected into muscles to intentionally paralyze them for therapeutic reasons, and later for cosmetic reasons. Until the 2000s, aspiration after inserting the needle was recommended as a safety measure, to ensure the injection was being administered in a muscle and not inadvertently in a vein.
Intramuscular injection | History
Injections into muscular tissue may have taken place as early as the year 500. Beginning in the late 1800s, the procedure began to be described in more detail and techniques began to be developed by physicians practicing at the time. In the early days of intramuscular injections, the procedure was performed almost exclusively by physicians. In the mid 1900s, nurses began preparing equipment and patients for intramuscular injections as part of their delegated duties from physicians, and by 1961 they had "essentially taken over the procedure". To this time, there was not uniform procedures or education for nurses in proper administration of intramuscular injections, and complications from improper injection were common.
Intramuscular injection | History
However, this is no longer recommended as evidence shows no safety benefit and it lengthens the injection, which causes more pain.
Intramuscular injection | History
As with any injection which pierces the skin, there is a risk of infection from bacteria or other organisms present in the environment or on the skin prior to the injection. This risk is lessened with proper aseptic technique and cleansing of the area prior to administration. Intramuscular injections may also cause an abscess or gangrene at the injection site, depending on the specific medication and amount administered. There is also a risk of nerve or vascular injury if a nerve or blood vessel is inadvertently hit during injection. If single-use or sterilized equipment is not used, there is the risk of transmission of infectious disease between users.
Intramuscular injection | Risks and complications
Rarely, nerves or blood vessels around the injection site can be damaged, resulting in severe pain or paralysis. If proper technique is not followed, intramuscular injections can result in localized infections such as abscesses and gangrene. While historically aspiration was recommended to prevent inadvertent administration into a vein, it is no longer recommended for most injection sites.
Intramuscular injection | Introduction
Dr. Glenn pioneered needle free delivery to the skin and spawned general interest in skin-targeting vaccine technologies, including intradermal delivery and the use of the heat labile toxin as an adjuvant and the adjuvant patch.
IOMAI | Introduction
He appears to have used his family in his experiments, and a young son was the subject of a series, in which Dr Oliver measured the diameter of the radial artery, and observed the effect upon it of injecting extracts of various animal glands under the skin. … We may picture, then, Professor Schafer, in the old physiological laboratory at University College, … finishing an experiment of some kind, in which he was recording the arterial blood pressure of an anaesthetised dog. … To him enters Dr Oliver, with the story of the experiments on his boy, and, in particular, with the statement that injection under the skin of a glycerin extract from calf’s suprarenal gland was followed by a definite narrowing of the radial artery.
History of catecholamine research | Oliver and Schäfer 1893/94
After immunoglobulin therapy's discovery and description in "Pediatrics" in 1952, weekly intramuscular injections of immunoglobulin (IMIg) were the norm until intravenous formulations (IVIg) began to be introduced in the 1980s. During the mid and late 1950s, one-time IMIG injections were a common public health response to outbreaks of polio before the widespread availability of vaccines. Intramuscular injections were extremely poorly tolerated due to their extreme pain and poor efficacy – rarely could intramuscular injections alone raise plasma immunoglobulin levels enough to make a clinically meaningful difference.
Immunoglobulin therapy | 1950s – intramuscular
The area must be cleaned prior to administering the injection, and the injection should be administered in a fast, darting motion to decrease the discomfort to the individual. The volume to be injected in the muscle is usually limited to 2-5 milliliters, depending on injection site. A site should not be chosen which has signs of infection or muscle atrophy. Intramuscular injections should not be used in people with myopathies or clotting problems. Intramuscular injections commonly result in pain, redness, and swelling or inflammation around the injection site. These side effects are generally mild and last no more than a few days at most.
Intramuscular injection | Introduction
Intramuscular injection, often abbreviated IM, is the injection of a substance into a muscle. In medicine, it is one of several methods for parenteral administration of medications. Intramuscular injection may be preferred because muscles have larger and more numerous blood vessels than subcutaneous tissue, leading to faster absorption than subcutaneous or intradermal injections. Medication administered via intramuscular injection also is not subject to the first-pass metabolism effect which affects oral medications. Common sites for intramuscular injections include the deltoid muscle of the upper arm and the gluteal muscle of the buttock. In infants, the vastus lateralis muscle of the thigh is commonly used.
Intramuscular injection | Introduction
An intramuscular injection can be administered in multiple different muscles of the body. Common sites for IM injection include: deltoid, dorsogluteal, rectus femoris, vastus lateralis and ventrogluteal muscles. Sites that are bruised, tender, red, swollen, inflamed or scarred are generally avoided. The specific medication and amount being administered will influence the decision of the specific muscle chosen for injection. The injection site is first cleaned using an antimicrobial and allowed to dry. The injection is performed in a quick, darting motion perpendicular to the skin, at an angle between 72 and 90 degrees. The practitioner will stabilize the needle with one hand while using their other hand to depress the plunger to slowly inject the medication - a rapid injection causes more discomfort.
Intramuscular injection | Technique
The Arthus reaction was discovered by Nicolas Maurice Arthus in 1903. Arthus repeatedly injected horse serum subcutaneously into rabbits. After four injections, he found that there was edema and that the serum was absorbed slowly. Further injections eventually led to gangrene.
Arthus reaction | History
Bliss sought to find another method of immunization that was within the means of Shaowu. He built off of the discovery of Robert Koch, who found that if the bile from a rinderpest gall bladder were diluted with an equal amount of pure glycerin, it would lose its virulence and would be safe to inject after 10 days. This would provide immunity lasting several months. Bliss then deducted that if a cow was injected with a small quantity of rinderpest blood ten days after being injected with the bile, it would have immunity. He tested this and found he was correct.
