Caroline ; the Extract of the 
Heart. 
Its Preparation and Physiological and 
Therapeutical Effects. 
WILLIAM A. HAMMOND, M. D., 
Surgeon-General, U. S. Army (Ketired List). 
BY 
REPRINTED PROM THE 
Weto sTorlt Metrical Journal 
for April 22, 1893. Reprinted from the New York Medical Journal 
for April 22, 1893. 
CARDINE; 
THE EXTRACT OF THE HEART. 
ITS PREPARATION 
AND PHYSIOLOGICAL AND THERAPEUTICAL EFFECTS. 
By WILLIAM A. HAMMOND, M. D., 
SURGEON-GENERAL, U. 8. ARMY (RETIRED LIST). 
In continuation of the article on Certain Organic Ex- 
tracts, etc., which appeared in the New York Medical Jour- 
nal for January 28, 1893, I have to submit the following 
remarks on the subject of cardinc, which, as the name im- 
ports, is the extract of the heart, and in this instance of the 
heart of the ox. I have experimented with the heart of the 
sheep, the dog, and the common fowl, but that of the ox has 
afforded the most decided physiological effects, and is there- 
fore to be preferred. So far as lam aware, no such prepa- 
ration as the one I am about to describe has yet been used 
in medicine, nor has the organ, to my knowledge, been em- 
ployed for the treatment of the disorders of the heart un- 
less, perhaps, by the German physician of some forty years 
ago to whom I alluded in my previous communication as 
having proposed to cure diseases of the various organs of 
Copyright, 1893, by D. Appleton and Company. 2 
CARBINE. 
the body by causing the subjects of them to eat the cor- 
responding organs of animals. As I then stated, my 
reference is entirely from memory of what I had read 
in medical journals at about the time of the publication 
of his essay. 
Cardine, as used by me, is prepared as follows : One 
thousand grammes of the finely minced fresh heart of the 
ox, previously well washed in a saturated solution of boric 
acid, are submitted to the action of a menstruum consisting 
of twelve hundred grammes of glycerin, one thousand 
grammes of a saturated solution at 60° F. of boric acid, and 
eight hundred grammes of alcohol. These proportions are 
the result of a large number of experiments and are those, 
I think, which are most efficacious in extracting from the 
heart its peculiar principle. 
The mixture is made in a strong porcelain, glass, or glazed 
earthenware jar provided with a closely fitting cover, and 
every day for a period of at least eight months—and I am 
disposed to think that a year is preferable—the mixture is 
stirred and the heart substance subjected to strong pressure 
with a boxwood masher, such as is used in the preparation 
of certain vegetables for the table. If a much less period 
than eight months is given to the process of maceration the 
product is inefficient, and indeed, as I have said, it is bet- 
ter to let the extraction go on for a much longer period. 
Experiments that I have made with the freshly expressed 
juice of the heart, either pure or in combination with gly- 
cerin or alcohol in various proportions, show that it is abso- 
lutely without physiological or therapeutical influence other 
than that of the transitory stimulating effect of the alcohol 
when the proportion of this substance is great. 
At the end of the period of maceration the supernatant 
liquid is poured into the upper receptacle of a porous stone 
filter and allowed to percolate through into the lower vessel. CARDINE. 
3 
The finely comminuted heart substance remaining is sub- 
jected to very strong pressure in a metallic press and the 
resultant juice also poured into the filter. The filtration is 
a very slow process, the solution of the heart being even 
more refractory than that of the brain and other nervous 
structures, and several weeks are required for the comple- 
tion of the process. Percolation through filtering paper will 
not answer. 
As thus prepared, the solution of cardine is a clear, 
transparent liquid of a pale straw-color, with the specific 
gravity of PO7O. Under the microscope it exhibits no 
morphological constituents; it does not change, so far as I 
am aware, under any ordinary circumstances, and no bacte- 
ria possess sufficient vitality to exist in it. It is perhaps 
better, however, that it should be kept in a cool place in 
well-stoppered phials. 
