MODERN NEUROTOMY. 
207 
MODERN NEUROTOMY, WITH ESPECIAL REFERENCE 
TO THE LOW OPERATION. 
By T. B. Rogers, D.V.S. 
Local anaesthesia. —The use of cocaine for the purpose of pro¬ 
ducing local anaesthesia during the performance of neurotomy 
is, I believe, a distinctly American procedure ; the first time I 
ever saw it used was about ten years ago, when Prof. R. S. 
Huidekoper made the upper operation on a patient suffering 
from tetanus. While cocaine is the drug usually used when 
painless section of the common integument, or other tissues is 
desired, I have found cold water equally efficacious in 
large incisions of the skin necessary in the removal of tumors, 
&c., indeed the most perfect local anaesthesia I ever saw was 
due to the injection of water prior to the operation for fistulous 
withers. 
The local anaesthesia following the cocaine injection is usually 
marked, though occasionally cases are met with, where either 
through idiosyncrasy or systemic absorption of a too concentrated 
solution, the patient becomes unmanageable. 
Part of this anaesthetic effect is doubtless due to pressure on 
the nerve endings by the injected liquids, part to the specific 
effect of the drug. (I may mention in passing that I have on 
one occasion used a ten per cent, solution of citrate of caffein 
with great success in a case of needle firing of the fetlock). As 
cocaine produces a temporary vaso-motor constriction, and hence 
diminishes the local blood supply, its use makes the operation 
somewhat less bloody. 
Strength of the solution.—A four per cent solution has given 
me uniformly good results, and is less liable to cause excite¬ 
ment than the stronger solutions used by some operators, under 
the mistaken idea that a more perfect anaesthesia will be thus 
obtained. 
Not more than thirty minims should be injected over each nerve, 
