MEDICAL NOTES AND REFERENCES.
Cocaine is a mydriatic; slightly raises the temperature, quickens
respiration, and pulse is more frequent; by long use, sleep is longer
and more profound. Improves nutrition, useful in insomnia and simple
melancholia.—M.R. 1883, 86.
Eleven successful cases, including three of operation for cataract,
one double iridectomy, one removal of tumour from lid, and three for
convergent strabismus. In cases of intolerance of light it acts like
magic.—L. ii./84,911.
In papillomata of larynx, interior painted with 20 per cent. solution
of hydrochlorate of Cocaine once, in five minutes was able to introduce
the forceps four times and remove large portions of tumours without
patient experiencing any pain or subsequent shock.—L. ii./84,912.
In quinsy, a 20 per cent. solution useful to paint fauces.—Pr. xli. 47.
Coca and Cocaine are said to have a deleterious action on the voice,
slackening and deadening the vocal cords through the paralysis of
the extensor muscles. The aphony produced is painless.—Th. Gaz. May,
1889,353.
Physiological effects on the eye.—L. ii./84,911.
Seven eye cases under its influence.—Med. Rec. (N. Y.) 1884,510.
Use in the nasal cavity, cotton wool soaked in 2 per cent. solution
applied at the end of a probe in over forty cases, including
hypertrophy of the nasal mucous membrane (twenty-seven cases
cauterized), acute coryza, nasal polypus and hay-fever, all having
marked swelling of the nasal mucous membrane, both from chronic and
acute causes; in every case there was complete subsidence of the
turgescence of the membrane and the sinuses were emptied of their
blood.—Med. Rec. (N.Y.) 1884,533.
Cocaine solution applied to a blistered surface anæsthetizes the
part.—B.M.J. i./85,300.
Solution painted on or injected into piles relieves the pain of
operating on them.—B.M.J. i./85,227.
References to its surgical use as a local anæsthetic:—L. ii./84,608
(ophthalmic), 683 (ophthalmic), 936 (laryngeal), 975 (ophthalmic),
975 (nasal), 992 (ophthalmic), 1022 (physiological action), 1023
(ophthalmic and aural), 1068 (ophthalmic), 1097 (ophthalmic), 1123
(ophthalmic and dental), 1167 (circumcision and catheter passing);
L. i./85,86 (uterine, vaginal, and oral), 123 (in tenesmus), 130
(on mucous membranes), 168 (dental), 220 (rectal), 226,315 (minor
surgery), 965 (ophthalmic), 1033 (fistulas, canals), 1067 (ophthalmic),
1097 (nasal), 1112 (ophthalmic); B.M.J. ii/84,761 (ophthalmic),
1074 (laryngeal), 1132, 1142,1143,1249,1256 (ophthalmic), 1133
(dysphagia), 1188 (throat and nose), 1255 (laryngoscopic), 1256
(midwifery and tinnitus); B.M.J. i./85,45,77,134,145,863 (effects
on the eye); B.M.J. i./85,24,36,77,235,286,456,792,1266 (ophthalmic
surgery); B.M.J. i./85,36,47,209,456,479 (nose and larynx); B.M.J.
i./85,377 (cancer); B.M.J. i./85,227,653,994 (rectal operations);
B.M.J. i./85,17,36,47,361,994 (vagina and urethra); B.M.J.
i./85,17,24,36,69,736,926 (in dentistry); B.M.J. i./85,402 (for
scalds); B.M.J. ii./85,396 (tumour of lip removed); B.M.J. ii./85,1060
(removal of ingrowing toe-nail); L. ii./85,829; Th. Gaz., June, 1890,
415 (preceding iodine injection in hydrocele); B.M.J. ii./86,413
(dilatation of urethra); B.M.J. ii./88,491; i./8,1113 (minor surgery);
B.M.J. i./89,943 (circumcision).
Translation of Carl Koller’s report of the earliest observations on the
use of cocaine and its salts as local anæsthetics.—L. ii./84,990.
