ON ANZSTHETICS. 239 
labourer earning 16s. a week. She consulted a wholly unqualified and 
unregistered ‘practitioner of dentistry,’ agreeing to pay him four 
guineas for preliminary tooth extraction and subsequent artificial teeth. 
The ‘ practitioner of dentistry ’ admitted that whilst the law permitted 
him to use this title he could not call himself a ‘ dental practitioner.’ 
Before the extraction he injected a solution of cocaine and adrenalin, 
disregarding the fact that the gums were very unhealthy. He also 
ignored the warning on the label of the bottle containing the analgesic 
solution: ‘The contents of this package are only to be used in accord- 
ance with the prescription of a medical practitioner.’ Some hours after 
the operation the patient became semi-delirious and retched. Next 
morning she became unconscious and convulsed. She died early on the 
following morning. The ‘ practitioner of dentistry ’ stated in evidence 
that he had only injected 4 gr. cocaine. At the post-mortem the gums 
were found to be lacerated and the heart and kidneys to be diseased, but 
the cause of death, in the opinion of the two medical men called in, was 
cocaine poisoning. The jury returned a verdict of death by misadven- 
ture, but ‘ asked the coroner to severely censure Mr. for admin- 
istering such large quantities of cocaine without having the necessary 
qualification.’ 
At the second inquest the evidence showed that the patient had been 
a perfectly healthy woman, aged twenty-nine, the wife of a bricklayer. 
Suffering from toothache she consulted a so-called ‘ dental operator,’ 
who injected cocaine and then extracted a decayed tooth. There was 
considerable inflammation around the tooth—a state which is now 
generally regarded as strongly contra-indicating injection. The patient on 
her return home lay ‘ in a dizzy condition.’ A week after the operation 
& medical man was called in who found the patient to be ‘ suffering 
from some narcotic poison.’ She was in a ‘ collapsed condition.” Next 
day the narcotic symptoms passed off and the mouth was found to be 
septic. The patient died four days later. At the post-mortem a condi- 
tion of pyzeemia was found originating in disease of the jaw around the 
tooth socket. In his remarks to the jury the coroner said ‘ he thought 
the position was certainly a very unsatisfactory one that people without 
any qualification of having been apprenticed—in what he might call a 
legal way—to a dentist should be allowed to operate by injecting cocaine 
or any derivative of cocaine, or any other drug of that kind.’ Owing, 
no doubt, to the fact that the ‘dental operator’ exercised his right to 
answer no incriminating questions, the hands of the jury were to a 
great extent tied, and after much difficulty they returned a verdict 
“that the deceased died from blood-poisoning, but that there was not 
sufficient evidence to show how it was produced.’ Fortunately, further 
light was thrown upon this lamentable case some two months after the 
inquest, when the husband of the deceased woman sued the so-called 
“dental operator’ for damages in respect of his wife’s death and 
obtained judgment for 70). At the civil proceedings it was shown that 
the defendant ‘ advertised painless extractions with no after-effects.’ 
The prosecution stated that ‘ the negligence complained of was that the 
defendant wrongly injected a solution of cocaine into an abscess which 