I have said that it is unchangeable under ordinary cir- 
cumstances, but occasionally when the phials containing it 
have been subjected to extreme variations of temperature 
and to agitation, about two per cent, of them will exhibit a 
slight flocculent precipitate which is albuminous in charac- 
ter. When this occurs, filtration through Swedish filtering 
paper or through a funnel, the throat of which is closed 
with absorbent cotton, suffices for its removal. The re- 
maining liquid, under these circumstances, loses none of its 
properties. 
Of course the most rigid antiseptic precautions must he 
taken in the preparation of this and all the other animal 
extracts which I have used. It must he borne in mind, 
however, that as the extract is to he injected into the blood, 
the substances employed for the prevention of septicism 
must he such as are not deleterious to the human system 
or which of themselves have any marked or positive physio- 
logical effect. Carbolic acid and corrosive sublimate, 4 
GARDINE. 
therefore, are out of the question. Heat and boric acid I 
have found to be entirely efficacious, and the latter, form 
ing as it does one of the constituents of the mixture, is 
especially eligible. 
A great many experiments were required in regard to 
the dose of cardine to be hypodermically administered, and 
it is therefore necessary to insist upon a due observance of 
the proportions of ’the various substances entering into its 
composition being strictly adhered to. Regard must also 
he paid to the period of time during which maceration is 
continued. Thus action for a month or two produces a 
liquid which contains such a small amount of the essential 
principle that it is almost, if not entirely, inert. Macera- 
tion for six months results in a product the effects of which 
are perceptible, but of which the dose must be fifteen or 
twenty minims, and even then the physiological and thera- 
peutical influence is feeble. After eight months, however, 
the action is much more decided, and five minims hypo- 
dermically injected is a good average dose for an adult, 
some persons requiring a minim or two more, while with 
others a minim or two less suffices. I have arranged the 
dose after many experiments upon healthy men and women 
of average size, and have accordingly fixed upon five minims 
as the proper dose of cardine after a maceration of from 
eight to ten months. 
I can not too strongly insist upon proper filtration of 
cardine, as well as of all the other animal extracts obtained 
by my process. It is absolutely essential that no morpho- 
logical matter should be present in the liquid used for 
hypodermic injection. If this precaution is not observed, 
abscesses, and even more serious disturbance, will most cer- 
tainly follow. After proper preparation cardine is, as I 
have said, absolutely fatal to bacterial life. At the time of 
injection it is well, though not essential, to add to the quan- GAR DINK. 
5 
tity used a like amount of sterilized distilled water. I say 
sterilized, for, although I am sure that bacteria will not live 
in pure cardine, they may be able to live in it when it is 
diluted with water. 
The physiological effects of cardine, in their order of 
occurrence, as nearly as I can arrange them, are as follows: 
1. Within ten minutes the pulse becomes fuller, 
stronger, and sometimes more frequent. The sphygmo- 
graph shows this very clearly. The accompanying tracing 
(Fig. 1) is that obtained from a man, thirty years of age, in 
good health. The pulse at the time was beating 76 in a 
minute. 
Fig. 1. 
Fig. 2 shows a sphygmographic tracing taken from the 
same person ten minutes after receiving a hypodermic in- 
Fig. 2. 
jection of five minims of cardine. It is scarcely necessary 
to comment on the differences which exist. The influence 
in increasing the force and frequency of the pulsations is 
Fig. 3. 
remarkable, and it is still more remarkable that a tracing 
(Fig. 3) taken eight hours subsequent to the injection 6 
CARBINE. 
shows that the effect upon the heart was still present in a 
scarcely diminished degree. 
2. These tracings show what is also evident from a 
digital examination of the pulse—that the arterial tension is 
augmented. 
3. Increasing, as cardine does, the heart pressure, the 
effect upon the kidneys follows as a logical consequence. 
Many observations, made as far as possible under exactly 
similar conditions, establish the fact that the amount of 
urine daily excreted is increased by from ten to eighteen 
ounces. 
4. The number of red corpuscles in the blood is in- 
creased by the use of cardine. 