Edward Bliss | Rinderpest work
In 1916, Weinberg and Séguin isolated this bacterium from patients with gas gangrene and called it "Bacillus histolyticus". They discovered this bacterium was pathogenic for guinea pigs, mice, and rabbits, but less so for rats. Intramuscular injection of culture caused extensive local tissue destruction, extrusion of a hemorrhagic muscle pulp, splitting of the skin, denudation of the bone, and sometimes autoamputation. In 1922, Heller renamed the bacterium "Weinbergillus histolyticus", and a year later Bergey, Harrison, et al. reclassified it as "Clostridium histolyticum".
Clostridium histolyticum | History
In some populations, a change in injection site, needle length, or technique is necessary. For example, in very young people or frail elderly people, a normal length needle may be too long to safely inject in the desired muscle. For this reason, in these people, a shorter needle is recommended to decrease the risk of injecting too deep. It is also recommended to consider using the anterolateral thigh as an injection site in infants under one year old. To help infants and children cooperate with injection administration, the Advisory Committee on Immunization Practices in the United States recommends using distractions, giving something sweet, and slow lateral swaying.
Intramuscular injection | Special populations
The needle is withdrawn at the same angle inserted. Gentle pressure may be applied with gauze if bleeding occurs. Pressure or gentle massage of the muscle following injection may reduce the risk of pain. The CDC does not recommend the practice of aspirating for blood to rule out injecting into a blood vessel, as aspiration may increase the risk of pain. There is no evidence that aspiration is useful to increase safety of intramuscular injections when injecting in a site other than the dorsogluteal site.
Intramuscular injection | Technique
In 1973, Kitabchi's first study discovered that low doses of insulin were more effective at resolving DKA, and that intravenous (IV) injections worked more rapidly than subcutaneous or intramuscular methods. In subsequent trials, he continued refining his knowledge and testing various non-insulin therapies, including insulin analogs, His studies with the latter found that in combination with insulin IVs, subcutaneously applied analogs were equally effective, and led to lower hospitalization costs by as much as nearly 40%. His work in this area soon became the standard, dramatically decreasing mortality rates in the U.S. from more than 15% to around 1%. His efforts also led to further therapies involving the use of insulin in the treatment of DKA, diabetes-related cardiovascular risks, inflammation, and other symptoms and issues.
Abbas Eqbal Kitabchi | Treatment of DKA
Ophthalmologists specializing in eye muscle disorders (strabismus) had developed the method of EMG-guided injection (using the electromyogram, the electrical signal from an activated muscle, to guide injection) of local anesthetics as a diagnostic technique for evaluating an individual muscle's contribution to an eye movement. Because strabismus surgery frequently needed repeating, a search was undertaken for non-surgical, injection treatments using various anesthetics, alcohols, enzymes, enzyme blockers, and snake neurotoxins. Finally, inspired by Daniel Drachman's work with chicks at Johns Hopkins, Alan B. Scott and colleagues injected botulinum toxin into monkey extraocular muscles. The result was remarkable; a few picograms induced paralysis that was confined to the target muscle, long in duration, and without side effects.
Botulinum toxin | Strabismus
Additionally, the body's reaction to substances is more easily visible since it is closer to the surface.
Intradermal injection | Introduction
The site is located by dividing the front thigh into thirds vertically and horizontally to form nine squares; the injection is administered in the outer middle square. This site is also the usual site of administration for epinephrine autoinjectors, which are used in the outer thigh, corresponding to the location of the vastus lateralis muscle.
Intramuscular injection | Injection sites
Finding no entry wound, Hingson deduced that a high-pressure oil hose aboard the seaman’s vessel had developed a minute leak. A high-pressure jet of oil had then painlessly perforated the man’s thumb and filled his hand with oil. A fortuitous accident, Hingson not only healed the seaman but began research on a high-pressure injection system for medical use. Before Hingson’s innovation, inoculation as preventive medicine in underdeveloped countries was time-consuming, but with the jet injector, inoculations could be administered at a rate of 1,000 patients per hour. The efficacy of the mass inoculation technology was astonishing. For instance, in 1958, smallpox claimed 150 million victims worldwide.
Robert Andrew Hingson | Inventions and innovations
Alan B. Scott first injected botulinum toxin into extraocular muscles since the early 1970s and published his results 1981, giving rise to a wide scope of clinical research on the use of the toxin. The effect of bupivaine injection on extraocular muscles was first known as causing postsurgical strabismus as a complication of cataract surgery due to the myotoxicity of the local anaesthetic drug bupivaine when inadvertently injected into an extraocular muscle.
Botulinum toxin therapy of strabismus | History
In the 1970s, he contributed to the immunology of orthopoxvirus infections by being the first to develop means of distinguishing between antibodies due to infections with variola, vaccinia and monkeypox.
Rijk Gispen | Introduction
Injections into the deltoid site in the arm can result in unintentional damage to the radial and axillary nerves. In rare cases when not performed properly, the injection may result in shoulder dysfunction. The most frequent complications of a deltoid injection include pain, redness, and inflammation around the injection site, which are almost always mild and last only a few days at most. The dorsogluteal site of injection is associated with a higher risk of skin and tissue trauma, muscle fibrosis or contracture, haematoma, nerve palsy, paralysis, and infections such as abscesses and gangrene. Furthermore, injection in the gluteal muscle poses a risk for damage to the sciatic nerve, which may cause shooting pain or a sensation of burning.
Intramuscular injection | Risks and complications
Professor Schafer is said to have been entirely sceptical, and to have attributed the observation to self-delusion. … He can hardly be blamed, I think; knowing even what we now know about the action of this extract, which of us would be prepared to believe that injecting it under a boy’s skin would cause his radial artery to become measurably more slender? Dr Oliver, however, is persistent; he … suggests that, at least, it will do no harm to inject into the circulation, through a vein, a little of the suprarenal extract, which he produces from his pocket. So Professor Schafer makes the injection, expecting a triumphant demonstration of nothing, and finds himself standing ′like some watcher of the skies, when a new planet swims into his ken,′ watching the mercury rise in the manometer with amazing rapidity and to an astounding height.