Hydrochlorate of cocaine, 20 per cent. solution allowed nitric acid to
be applied to the tongue without pain.—L. ii./84,1023.
In skin diseases, relieves the inflammation in eczema and acne and the
irritation of urticaria.—L. i. 85,76.
Fungoid growths in aqueous solutions of salts of cocaine and other
alkaloids.—L. i./80,224,315,504,597,647.
Physiological action.—L. i/85,439; i./88,1041; B.M.J. ii./84,1313;
i./85,17,97,863.
Summary of its pharmacy.—L. i./85,488.
Checks hæmorrhage from lips and gums in purpura.—L. i./85,581; Pr.
xxxiv. 450.
Chemical researches by Paul.—P.J. 1888,781; B.M.J. i./88,709.
Hay fever relieved by solution applied locally to nose and eyes.—L.
i./85,925: L. ii./85,50,99,123,232,820; B.M.J. i./85,1084,1291;
ii./86,18; i./88,1329.
For moles, warts, &c., about 6 grains of cocaine to a drachm of nitric
acid applied once or twice a day with the point of the rod of an acid
bottle is painless; a ring of melted wax should be put round the mole
first.—L. i./85,1052.
Résumé of action and uses.—B.M.J. ii/84,1081,1132 B.M.J. i./85,36; Pr.
xxxiv. 56.
In senile gangrene, the intense pain of, relieved by a 4 per cent.
solution on contiguous parts.—B.M.J. i./85,653.
In coryza, 4 per cent. solution useful applied on cotton wool.—B.M.J.
i./85,430,1084.
The mydriatic effects on the iris, and on the tension of the eyeball,
caused by its local application.—B.M.J. i./85,1303.
The painless removal of urethral caruncles.—B.M.J. ii./85,153; and of
epithelioma.—L. i./87,56.
In obstetrics, several valuable applications.—Pr. xxxiv. 65; L.
ii./87,754, 1061; ii./90,474.
The oleate is useless, except for sores on penis and anus.—Pr. xxxiv.
451.
Hypodermic injections apt to be followed by faintness.—Pr. xxxiv. 450.
Gonorrhœa, acute, 2 per cent. solution injected relieves the pain.—Pr.
xxxiv. 222.
Rectal and prostatic pains relieved by ½-grain suppositories.—Pr.
xxxiv. 128.
Summary of its effects on the eye, viz., dilatation of pupils,
constriction of small peripheral vessels, paralysis of accommodation,
and enlargement of the palpebral fissure; the effect is local only,
by paralysing the endings of the sensory nerves, and irritating the
sympathetic nerves.—Pr. xxxiv. 1.
Dysmenorrhœa, the pain of, removed by painting the cervix with 4 per
cent. solution.—B.M.J. ii/85,399.
After lithotrity, ½ an ounce of 4 per cent. solution injected for
painless removal of fragments.—Pr. xxxiv. 128.
In labour pain attending the dilatation of the os in primiparæ relieved
by painting the os and cervix with 12 per cent. solution.—B.M.J.
ii./85,473.
In supra-orbital neuralgia, a 10 or 20 per cent. solution in oil of
cloves rubbed into the part affords immediate relief; with summary of
its medical uses.—Pr. xxxiv. 59; M.R. 1884,516.
In sea-sickness, several cases, ¹⁄₁₆ grain doses every two or three
hours in aqueous solution were successful. A girl of 18 had been sick
24 hours before it was tried; she had a double dose every half-hour
with “truly magical effect.”—L. ii./85,451; B.M.J. ii./85,627.
German and Russian recommendations of its use in sea sickness.—L.
ii./85,912.
Sea sickness effectually checked by two lozenges each containing ¹⁄₁₂
grain of hydrochlorate of cocaine taken when first threatened, and two
more in twenty minutes. One grain doses in solution also effectual.—P.
J. 1886,712.—B.M.J. ii./87,1236.
Thimble-shaped pessaries, composed of cocaine and oil of theobroma,
relieved the pains of the first stage of labour, when inserted into the
dilated os uteri. B.M.J. ii./85,1140,1159.
