Studies in Experimental Frostbite. III. An Evaluation of Several Methods for Early Treatment *

Experience with severe frostbite and other similar cold injuries during the recent war demonstrated the inadequacy of our knowledge of these conditions and the need for developing effective means for preventing their serious sequelae. Great controversy exists concerning the proper early treatment of severe frostbite. The radically divergent opinions held arise from disagreement as to the exact pathogenesis of tissue damage in severe cold injury; various workers having incriminated, singularly or in combinations, the direct traumatic action of cold on the protoplasm, the development of edema, vaso-constriction, silting of the formed elements of the blood, and the formation of thrombi. Suggested methods of treatment have differed according to which of these factors was deemed most important. They have included alteration of the environmental temperature to which the part was exposed, anticoagulants, and methods for altering the vascular tonus. No one method has been established by clinical and by experimental study to be entirely reliable, varying degrees of success have been reported with all. The present study was undertaken with the object of investigating the value of several methods in the early treatment of severe experimental frostbite. It was hoped that some additional insight into the pathogenesis of tissue damage in frostbite might also be gained.