History of catecholamine research | Oliver and Schäfer 1893/94
After conducting tests on animals to establish his findings, Hunter campaigned for the "general therapeutic effect" of what he initially called the "ipodermic" method, later inventing the term "hypodermic". He published his findings in 1865, and popularised the use of the syringe in medical circles by speaking at medical society meetings and publishing papers on the subject of hypodermics. Hunter and Wood then entered into a debate about whose theory was correct. Wood wrote to the "Medical Times and Gazette" both challenging Hunter's idea that injected drugs could work across the body and also emphasising that he had been the first to look into the effects of injecting.
Charles Hunter (physician) | Hypodermic research and debate over injection methods
Youngner demonstrated the separation of monkey kidney cells using the pancreatic enzyme trypsin, a technique previously proven by the Rockefeller Institute could be applied to high titer virus stocks. Applying this method to a single kidney "could produce enough raw material for 6000 shots of polio vaccine." This advance in production of virus raw material directly led to vaccine viability.
Julius Youngner | Trypsinization
Tetanus was well known to ancient people who recognized the relationship between wounds and fatal muscle spasms. In 1884, Arthur Nicolaier isolated the strychnine-like toxin of tetanus from free-living, anaerobic soil bacteria. The etiology of the disease was further elucidated in 1884 by Antonio Carle and Giorgio Rattone, two pathologists of the University of Turin, who demonstrated the transmissibility of tetanus for the first time. They produced tetanus in rabbits by injecting pus from a person with fatal tetanus into their sciatic nerves. In 1891, "C. tetani" was isolated from a human victim by Kitasato Shibasaburō, who later showed that the organism could produce disease when injected into animals, and that the toxin could be neutralized by specific antibodies.
Tetanus | History
After completing his Ph.D, Fu conducted research in his lab for 2 years on arthritic rats. During these trials, when the needle was inserted into the local point of sensitivity, there were no profound changes in VAS and Range of Movements. Notable changes in VAS and Range of Movements were observed however when the needle was inserted parallel to the skin surface.
Fu's subcutaneous needle | Development
It can be contrasted with intraperitoneal injection as an alternative choice of route of administration with differing pharmacokinetic and pharmacodynamic effects. The Ommaya reservoir is a catheter system invented by Ayub Ommaya, a Pakistani neurosurgeon in 1963. The reservoir is implanted under the scalp and attached to a catheter which is intracerebroventricularly inserted into the lateral ventricle.
Intracerebroventricular injection | Introduction
Certain substances, including ketamine, may be injected intramuscularly for recreational purposes. Disadvantages of intramuscular administration include skill and technique required, pain from injection, anxiety or fear (especially in children), and difficult proper self-administration of medications. Vaccines, especially inactivated vaccines, are commonly administered via intramuscular injection. However, it has been estimated that for every vaccine injected intramuscularly, over 20 injections are given to administer drugs or other therapy. This can include medications such as antibiotics, immunoglobulin, and hormones such as testosterone and medroxyprogesterone. In a case of severe allergic reaction, or anaphylaxis, a person may use an epinephrine autoinjector to self-administer epinephrine in the muscle.
Intramuscular injection | Uses
Sergio Amedeo Pignari from the Politecnico di Milano, Milano, Italy was named Fellow of the Institute of Electrical and Electronics Engineers (IEEE) in 2012 "for contributions to immunity characterization using bulk current injection test methods".
Sergio Amedeo Pignari | Introduction
Ommaya's invention, the Ommaya reservoir, was the first subcutaneous reservoir that allowed for repeated intrathecal injections. Before his invention patients had to suffer repeated lumbar punctures for intrathecal drug administration. Spinal angiography was pioneered by Ommaya, Di Chiro, and Doppman. This work allowed for the visualization of arteries and veins and allowed for understanding of spinal cord arteriography. The same team reported the treatment of spinal cord AVMs by percutaneous embolization of an intercostal artery using stainless steel pellets. This was one of the first reports of interventional neuroradiology. Ommaya's models and work in traumatic injury were foundational to the biomechanics of traumatic brain injury.
Ayub Ommaya | Many firsts
In 1908, Auer and Meltzer began studying magnesium sulfate and its application as an anesthetic. They found that injection of the compound would result in a loss of consciousness and total muscle relaxation. Coupled with the continuous inflation of the lungs via an endotracheal tube, one could maintain ventilation of the body while immobilizing the chest. The patient could then be roused from their unconscious state by the administration of calcium chloride. The application was recognized and further developed by Nobel laureate and Rockefeller colleague Alexis Carrel. Carrel used the techniques set forth by Auer and Meltzer to develop the modern methods of thoracic surgery.
John Auer | Thoracic surgery
The concern of potential adverse effects led to the introduction of intracutaneous skin tests by I. Chandler Walker in 1917. Investigators later concluded that autogenous vaccines provide hyposensitisation in patients with chronic and recurrent infections who may induce allergic reactions.
Autogenous vaccines | History
He recalled his experiences in 1880–1881 showing that injection of the rabies virus in the veins of sheep and goats did not cause rabies, but instead conferred immunity. He noted that research in 1884 by Edmond Nocard and Emile Roux confirmed the validity of these deductions. These authors noted that intravenous injection can prevent rabies after inoculation into the eye, and after the bite of a rabid animal.
Pierre-Victor Galtier | 1888
He also accomplished a number of experiments concerning the practical application of peroxide of hydrogen for the cleansing of wounds. Morris had invented a sort of artificial synovial fluid. Made out by a mixture of boroglyceride, glycerine and normal saline solution, it resulted to be antiseptic and hygroscopic, so that it had a tendency to draw serous fluids towards itself. The consequences of all of its specific characteristics were that when injected into a joint, this fluid resisted absorption longer that an oil could. And these properties were particularly useful in cases of painful joints (especially those one of knee and shoulder).
