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The spreading factor of Duran-Reyals, hyaluronidase, has been advocated for two clinical purposes: one, as an addition to semen perhaps to facilitate dispersion of the cumulus oophorus and increase the chances of fertilization, and, the other, as an adjunct to subcutaneous therapy to allow rapid dispersion and absorption of parenterally administered fluids.
Surgeons, and more especially urologists, appear to have failed to make use of this substance in excretory urography. Hechter, Dopkeen and Yudell reported in the Journal of Pediatrics in 1947 that hyaluronidase greatly increased the rate of absorption of hypodermoclyses and detected no toxic reactions. Toxicity is apparently absent, and the incidence of sensitivity to the commercial extract derived from the testes of bulls is as low as 0.4%. One instance of contact dermatitis has been reported.
Mention of the use of hyaluronidase to hasten the uptake of dye in excretory urography in infants has appeared in several