In 2024, we celebrate the 100-year anniversary of the publication by Rudolf Matas, a vascular surgeon at Tulane University, who published the first paper on how to go about administering intravenous fluids through a drip while treating acute hypovolemia [1]. Intravenous injections were already known since Christopher Wren (who is better known today for his architecture) who used them in animals in 1656. Saline was used for cholera, quinine infusion was used for malaria, and colloid silver injections were used for infections in the beginning of the twentieth century. Using tubing and bottles (and basically gravity) was an innovative approach and allowed adjusting of flow. Hendon coined the procedure venoclysis (and took it from proctoclysis, which was rectal infusion of fluids often used in children). He wrote:

If venoclysis is denied admission to our medical vocabulary, in order to be consistent, we must banish such words as ovariotomy, appendectomy and almost all of those ending in the good old Greek suffix “itis.” Even appendicitis, duodenitis and a host of others would have to go. Besides, venoclysis is such a nice word. It possesses euphony. It trips lightly off the tongue and falls musically on the membrana tympani. It at once proclaims its meaning and makes a proximate appeal to the average man and has rendered ten years of useful service. [2, 3]

Hendon added that “safest” would be “drop by drop as the heart beats” [2] (Fig. 1). Maintenance of temperature was a concern, and fluids were kept at 100 °F. Hendon noted: “I have found it possible to produce chills by a process that is called ‘milking the tube.’ By that I mean making pressure on the delivery tube of the apparatus that will cause a sudden, rapid and intermittent delivery of the solution into the circulation” [3]. Herdon would describe its usefulness (and lifesaving measure in some) in a variety of conditions, such as peritonitis and adynamic ileus.

Venoclysis needle and infusion (from Hendon reference 3)

The fluids that were used were sterilized, and fluids were mostly Ringer’s solution (a newly made solution to provide electrolytes rather than water) or Fisher’s solution, which was dextrose in normal saline and dextrose in plain sterile water [4]. In 1859, Sydney Ringer reported the mixture, the predecessor for future physiological saline solutions, and Alexis Hartmann combined it with sodium lactate in cases with acidosis, hence the term ‘lactated Ringer’s.’

“A mixture containing 100 c.c. saline [0.75% NaCl], 5 c.c. sodium bicarbonate [0.5%], 5 c.c. calcium chloride … [1 in 1082, i.e. approximately 0.1% Ca], with 1 c.c. potassium chloride … [1%] makes an excellent artificial circulating fluid, for with this mixture the heart will continue beating perfectly” [5, 6].

This physiologic solution for perfusion consisted of sodium, potassium, chloride, and calcium (the solution was used in physiology laboratories for bathing excised frog hearts). Moreover, the terms ‘normal’ and ‘physiological,’ applied to 0.9% saline, may have aided its widespread acceptance in practice, despite the fact that it was not similar to extracellular fluid.

Well into the l950s, intravenous sets consisted of steel reusable needles with a stylet inside to keep the lumen open [7]. A final landmark contribution came from Massa’s new plastic cannula and reduced the need to perform venous cutdowns in patients requiring prolonged or repeated intravenous therapy. Massa’s new catheter was designed to allow plastic tubing attached to a shortened 16-gauge steel needle to be threaded over a 19-gauge needle that acted as a stylet. Once this stylet needle had been inserted into a vein, the plastic catheter was threaded over it and the stylet was withdrawn [8, 9].