Robert Tuttle Morris | Experimental work
The ancient Greeks and Romans knew injection as a method of medicinal delivery from observations of snakebites and poisoned weapons. There are also references to "anointing" and "inunction" in the Old Testament as well as the works of Homer, but injection as a legitimate medical tool was not truly explored until the 17th century. Christopher Wren performed the earliest confirmed experiments with crude hypodermic needles, performing intravenous injection into dogs in 1656. These experiments consisted of using animal bladders (as the syringe) and goose quills (as the needle) to administer drugs such as opium intravenously to dogs. Wren and others' main interest was to learn if medicines traditionally administered orally would be effective intravenously.
Hypodermic needle | Early use and experimentation
Sciatic nerve damage can also affect a person's ability to move their foot on the affected side, and other parts of the body controlled by the nerve. Damage to the sciatic nerve can be prevented by using the ventrogluteal site instead, and by selecting an appropriate size and length of needle for the injection.
Intramuscular injection | Risks and complications
Hunter was very early in his career when he became interested in using syringes to administer injections of pain relief. In the 1860s, he improved on the design of the syringe that had been invented by Alexander Wood by adding the needle point and lateral opening. He also created a locking mechanism to prevent the needle from becoming detached when the plunger was pushed. Hunter initially followed Wood's method of using syringes to inject morphine locally, into the area where pain was located. However, when this area became infected for one of his patients, he injected elsewhere and realised that the results were still effective.
Charles Hunter (physician) | Hypodermic research and debate over injection methods
Intramuscular administration of medication is contraindicated in people with an active infection at the injection site, and those with thrombocytopenia or clotting problems. It is also not recommended in people who are suffering from hypovolemic shock, myopathies, or muscle atrophy, as these may affect the absorption of the medication. Other forms of administration are preferred in people with a myocardial infarction, as the damage to the muscle from an injection may affect tests used in the evaluation thereof.
Intramuscular injection | Contraindications
Hunter replied, saying that he had cited Wood and never claimed to have been first, and that his belief in the generalised effect of injected narcotics was correct rather than Wood's belief that morphine only worked locally.
Charles Hunter (physician) | Hypodermic research and debate over injection methods
At that moment almost the same observation was made by Hugh Huxley and Jean Hanson at the Massachusetts Institute of Technology. Authored in pairs their papers were simultaneously published in the 22 May 1954 issue of "Nature". Their conclusion states that the observation: This was the discovery of "Sliding Filament Theory", the first scientific evidence and the basis of modern understanding of muscle contraction. Contrary to scientific view of the time they found that the muscle as a whole do not contract of expand, but it was individual group of the muscle fibres (called I or light bands), while other fibres (A or dark bands) are never changed.
Rolf Niedergerke | Career
In people who are overweight, a 1.5-inch needle may be used to ensure the injection is given below the subcutaneous layer of skin, while a -inch needle may be used for people who weigh under . In any case, the skin does not need to be pinched up prior to injecting when the appropriate length needle is used.
Intramuscular injection | Special populations
Side effects following intratumoral injection are limited to flu-like symptoms and resolve within 24 hours. Toxicology studies in New Zealand White rabbits (3 weekly i.v. doses of 10 PFU) showed that JX-594 was well tolerated, and no toxicologically significant effects were observed. There were no overt clinical signs, with the exception of ~5% of body weight loss by day 6 that was followed by a recovery by day 33.
Jennerex | Safety
Anatolii Al'bertovich Shatkin, in 1961, injected trachoma virus into the conjunctival sac of his eye and rapidly developed trachoma. He did not begin treatment of the condition for 26 days.
Self-experimentation in medicine | Trachoma
In 1796, Edward Jenner FRS, a doctor and scientist who had practiced variolation, performed an experiment based on the folk-knowledge that infection with cowpox, a disease with minor symptoms which was never fatal, also conferred immunity to smallpox. The idea was not new; it had been demonstrated some years earlier by Benjamin Jesty, who had not publicized his discovery. In 1798, Jenner extended his observations by showing that cowpox could be passed from a lesion on one patient to others through four arm to arm transfers and that the last in the series was immune by exposing him to smallpox.
Artificial induction of immunity | Vaccination
Therefore, when he tested his pancreatic extract on humans on February 25, 1922, he administered the extract rectally. The patients seemed to show some reduction in glycosuria. This apparent success emboldened him to inject his extract intravenously into a diabetic patient on March 24, after which the patient's blood sugar apparently fell to zero (".000", "véritable AGLYCÉMIE"). A blood sugar level of zero should have placed the patient into a diabetic coma, but he made no mention of this effect in any of his papers. In contrast, the Toronto team had known for several months that dogs could be placed into a diabetic coma by an overdose of insulin, so they prepared orange juice and candy for the clinical trials.
Nicolae Paulescu | Nobel Prize controversy
Injections into the skin and soft tissue generally do not cause any permanent damage, and the puncture heals within a few days. However, in some cases, injections can cause long-term adverse effects. Intravenous and intramuscular injections may cause damage to a nerve, leading to palsy or paralysis. Intramuscular injections may cause fibrosis or contracture. Injections also cause localized bleeding, which may lead to a hematoma. Intravenous injections may also cause phlebitis, especially when multiple injections are given in a vein over a short period of time. Infiltration and extravasation may also occur when a medication intended to be injected into a vein is inadvertently injected into surrounding tissues.
Injection (medicine) | Others
Bliss also discovered that the calves of immune cows had a temporary immunity that decreased as they aged. He found that if they were injected with a small amount of rinderpest blood within their first month of life, they would have immunity.
Edward Bliss | Rinderpest work
His work included studies on serum proteins, the action of bromoacetic acid on muscle, the toxicity of chloroform, and the metabolic oxidation of alcohols and fatty acids. In 1891 he isolated the compound aristolochin from "Aristolochia clematitis".
