240 REPORTS ON THE STATE OF SCIENCE.—1913. 
he ought to have known to exist, thereby causing blood-poisoning and 
death.’ In the course of the proceedings the defendant admitted that on 
one occasion he had paid 2/. compensation to a patient upon whom he 
had performed an injection, and that in two other cases he had been 
obliged to pay for medical advice required by patients after his opera- 
tions. The judge found that the deceased ‘ was negligently treated by 
the defendant—ignorantly of course, but negligently. This negligence 
was the cause of the illness with which she was seized, and that illness 
caused her death.’ 
The third inquest was held upon the body of a young married 
woman twenty-three years of age, whose occupation had been that of 
shirt-making. Though quite able to do her work her general health had 
not been very good. She had suffered from toothache. The evidence 
showed that she had obtained the services of a ‘ dental operating 
mechanic,’ who, having come to the house, injected cocaine as a pre- 
liminary to tooth extraction. Very shortly after the injection the 
patient complained of curious sensations in her hands and feet, and 
rapidly became unconscious. ‘ Her lips, face and hands were blue, and 
she was breathing heavily.’ She died very shortly afterwards. The 
post-mortem examination showed that the deceased was ‘ well-nour- 
ished and sound.’ In summing up the coroner said ‘he thought 
that, in view of the fact that there was so much of this injecting going 
on by unqualified persons, the sooner something was done to prevent 
it the better it would be for the public.’ The jury returned a ‘ verdict 
that death was due to misadventure, but added a recommendation that 
the law should be so amended as to prohibit the use of anesthetics 
except by fully qualified practitioners.’ The coroner said‘ he cordially 
agreed with the recommendation and would communicate it to the 
Home Office.’ 
There have been several similar inquests in recent years. At one 
of these, held in Ireland, upon a young woman of nineteen, to whom 
cocaine had been administered, but whose death was more probably due 
to hemorrhage, the jury strongly condemned the action of unqualified 
persons going about the country performing dental operations. The 
unqualified dentist was committed for manslaughter, and, in summing 
up at the trial the judge said: ‘ So far as the citizens were concerned 
he thought it was a highly dangerous thing that these young men should 
be let out to try their apprentice hand—for it was nothing else—upon 
patients.’ The prisoner was found guilty, but recommended to mercy 
on the grounds of his ignorance, the judge considering the dental firm, 
whose employé the prisoner was, more culpable. 
It is highly important, in this connection, to bear in mind the 
following facts with regard to cocaine and its derivatives : (1) The risk 
attendant upon the injection of cocaine and similar analgesics is quite as 
great from the septic as from the purely toxic side. It hence happens 
that apart from the numerous cases of cocaine poisoning which occur, 
a few of which terminate in inquests, there are a large number of 
others which escape attention, the victims either suffering from pro- 
longed impairment of health or dying from sequele rarely traced to 