Thus I found that in a woman in good general health 
and development the number of red corpuscles, as deter- 
mined by the haemocytometer, was four million three 
hundred thousand to the cubic millimetre. After two 
hypodermic injections of cardine daily for five successive 
days the number of red corpuscles had increased to four 
million eight hundred and twenty thousand. By means 
of the luemometer similar results were obtained, the 
degree of coloration being 83° before the injection of 
the cardine, while after the use of this substance, con- 
tinued as in the previously mentioned experiment, it rose 
to 96°. 
Many experiments of like character have led to similar 
conclusions. Indeed, I know of no fact more definitely 
established than this of the effect of cardine upon the 
composition of the blood. 
My object in the present communication is mainly to 
show the physiological effects of cardine, leaving to the in- 
telligent physician the office of drawing his own deductions 
a-s to its therapeuticul uses. It is clearly a heart tonic of 
great power, a diuretic of notable value, and an agent CARBINE. 
7 
capable of exercising a marked effect over the composition 
of the blood. 
In cases of cardiac weakness, from whatever cause it 
may arise, cardine is of inestimable value. It appears to 
me, from the few cases in which I have employed it 
in this connection, to be useful in fatty degeneration of 
the heart, improving the nutrition of the organ not only 
by its action on the blood, to which I have made refer- 
ence, but by its effects on the nervous organization of the 
cardiac tissue. 
In one patient under my charge—a gentleman from North 
Carolina in whom the pulse was, while he was in a state of 
rest, only 40 in a minute, and in whom the heart impulse was 
exceedingly weak, and in whom also there was an anasarooos 
condition of the feet and legs—cardine, in five minim doses ad- 
ministered hypodermically twice dady, began at once to exer- 
cise a beneficial effect. The pulse rose to 64 and occasionally to 70 
in a minute. The heart-beat was increased in force, the amount 
of urine augmented, the dropsy of the extremities disappeared, 
and many symptoms of gastric and intestinal dyspepsia from 
which he suffered were entirely dissipated, and this after about a 
month’s treatment. Six weeks have elapsed and this good con- 
dition continues in every respect. That it will remain as at 
present without further treatment is perhaps scarcely to be 
hoped for, but I think this result is quite within the range of 
possibility; and should the symptoms recur, I have no doubt 
that cardine will prove equally effectual as in the first instance. 
In another case of a gentleman in whom, from the excessive 
use of tobacco, the heart rhythm was intermittent and other- 
wise irregular, this condition disappeared after a treatment of 
only four days’ duration, and the patient has now a heart ap- 
parently as sound as it ever was. 
But 1 have employed cardine more frequently in those 
cases of nervous prostration attended with anaemia and 
sometimes chlorosis. In such patients its action is so prompt OAR DINE. 
and effectual as to excite surprise in all who have witnessed 
the change. In all these cases I have verified the great im- 
provement in the appearance and apparent condition of the 
patients by the use of the hmmocytometer and haemometer. 
In mild cases a week or ten days’ treatment has been suffi- 
cient, but never more than four or five weeks. 
A distinguished physician from the Dominion of Canada 
consulted me in January last for great cardiac irritability, the 
result of overwork, both professional and political. I treated 
him for two or three days with hypodermic injections of cardine, 
and the result was in the highest degree gratifying. The attacks 
of vertigo from which he had suffered, and which were clearly 
the result of weak heart, entirely disappeared. He returned 
home and entered at once with energy into an exciting politi- 
cal campaign, from which he emerged successfully after making 
over one hundred speeches. He writes me that he endured this 
tremendous exertion without discomfort, and that the cardine 
worked wonders with him. 
In a similar case, that of a prominent physician of Indiana, 
the heart-beat was feeble and irregular, and there was constant 
vertigo while walking, or even while in a standing position. In 
this case the relief was equally prompt. He remained under 
my care only three days, being summoned home by telegram by 
sickness in his family, after making arrangements to procure a 
sufficiency of cardine for home use, and I advised him to con- 
tinue it for at least a month. He arrived home before the car- 
dine reached him, and, feeling the need of it, he at once tele- 
graphed for it to be sent to him as soon as possible. He in- 
formed me that the effect upon him was so decided that, whereas 
formerly he was loath to walk even a few steps for fear of being 
overpowered by dizziness, a single injection enabled him to 
walk as much as he pleased for four or five hours afterward. 