Morphine habit of three years’ standing, 8½ grains taken during three
days was successful in curing.—B.M.J. ii./85,1112. Counteracting
effects unsatisfactory.—L. i./89,287.
Poisonous effects attributed to local use in fourteen eye cases and
three hypodermic injections.—B.M.J. ii./85,983.
Vaginismus, ointment and pessaries of cocaine useful.—B.M.J.
ii./88,720,817; B.M.J. Supp. ii./90,30; Relief temporary only.—B.M.J.
ii./88,790.
Cases of fainting when solution of cocaine salt was applied to the
eye.—B.M.J. ii./85,1060; i./86,67. Also after hypodermic injection.—Pr.
xxxiv. 450.
In eye operations, the diminished elasticity produced by cocaine may be
a source of inconvenience.—L. ii./85,1158.
Dangers from use of cocaine in eye cases supposed to be due to
decomposition accompanying fungoid growth. Graefe recommends the
cocaine salt to be dissolved in solution of mercuric chloride 1 in
20,000.—L. ii./85,863,996,1070,1119,1167; B.M.J. ii./85,971,1184.
Cocaine craving, 5 to 7 drachms per day of 4 per cent. solution caused
a state of system allied to delirium tremens.—L. ii./85,732.
Facial neuralgia relieved by quarter of a grain of salicylate of
cocaine—L. ii./85,733.
Hydrocele, medical cure of, a preliminary injection of cocaine solution
before the injection of iodine recommended.—L. ii./85,829.
Earache, a 2 per cent. solution of the hydrochlorate on wool is
useful.—B.M.J. i./86,87.
Toe-nail ingrowing, removal of, local injections should precede.—B.M.J.
ii./85,1060.
Larynx painted with 20 per cent. solution, a state of spasm was caused
which required chloroform to subside it.—L. ii./85,946.
Whooping-cough, 15 to 20 per cent. solution a valuable pigment to
the larynx.—B.M.J. ii./85,981,992. Also in spray with glycerine.—L.
ii./89,1098.
For removal of a pile, after bathing it with hot water, some dry
hydrochlorate was dusted over it, and one grain injected into its
base; in 10 minutes after on applying the clamp and cautery, it was
painlessly removed; the patient was next day able to attend his
business; also found useful in many minor operations.—L. i./86,527.
General résumé of its effects and uses. B.M.J. i./86,527,574.
Thigh successfully amputated under the influence of cocaine, 1 per
cent. solution injected into the skin and a half per cent. solution
into the deeper parts; only during the sawing of the bone did the man
complain of pain.—L. i./86,561 _ex Med. Jour._ N.Y., Feb. 20th.
Angina pectoris, ½ grain three times a day.—L. ii./86,459.
Morphine and nitrite of amyl are the best antidotes.—B.M.J. i./88,757.
Vomiting of pregnancy relieved by internal use.—L. ii./87,754, and for
sore nipples, 1061; B.M.J. ii./87,94.
Camphor 5, chloral 5, cocaine hydrochlorate 1, warmed, form an oily
liquid which cures toothache.—L. ii./86,324.
Slight pains especially spasmodic, relieved by injection of a 20 per
cent. solution into urethra.—L. i./88,871.
Painless tooth extraction if a 15 per cent. solution be injected into
the gum.—B.M.J. ii./86,601.
In dentistry is of doubtful advantage, there is some danger, the gums
do not absorb it.—L. ii./86,1190.
Two cases of poisonous symptoms following the injection of one grain
in 20 minims into gums, in tooth extraction.—L. i./88,872. Another
case.—Pr. xli. 288.
Lithotrity rendered painless by the injection of 16 grains dissolved
in 12 ounces of warm water into the bladder.—B.M.J. i./88,972.
Several cases of dangerous symptoms following its use in surgery.—L.
i./87,780; St. Thomas Hosp. Rep. vol. xv.
Thirty cases of danger narrated, chiefly following its hypodermic
use.—Th. Gaz. Jan. 1888, 16.
