Agreement as to the mechanism of the action of methylene blue in cyanide poisoning has not yet been reached. Wendel1 has studied this question by a series of carefully planned observations on dogs. He corroborated other observers in failing to note an accumulation of methemoglobin in the blood of dogs twenty minutes or more after intravenous injection of therapeutically employed quantities of methylene blue. In his opinion, however, this fact does not signify the nonformation of methemoglobin or its failure to play the essential part in the protective mechanism. In order to test this opinion, blood was withdrawn from normal dogs and defibrinated. The erythrocytes were separated from the serum by centrifugation, treated with physiologic solution of sodium chloride containing amyl nitrite to convert the hemoglobin to methemoglobin, freed from excess nitrite by repeated washing, and finally suspended in an equal volume of salt solution. This was reinjected intravenously
METHYLENE BLUE IN CYANIDE POISONING. JAMA. 1935;105(9):721–722. doi:10.1001/jama.1935.02760350081015
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