Julius Pohl | Introduction
Heidelberger passed muster, and in September 1912 began working in Walter Abraham Jacobs' laboratory on a derivative of hexamethylene tetramine, a complex that seemed to prolong the life of monkeys suffering from polio, and that Flexner hoped could be adapted for use in humans. Results appeared promising at first, but Heidelberger and Jacobs later attributed them to loss of virulence of the virus. In the summer of 1915, after attending officer training camp in Plattsburgh, New York, for a proposed volunteer army (an outgrowth of the movement to prepare the United States for entry into World War I) and earning a commendation as a marksman, Heidelberger traveled to Lake Kezar in Maine for a vacation.
Michael Heidelberger | Rockefeller Institute
Henneman received his bachelor's degree from Harvard College in Cambridge, Massachusetts in 1937. In 1943 he finished his medical studies at McGill University in Montreal. During a research fellowship at Johns Hopkins University in Baltimore, Maryland, Henneman and colleague, Vernon Mountcastle, showed that tactile information about the extremities is represented in an orderly map in the ventrolateral thalamus of the cat and monkey. Further research positions followed, including at the Royal Victorian Hospital and at the Illinois Neuropsychiatric Institute (NPI) in Chicago. At NPI, Henneman discovered that the drug Mephenesin (Myensin) inhibits interneurons in the spinal cord and thus causes muscle relaxation.
Elwood Henneman | Biography and Research
Galtier remarked "intravenous inoculation is ineffective. [But] immunity follows this inoculation in sheep", and he noted the absence of virus in the nerve centers. This last point drew the attention of Louis Pasteur who saw a lack of sensitivity due to the subcutaneous inoculation technique. With his student Émile Roux, Pasteur developed an intracranial inoculation, by trepanning the skull of a dog. This isolated the virus in the nerve centers, and supported the idea that rabies is neurotropic, meaning that the virus preferentially develops in nerve cells, and spreads through nerve pathways from the peripheral inoculation point to the brain.
Pierre-Victor Galtier | 1882
Intravitreal injection was first mentioned in a study in 1911, in which the injection of air was used to repair a detached retina. There were also investigations evaluating intravitreal antibiotics injection using sulfanilamide and penicillin to treat endophthalmitis in the 1940s, yet due to the inconsistency of results and safety concerns, this form of drug delivery was only for experimental use and not applied in patients. It was until 1998, that fomivirsen (Vitravene™), the first intravitreal administered medication, was approved by the U.S. Food and Drug Administration (FDA). In 2004, when Aiello et al. published the first guidelines for intravitreal injection in the journal ‘Retina’, fomivirsen was still the only medication licensed by the FDA for intravitreal injection.
Intravitreal injection | History
Simultaneous to Wood's work in Edinburgh, Charles Pravaz of Lyon also experimented with sub-dermal injections in sheep using a syringe of his own design. Pravaz designed a syringe measuring 3 cm (1.18 in) long and 5 mm (0.2 in) in diameter; it was made entirely of silver. Charles Hunter, a London surgeon, is credited with the coining of the term "hypodermic" to describe subcutaneous injection in 1858. The name originates from two Greek words: "hypo", "under", and "derma", "skin". Furthermore, Hunter is credited with acknowledging the systemic effects of injection after noticing that a patient's pain was alleviated regardless of the injection’s proximity to the pained area.
Hypodermic needle | 19th-century development
… I found that my visitor was Dr. George Oliver, was desirous of discussing with me the results which he had been obtaining from the exhibition by the mouth of extracts from certain animal tissues, and the effects which these had in his hands produced upon the blood vessels of man.” Systemic effects of orally given adrenaline are highly unlikely. So details of the canonical text may be legend.
History of catecholamine research | Oliver and Schäfer 1893/94
Through this experimentation, he developed an arterial solution, which went on to be manufactured commercially and was sold for $3.00 per, and injection apparatus.
Thomas Holmes (mortician) | Study of embalming
Intramuscular injections, abbreviated as IM, deliver a substance deep into a muscle, where they are quickly absorbed by the blood vessels into systemic circulation. Common injection sites include the deltoid, vastus lateralis, and ventrogluteal muscles. Medical professionals are trained to give IM injections, but people who are not medical professionals can also be trained to administer medications like epinephrine using an autoinjector in an emergency. Some depot injections are also administered intramuscularly, including medroxyprogesterone acetate among others. In addition to medications, most inactivated vaccines, including the influenza vaccine, are given as an IM injection.
Injection (medicine) | Intramuscular injection
Injection fibrosis is a complication of intramuscular injection, occurring especially often in infants and children. Injections are often delivered to the quadriceps, triceps, and gluteal muscles, and thus the complication often manifests itself in those muscles. Patients are unable to fully flex the affected muscle. The condition is painless but progressively worsens over time. Orthopedic surgery is the typical treatment.
Injection fibrosis | Introduction
He proposed in 1907 that the "possible danger" of blood transfusions "can be avoided by the selection of a donor whose corpuscles are not agglutinated by the serum of the recipient and whose serum does not agglutinate the corpuscles of the latter". This made him the first to describe the principle of crossmatching. In 1917, while studying immunity in rabbits, he published a description of what is now known as the anamnestic response; and in 1933, working with William H. Welker, he introduced the use of aluminum hydroxide as an adjuvant to increase the immunogenic potential of injected antigens. Hektoen also conducted research into measles, tuberculosis and poliomyelitis and the use of blood cultures for diagnosis.
