204 THE DUCTLESS GLANDS 



Q. The Medical and Surgical Employment of Adrenal 



Preparations 



After the observation of Oliver, that an artery in the frog's 

 mesentery is contracted by adrenal extract to such an extent 

 that blood ceases to be driven through it, he began to use 

 the extract as a styptic in his experimental operations ; its 

 application for this and similar purposes is now general. 



Surgical Employment of Adrenin alone or combined with other 

 Drugs. A subcutaneous injection of adrenalin solution (1 in 

 10,000) produces a bloodless condition of the tissues quite as 

 readily as the method of bandaging or freezing. If adrenalin 

 is combined with cocaine for subcutaneous injection, it is found 

 that the effect of the cocaine is increased and lasts for a longer 

 time. A combination of adrenalin with eucaine is also found 

 to be very beneficial. It is stated that the toxic effects of 

 cocaine are to a certain extent neutralized by the simultaneous 

 employment of adrenalin. 1 



Braun has made extensive use of this method, employing 

 the following solution : 100 c.c. of a 0-05 per cent, solution of 

 cocaine hydrochloride, using 6 per cent, sodium chloride solu- 

 tion as a solvent, to which 3 to 5 drops of adrenalin hydro- 

 chloride (1 in 1,000) are added ; the dose is 50 c.c. to 100 c.c. 

 The operation may be performed ten minutes after the injec- 

 tion. The lower part of the rectum may thus be rendered 

 insensitive, and operations for fistulae or haemorrhoids, or 

 dilatation of the sphincter, may be performed in a painless 

 manner. The method may also be used for excision of a piece 

 of rib, for operations on the scalp, for removal of sebaceous 

 cysts, for amputation of a finger, etc. 



Major operations under spinal anaesthesia produced by 1 in 

 2,000 adrenalin solution in conjunction with 0-0075 to 0-015 

 gramme cocaine, have also been performed without ill 

 effects. 



Honigmann uses /?-eucaine instead of cocaine for local 

 anaesthesia. The use of cocaine and adrenalin combined is 

 also recommended by several other authors. 



1 Novocaine is now frequently employed. 



