462 KANSAS CITY REVIEW OF SCIENCE. 



MEDICINE AND HYGIENE. 



COCAINE AS A LOCAL ANESTHETIC. 



FLAVEL B. TIFFANY, M. D. 



Cocaine, a local anaesthetic which is now engaging the attention of the 

 medical profession throughout Europe and America, is an alkaloid of the ery- 

 throxylon coca. For nearly thirty years the natives of Peru, the country in 

 which the shrub is indigenous, have used the leaves of the plant when making 

 long journeys, as an exhilarant and a promoter of a greater power of endurance 

 and of respiration. Scientific knowledge of the power of this drug dates only one 

 year back. The Germans first employed it in the examination and treatment of 

 the throat. To Dr. Kohler, a student of Vienna, belongs the honor of discovering 

 this boon in ophthalmic surgery. He communicated this discovery to Dr. Bret- 

 taner, of Trieste, who demonstrated its magic power before the last ophthalmolog- 

 ical congress of Heidelberg. 



It was first introduced into the United States, October ii, 1884, by our dis- 

 tinguished confrere H. D. Noyes, who witnessed the experiments at Heidelberg. 

 Since that time, a little more than two months, all the prominent members of the 

 medical profession here have been on the quivive to test the power of this drug 

 to the utmost. Drs. Agnew, Knapp, and others, have reported of several cases 

 of major and minor operations upon the eye, in which its efficacy as a local anaes- 

 thetic was thoroughly proven. Dr. Wm. Olive Moore and more recently many 

 others, have used it with good results in inflammations and ulcerations of the cor- 

 nea and conjunctiva (front part of the eye-ball). Last Tuesday, November i8th, 

 I used a two per cent solution of the hydro-chloride of cocaine upon a man sixty- 

 seven years of age, for the extraction of a cataract. I made a preliminary appli- 

 cation in the morning that I might observe its action. In about three minutes 

 after an instillation of three drops there was complete anaesthesia of the anterior 

 portion of the eye-ball, so that I was able to pass my finger-nail over the front of 

 the eye without the least discomfort to the patient. The anaesthesia passed off 

 in about thirty minutes, leaving no irritation of the eye. In the afternoon of the 

 same day, at the Sisters' Hospital, I used the same per cent solution, increasing 

 the number of drops, and in about three minutes the eye was completely be- 

 numbed. 



The patient, passing his finger over his eye, said that there was no feeling 

 there : " Doctor you could gouge my eye out now, if you wanted to, and I should 

 not feel it." I then made the operation without the least discomfort to the patient 

 and the results of the operation have been perfect. On Monday the 24th, I 

 again employed it in the same operation on a man aged seventy-nine years 