Ludvig Hektoen | Research
Mogil and colleagues revealed a number of previously unidentified factors affecting the conclusions drawn from biomedical experiments. In 1996, they demonstrated that the newly discovered orphan opioid peptide, orphanin FQ/nociception, did not produce hyperalgesia as originally reported, but rather was reversing the stress-induced analgesia resulting from the intracerebroventricular injection through which it was administered. In 1999, they showed that different inbred strains of mice displayed very different pain sensitivity. Chief among these methodological confounds was the observation that mice display a stress response to the presence of nearby males of a number of mammalian species, including human male experimenters, calling into question the results of thousands of studies in the animal literature when the sex of the experimenter was not controlled, an animal equivalent to the "sweaty t-shirt study" in humans.
Jeffrey Mogil | Discovery of factors affecting experiments
However often this tale has been reiterated, it is not beyond doubt. Dale himself said that it was handed down in University College, and showed some surprise that the constriction of the radial artery was measurable. Of Oliver's descendants, none recalled experiments on his son. Dale's report of subcutaneous injections contradicts the concerned parties. Oliver: “During the winter of 1893–4, while prosecuting an inquiry as to … agents that vary the calibre of … arteries … I found that the administration by the mouth of a glycerine extract of the adrenals of the sheep and calf produced a marked constrictive action on the arteries.” Schäfer: “In the autumn of 1893 there called upon me in my laboratory in University College a gentleman who was personally unknown to me.
History of catecholamine research | Oliver and Schäfer 1893/94
for CHNO: 370.1681. Found: 370.1692.
Intramolecular Heck reaction | Example Procedure
It was Dotter who, in 1950, developed an automatic X-Ray Roll-Film magazine capable of producing images at the rate of 2 per second. On January 16, 1964, at Oregon Health and Science University Dotter percutaneously dilated a tight, localized stenosis of the superficial femoral artery (SFA) in an 82-year-old woman with painful leg ischemia and gangrene who refused leg amputation. After successful dilation of the stenosis with a guide wire and coaxial Teflon catheters, the circulation returned to her leg. The dilated artery stayed open until her death from pneumonia two and a half years later. He also developed liver biopsy through the jugular vein, initially in animal models and in 1973 in humans.
Charles Theodore Dotter | Introduction
He was born in 1950 in Dorset, England. He obtained his undergraduate degree in 1971 from the University of Cambridge, and then completed his Ph.D. in Dennis Bray’s laboratory in the MRC Laboratory of Molecular Biology (LMB), also in Cambridge, in 1975. Using biochemical techniques, he showed that at least two distinct types of myosin II exist in non-muscle cells and that some cells expressed both types.
Keith Burridge | Early life and education
Charles Mantoux (; May 14, 1877, Paris – 1947) was a French physician and the developer of the eponymous serological test for tuberculosis. He graduated from the University of Paris where he studied under Broca. For health reasons, he relocated to Cannes but continued to work in Paris during the long vacation periods granted to patients in sanatoriums. In 1908, he presented his first study of intradermal injections to the French Academy of Sciences and published this work in 1910. In the following years, the intradermal test replaced the subcutaneous test (Pirquet test). Mantoux completed this research and made other contributions to public health and radiology without any affiliation with major universities and institutions.
Charles Mantoux | Introduction
The original data from Stevens's stool and urine samples was collected for 340 days post-injection. Kenneth Scott analyzed the samples, but he never told Stevens the true reason for collecting them; he also recalled that Stevens's sister was a nurse and quite suspicious. Whenever Stevens had continued health problems, he would return to the U.C.S.F. hospital and receive free gastro-intestinal lab work by Dr. Robert Stone, a radiologist who performed extensive human experiments in the 1940s. About 10 years after the injection, a "radiologist noted 'rather marked' degeneration in the lumbar region of his spine and several degenerating discs." Plutonium, like radium and many other heavy metals, accumulates in the bones.
Albert Stevens | After surgery
Around 1886, Nicholas Senn pumped nearly six litres of hydrogen through his anus. Senn used a rubber balloon holding four US gallons connected to a rubber tube inserted in the anus. An assistant sealed the tube by squeezing the anus against it. The hydrogen was inserted by squeezing the balloon while monitoring the pressure on a manometer. Senn had previously carried out this experiment on dogs to the point of rupturing the intestine. Senn was a pioneer of using this technique to determine if the bullet in gunshot wounds had penetrated the intestinal tract. In experiments on gunshot wounds to dogs, Senn verified that the gas escaping from the wound was hydrogen by setting light to it.
Self-experimentation in medicine | Hydrogen
Maurice Brodie joined the New York City Health Department and the bacteriology department at New York University Medical College. In 1935, Brodie demonstrated induction of immunity in monkeys with inactivated polio virus. Isabel Morgan demonstrated the same phenomenon again a decade later. Brodie was head of one of two separate teams that developed polio vaccines and reported their results at the annual meeting of the American Public Health Association in November 1935. Both projects were cancelled as a result of the angry reaction from other researchers there, and no researchers dared attempt a polio vaccine for another 20 years. Professor John Kolmer, MD (1886–1962), of Temple University in Philadelphia, presented his findings first.
Maurice Brodie | Polio research
S.O. Levinson with H.J. Shaugnessy – and others between 1942 and 1947 – injected themselves with a vaccine against dysentery. The vaccine had previously been tested on mice, which had all died within minutes, and the effect on humans was completely unknown. The experimenters survived but suffered strong side effects.
Self-experimentation in medicine | Dysentery
After the first dose, the formulation had to be re-worked, a process that took 12 days. The second dose was effective. These two won the Nobel Prize in Physiology or Medicine in 1923 for their discovery of insulin and its treatment of diabetes mellitus. Thompson lived 13 more years taking insulin. Before insulin's clinical use, a diagnosis of diabetes mellitus meant death; Thompson had been diagnosed in 1919. In 1943, Selman Waksman's laboratory discovered streptomycin using a series of screens to find antibacterial substances from the soil. Waksman coined the term antibiotic with regards to these substances. Waksman would win the Nobel Prize in Physiology or Medicine in 1952 for his discoveries in antibiotics.
History of animal testing | In medicine
He saved many lives with this discovery.