Of course, it is too soon to fix definitely the therapeu- 
tical value of cardine, or, in fact, of any other of the ani- 
mal extracts made by my process. There is danger that 
over-enthusiastic and inexperienced or ignorant persons will CARDINE. 
9 
claim too much for them. Already I see that they are 
spoken of in various quarters as “ elixirs of life,” and that 
absurd stories are told of their power. No one person can 
he expected to determine the value of these extracts. That 
must be done by large numbers working toward the same 
end and for long periods. Ido not even pretend to assert 
that there may not he some better method of extracting 
the active principle of the several organs of the body which 
I have subjected to experiments. I only say that I have 
labored more than three years in the attempt to find the 
best method and that my experience should go for some- 
thing, and I feel called upon to warn the profession against 
the crude experiments of sciolists, who rush in with heavy 
foot where angels should tread lightly. I have heard of 
one of these experimenters who makes a mixture of brain 
substance, glycerin, and phosphate of sodium, and who injects 
this milky-looking compound into the blood. Of course, in- 
flammation ensues, abscesses will probably follow, and even 
worse consequences are to he feared. Glycerin of itself is 
not a preservative of the nervous tissue, except for a very 
short time, whereas I know that the mixture I use will keep 
it for at least a year and, I presume, indefinitely. 
As to the essential characteristics of cardine, while I 
am not able to give it a place in the nomenclature of or- 
ganic chemistry, I am sure, from a consideration of the 
process by which it is obtained, that it is a substance de- 
rived from the heart. There is no escape from this conclu- 
sion. As to how it acts, I can at present only call attention 
to the theory that I proposed in my first paper on the sub- 
ject, and that is briefly : 
That all the organs of the body possess the power, when 
in a state of health, of secreting from the blood the peculiar 
substance that they require for their nutrition, and that 
they take this substance and no other, never making a mis 10 
CARBINE. 
take in the matter. The brain separates brain substance ; 
the heart, heart substance, and so on. If through disease or 
from derangement of function they lose this power, or if the 
peculiar pabulum they require be not in the blood in suffi- 
cient quantity, their functions cease to be normal. General 
debility, producing a diminution of nerve force, may cause 
the loss of this power, or it may result from local disturb- 
ance either of structure or function, or some profound 
shock to the organism may so interfere with haematosis that 
the blood no longer contains the material which the organ 
needs. In either case, if we supply to the blood the peculiar 
principle which a diseased or disordered organ requires, we 
do that which Nature, unassisted, can not or does not do. 
Cardine, therefore, if this theory of its action he cor- 
rect, nourishes the heart. It is the substance which an ill- 
eonditioned heart must have for its well-being. It is al- 
ready in a fit form for assimilation, and it acts with a 
promptitude, a certainty, and a degree of permanence of 
which no other heart tonic within my knowledge is capable. 
It follows also that in all weak conditions of the sys- 
tem, and especially in those in which the blood is below 
the normal standard, cardine must prove to be of inestima- 
ble value. And in other and more serious affections, such 
as those in which depurative organs of the body, especially 
the kidneys, fall below the healthy standard of functiona- 
tion, cardine, increasing as it does the heart pressure, may 
augment the bodily comfort and materially prolong life. 
Cardine is not an annihilator of the influence of old age, 
but my experience convinces me that it lessens the effects of 
this factor of deterioration so far, at least, as the heart is 
concerned. This organ, as is well known, is one of the first 
to fail in physiological power, and this is shown not only 
by the examination of the pulse and of the heart itself, but 
by the accumulation of fluid, especially in the lower ex- CARBINE. 
11 
tremities, owing to a diminution of the heart pressure. 
Cardine, taken in conjunction with cerebrine, assuredly 
counteracts this influence, for, owing to the increase of the 
cardiac pressure, the passive anasarcous condition disap- 
pears, and the other indications of heart weakness are 
either greatly mitigated or altogether abolished. How 
long this power will remain in any particular case I am 
not at present able to say, but I know that a daily hypo- 
dermic injection continued for six months does not yet 
reveal any sensible loss in its influence. REASONS WHY 
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