Cases of toxic action; from urethral injection of 12 grains,—Pr.
xli./369; from vesical injection,—B.M.J. i./89,373; from rectal
injection,—L. ii./89,656; from hypodermic injections—B.M.J. i. 89,382;
L. ii./88,715; i./89,274; from internal use, 20 grains accidentally
swallowed,—L. i./89,292; 4 grains in child of 4 years,—Th. Gaz. Jan.
1889,26; other cases,—B.M.J. i./89,382; Th. Gaz. June 1888,373.
Résumé of poisoning cases; more than ¾ grain should not be injected
at once. Opium and morphine useless as antidotes; chloroform or
ether inhalation recommended to prevent respiratory tetanus.—B.M.J.
i./89,311. Toxic effects counteracted by ammonia.—L. i./88,394;
ii./88,715; ii./89,1126.
Erosis after hypodermic injection.—Pr. xliii./449.
Against indiscriminate use, and formation of cocaine habit.—B.M.J.
i./89,973.[32]
[Footnote 32: Cases of danger from cocaine have generally occurred
from its quick absorption in hypodermic use, especially in dental
operations. Those who have applied it otherwise most freely recognise
little danger. In a large experience of the drug, I have not met with
a case in which the so-called “Cocaine habit” has been formed.]
Best antidote is amyl nitrite.—B.M.J. i./88,757.
Pleurisy relieved by local hypodermic injection of ⅕ to ¼ grain.—B.M.J.
ii./88,76.
In diabetes, after codeine treatment, cocaine, ¼ grain doses given;
overcame obstinate constipation, and ataxic gait disappeared.—L.
ii./89,735.
Pruritus, several cases relieved by cocaine 2 per cent. in oil of
theobroma.—B.M.J. ii./89,194.
A successful anæsthetic in skin-grafting; the vitality of tissue is
unaffected by its use.—B.M.J. ii./90,113; Pr. xlv. 295.
The morning sickness following hypodermic injections of morphine
is prevented by combining ½ grain cocaine with the morphine
solution.—B.M.J. i./90,1367.
Useful in psoriasis of tongue, used before a meal averts pain from
passage of food; in painful affections of stomach, affords relief and
averts vomiting, as that of pregnancy; in pruritus ani and itching skin
diseases; and as an anal injection checks diarrhœa and straining of
dysentery.—Ringer’s “Therapeutics,” 12th Edition.
Cocaine adopted to relieve morphine craving led to extreme cocaine
abuse.—L. ii./90,424.
The addition of phenol to hypodermic solution, 1 part to 30, preserves
the solution, increases anæsthetic action, and diminishes risk of toxic
symptoms following its use. B.M.J. ii./90,94.
Resorcin prevents cocaine poisoning; value of both drugs enhanced by
combination.—B.M.J. ii./90,506.
A 2 per cent. solution recommended in preference to stronger, as
it appears to be more quickly absorbed. An overdose usually causes
quick pulse, rise of temperature, dilatation of pupil, anorexia,
and insomnia. This last yields best to chloral, but requires large
doses.—L. ii./91,663.
Successful case of laparotomy under cocaine; 12 minims of 20 per cent.
solution used.—B. M. J. ii./90, 1022.
Amputation of wrist under cocaine; no shock.—B. M. J., Supp. i./91,202.
Cystitis arising from cantharides blistering not prevented by camphor;
intolerable pain, unalleviated by morphine, attended fresh blistering,
but ceased instantly on the introduction into the prostatic urethra of
15 minims of 1 per cent. solution of cocaine hydrochlorate. The pain
recurred in three and a half hours, but yielded at once to ten minims
of the solution, and did not return.—L. ii./91,1351.
Cocaine decidedly useful in sea-sickness. In crossing Channel two
ladies, usually ill, were kept free from the horrid feeling, one by
taking six and the other three, ⅒ grain doses.—Mrs. Fenwick-Miller, in
Ladies’ Column, _Illustrated London News_, August 27, 1891.
_Printed at 74-76, Great Queen Street, London, W.C._