Percy Lavon Julian | Steroids
In Noguchi's defense, Rockefeller Institute business manager Jerome D. Greene wrote a letter to the anti-vivisection society, which had protested the experiment. Greene pointed out that Noguchi had tested the extract on himself before administering it to subjects, and his fellow researchers had done the same, so it was impossible that the injections could cause syphilis. However, Noguchi himself was diagnosed with untreated syphilis in 1913, for which he refused treatment from Rockefeller Hospital. At the time, Greene's explanation was considered a demonstration of the importance of the studies and care the doctors were taking in research. In May 1912 the New York Society for the Prevention for Cruelty to Children asked the New York district attorney to press charges against Noguchi; he declined.
Hideyo Noguchi | Human experimentation scandal
This was initially thought to be an indirect effect of reduced muscle tension, but it is now known that the toxin inhibits release of peripheral nociceptive neurotransmitters, suppressing the central pain processing systems responsible for migraine headache. In 2010, the FDA approved intramuscular botulinum toxin injections for prophylactic treatment of chronic migraine headache.
William J. Binder | Biography
Hyman Irving Biegeleisen (June 4, 1904 New York City – May 3, 1991, died at his home in Boca Raton, Florida) was an American physician and pioneer of phlebology. In 1964, he founded the Phlebology Society of America (now incorporated into the American College of Phlebology). He was one of the first doctors in the United States to use injection as a method of treating varicose veins, and coined the term "sclerotherapy" to describe the treatment.
H. I. Biegeleisen | Introduction
Thomas Lewis and Jonas Kellgren studied pain in the 1930s. To do this, they injected hypertonic saline into various parts of their own bodies.
Self-experimentation in medicine | Pain
Intramuscular injection is commonly used for medication administration. Medication administered in the muscle is generally quickly absorbed in the bloodstream, and avoids the first pass metabolism which occurs with oral administration. The medication may not be considered 100% bioavailable as it must still be absorbed from the muscle, which occurs over time. An intramuscular injection can be administered faster and is less invasive than an intravenous infusion, as the site of injection (a muscle versus a vein) is much larger. Medications administered in the muscle may also be administered as depot injections, which provide slow continuing release of medicine over a long period of time.
Intramuscular injection | Uses
This effect is highlighted and measured with a device created by Hurmuzescu - the electroscope that bears his name.
Dragomir Hurmuzescu | Doctoral studies
Together with colleagues Wilson Teixeira Beraldo and Gastão Rosenfeld, Rocha e Silva discovered in 1948 the powerful hypotensive effects of bradykinin in animal preparations. Bradykinin was detected in the plasma of animals after the addition of venom of "Bothrops jararaca" (Brazilian lancehead snake), which was brought by Rosenfeld from the Butantan Institute, in São Paulo, Brazil. This discovery was part of a continuing study on circulatory shock and proteolytic enzymes related to the toxicology of snake bites, started by Rocha e Silva as early as 1939. Bradykinin was to be proved a new autopharmacological principle, i.e., a substance that is released in the body by a metabolic modification from precursors, which are pharmacologically active.
Maurício Rocha e Silva | Work
Another nurse recalled that these were said to be vitamin injections, and it was also clear that the amounts of opiated injected were constant until September 1950, when another doctor first increased the dosage.
John Bodkin Adams | Trial
Lewis Thomas described in his memoir a physiologic experiment of 1941 in which he observed the prozone effect in vivo: immunity in rabbits to meningococcus, which was robust, unexpectedly decreased when immunization was used to induce a heightened antibody response. In other words, getting the rabbits' bodies to produce more antibodies against this bacterium had the counterproductive effect of decreasing their immunity to it. From the viewpoint of an overly simplistic notion of the antibody/antigen relationship, this seems paradoxical, although it is clearly logical from a viewpoint duly informed by present-day molecular biology. Thomas was interested in pursuing this physiologic research further, and remained so for decades afterward, but his career took him in other directions and he was not aware of anyone having pursued it by the time of his memoir.
Hook effect | In vivo observations
In 1899, the discovery of the existence of antibodies against sperm was made independently both by Serge Metchnikoff of the Pasteur Institute and by Nobel prize laureate Karl Landsteiner. In 1929, the first recorded attempt at immunocontraception was made by Morris Baskin, clinical director of the Denver Maternal Hygiene Committee. In this trial 20 women who were known to have at least 1 prior pregnancy were injected with their husband's semen, and no conception was recorded in 1 year of observation of these couples. A United States patent (number 2103240) was issued in 1937 for this approach as a contraceptive, but no product for widespread consumption ever came from this approach.
Immunocontraception | Early research
Eliscu applied for a patent for the tool he developed to use intradermal injections of permanent pigments.
Frank Eliscu | Military service
Tim Friede created his own vaccine against snakebite using pure venom injections from all four species of mambas, and four cobra species to achieve high immunity. He also survived anaphylactic shock six times during the development of his vaccine. Others have also injected venom to create immunity to snake venom: Bill Haast, Harold Mierkey, Ray Hunter, Joel La Rocque, Herschel Flowers, Martin Crimmins, and Charles Tanner.
Self-experimentation in medicine | Snake venom
Dense infiltration of with CD4 and CD8 T lymphocytes into the tumor was observed following intratumoral injection of JX-594. Despite the presence of anti-vaccinia antibodies, virally encoded GM-CSF mRNA was detected at injection sites up to 31 weeks following the intratumoral JX-594 inoculation and was not present in the serum. Systemic GM-CSF was detected up to 7 weeks following both intratumoral and intravenous injection of JX-594.
Jennerex | Immune response
Dr. Van M. Sim underwent an intravenous infusion of VX to evaluate its effects and to establish a baseline for future experimentation. After approximately 3.5 hours following initial administration of the agent, Sim suddenly became pale and delirious. The experiment was immediately terminated to preserve his life. In their conclusion, the researchers estimated that 2.12 μg/kg of VX delivered intravenously over the course of several hours would be the maximum tolerable dosage and that any more would risk death in a human subject.
