498 



SCIENCE 



[N. S. Vol. LI. No. 1325 



bane and mandragora. As moist poultices 

 the same substances were sometimes laid upon 

 tbe area where cutting, burning, or some 

 other surgical procedure was to be done. We 

 are told that sensation was thus removed and 

 no pain experienced, but the instance must 

 be assigned with great caution to the category 

 . of local anesthesia. The abolition of pain 

 may have resulted only after absorption of 

 these drugs into the circulation, by which 

 m.eans if carried to the brain in sufficient 

 quantity they would, by their central action, 

 produce general stupefaction. From what we 

 know of the action of these substances the 

 remote rather than the local action would be 

 expected. From among such old-time local 

 applications there has come down to us " lead 

 and opium wash," but modern pharmacologists 

 are most skeptical as to the efficiency of 

 opium applied externally. 



Prior to the school of Salerno, it is known, 

 ■of course, that oils and salves were frequently 

 applied to wounds and other painful areas. 

 Por example Dioscorides refers to the employ- 

 ment as an eye lotion, of rose oil, a substance 

 about which we shall have more to say later. 

 Of the use of local applications during actual 

 surgical procedure in those days I am aware 

 of no direct evidence. 



Many writers refer to the Memphis Stone, 

 of which the oldest descriptions are those of 

 Dioscorides and of Pliny, neither of whom 

 apparently saw it used. Husemann cites con- 

 flicting descriptions of its mineralogy. It 

 was called blunt, thick, the size of a pebble; 

 a soft black and hard white variety were ap- 

 lied to the forehead to relieve headache, while 

 an ash-gray variety was said to be of value 

 for snake bites. This talisman and panacea 

 according to both Dioscorides and Pliny was 

 of Egyptian origin and was used to produce 

 local anesthesia, for which purpose it was 

 sometimes powdered and mixed with vinegar. 

 In view of the fact that it was described as a 

 variety of marble the untenable hypothesis 

 has been suggested that the local anesthetic 

 effect was the result of the evolution of carbon 

 dioxide from this mixture when applied to the 

 area of oi)eration. 



A second local anesthetic of Egyptian 

 origin and referred to in the sixteenth cen- 

 tury by a Dutch physician, Ronsseus, was 

 crocodile fat. In a Latin poem, "Venatio 

 Medica," this author tells us that crocodile 

 fat and a salve of oil and burnt lizard skin 

 were efficient as local anesthetics if applied 

 before cutting or burning. 



In the seventeenth century, we are informed 

 of the use of another method of producing 

 local anesthesia, namely the application of 

 cold (for example, by ice and salt mixtures). 

 This was practised by Thomas Bartholinus, 

 who learned it apparently from a distin- 

 guished Danish physician. Marc Aurelio 

 Severino. Modern developments of this in- 

 clude the employment of ethyl chloride and 

 other substances of very low boiling point to 

 freeze the skin for minor operations. 



The story of modern local anesthetics be- 

 gins with the isolation in 1860, by Niemann 

 in the laboratory of the German chemist, 

 Wohler,^ of the alkaloid cocaine. Prom Lima, 

 had been brought the leaves of erythroxylon 

 coca, a plant which had for years attracted 

 the attention of travelers in Peru and Bolivia 

 on account of its widespread use by the 

 natives as a stimulant. The plant, native to 

 the slopes of the Andes, is a shrub attaining 

 a height of about six feet, with bright green 

 leaves, similar in size and shape to those of 

 tea, which are rapidly replaced when picked. 

 The annual consumption of these leaves in 

 South America is now estimated at one hun- 

 dred million pounds. 



The "coqueros" or chewers of coca leaves 

 had ascribed wonderful properties to them, 

 not only of abolishing hunger, fatigue, bodily 

 discomfort, etc., but also of psychic stimula- 

 tion of various sorts. When put to the test 

 in Europe these claims were but poorly sub- 

 stantiated owing, according to some, to dete- 

 rioration of the properties of the leaves in 

 transportation, but probably more to a differ- 

 ence in the subjective conditions of the test; 

 that is, the European investigators were prob- 

 ably neither as hungry and fatigued nor con- 



s Wohler, F. W., Ann. der Chem. u. Pliarm., 1860, 

 114, p. 213. 