VX (nerve agent) | Discovery
Marshall's investigation was preceded by David A. Robinson who, in 1980, ingested "Campylobacter jejuni," a bacterium found in cow's milk, to investigate whether gastritis could be caused by drinking milk infected with "C. jejuni." Robinson became sick as a result. Robinson needed to do a human experiment because the alternative, testing on cows, was not viable as infected cows frequently do not become ill.
Self-experimentation in medicine | "Campylobacter jejuni"
He develops specific techniques to explore penile hemodynamics and designs various original surgical interventions, such as the penis dorsal vein arterialization which is named after him. In 1982, he discovers, almost by chance that an old medication, papaverine injected directly into the penis is able to provoke a long lasting erection Thus, he develops the technique of intracavernous injection used worldwide since 1983 to treat erectile dysfunction. He was appointed as a consultant at Harvard Medical School. He also teaches within the different structures of French and foreign medical societies. He is a permanent member of the French National Academy of Surgery.
Ronald Virag | Biography
Although there are risks of infections or other complications, with suitable precautions throughout the injection process, chances for these complications could be lowered.
Intravitreal injection | Introduction
A paper has been published about their discoveries.
Tommy McHugh | Injury
In 1960 he moved to The Squibb Institute for Medical Research in New Jersey where he researched and developed Captopril in 1975.
Miguel Ondetti | Introduction
After working out techniques for freeze-drying, buffering with albumin, and assuring sterility, potency, and safety, Scott applied to the FDA for investigational drug use, and began manufacturing botulinum type A neurotoxin in his San Francisco lab. He injected the first strabismus patients in 1977, reported its clinical utility in 1980, and had soon trained hundreds of ophthalmologists in EMG-guided injection of the drug he named Oculinum ("eye aligner"). In 1986, Oculinum Inc, Scott's micromanufacturer and distributor of botulinum toxin, was unable to obtain product liability insurance, and could no longer supply the drug. As supplies became exhausted, patients who had come to rely on periodic injections became desperate.
Botulinum toxin | Strabismus
Vladimir Sergeevich Gulevich (, 1867–1933) was a Russian and Soviet biochemist who first isolated carnitine from mammalian muscle.
Vladimir Gulevich | Introduction
Finally, he went back to Paris to succeed Claude Bernard in 1878 as professor of experimental medicine in the Collège de France, and he remained there until his death, which occurred in 1894 at Sceaux, France. He was buried in Paris at the Cimetière du Montparnasse. Brown-Séquard was quite a controversial and eccentric figure, and is also known for self-reporting, at age 72, "rejuvenated sexual prowess after subcutaneous injection of extracts of monkey testis". Thousands of men tried the therapy. The endocrinologist Robert B. Greenblatt wrote that this therapy could not have possibly worked because, unlike the thyroid gland, the testes do not store the hormones they produce and, therefore, obtaining a therapeutic dose of testosterone directly from animal glands "would require about one-quarter ton of bull's testes." The positive response by many men is now thought to have been a placebo effect, but apparently this was "sufficient to set the field of endocrinology off and running."
Charles-Édouard Brown-Séquard | Later life
It was also experimented by Charles Waterton in 1814 when he injected three donkeys with curare. The first donkey was injected in the shoulder and died afterward. The second donkey had a tourniquet applied to the foreleg and was injected distal to the tourniquet. The donkey lived while the tourniquet was in place but died after it was removed. The third donkey after injected with curare appeared to be dead but was resuscitated using bellows. Charles Waterton's experiment confirmed the paralytic effect of curare. Another milestone in the development of NMBA was done by French Physiologist Claude Bernard when he injected curare into frog legs, the muscle in the leg would not contract when the nerve was directly stimulated but would contract when the muscle was directly stimulated.
Neuromuscular blocking agents | Early discoveries, milestones, and development
Julius Mount Bleyer (16 March 1859 – 3 April 1915) was a New York doctor who specialized in laryngology who took a keen interest in medical jurisprudence. He studied the methods used for capital punishment and as a member of a commission, was among the first to propose lethal injections in 1888. He pointed out in "The Medico-Legal Journal", the problems with other methods of executing death sentences including decapitation and electrocution. Lethal injections were however not used until the early 1980s. Bleyer was also a pioneer of photofluoroscopy, a method of visualizing x-rays to observe the functioning of internal organs.
Julius Mount Bleyer | Introduction
In the 1660s, J. D. Major of Kiel and J. S. Elsholtz of Berlin were the first to experiment with injections in humans. These early experiments were generally ineffective and in some cases fatal. Injection fell out of favor for two centuries.
Hypodermic needle | Early use and experimentation
He found that muscle seizure (tetany) was due to abrogation of parathyroid glands, and that injection of calcium salt could restore the condition. This directly laid the understanding of the role of calcium in muscle contraction. In 1909 he discovered that a disease gastric tetany was not due to parathyroid functions, but because of blockage of the stomach-intestine connection called pylorus. He wrote a definitive textbook "A Textbook of Pathology" which ran several editions and is still in print. A histochemical staining technique for Gram-negative bacteria called McCullum-Goodpasture stain is jointly named after him and the co-discoverer Ernest William Goodpasture.
William George MacCallum | Introduction
In 1992, Bellhouse was at work on a "powdered injector to deliver genetic material into plant cells" when he wondered if he could use the same method on people. A few hours after injecting himself with finely ground salt, the skin began to bleed. As he explained, "Salt bursts the red blood cells. This proved that it had worked. And it was utterly painless. It felt like a puff of air". Bellhouse developed PowderJect, a needle-free and pain-free injection system which shoots fine powder into the skin at high speed, and his son-in-law Paul Drayson brought along the financing needed to turn it into a commercial reality.
Brian Bellhouse | PowderJect