126 
Standard  Eye  Dropper. 
/Am.  .Jour.  Ph«rm. 
I      March,  1905. 
private  work  to  caution  the  patient  to  make  pressure  with  a  soft 
handkerchief  just  over  the  inner  corners  of  both  eyes,  where  are 
located  the  tops  of  the  tear  ducts.  In  this  way  any  excess  solution 
is  immediately  absorbed  by  the  handkerchief  and  is  prevented  from 
running  down  the  tear  canal  into  the  nose,  there  to  be  absorbed  into 
the  general  circulation.  In  this  connection  it  is  well  to  remember 
that  the  mucous  membrane  of  the  nose  is  twice  as  absorptive  as  that 
of  the  stomach,  so  that  the  entrance  of  of  a  grain  of  an  alkaloid 
there  would  be  equal  to  the  entrance  of  of  a  grain  by  the 
stomach. 
"  As  to  sterilizing  solutions,  whether  in  droppers  or  in  bottles,  it 
must  be  borne  in  mind  that  many  of  the  alkaloids  used  in  ophthal- 
mic work  are  very  delicate  in  nature  and  may  be  split  up  into  dif- 
ferent compounds  by  boiling.  Cocain,  for  instance,  loses  much  of 
its  anesthetizing  power  by  boiling.  I  recall  a  man  upon  whom  I 
operated  for  cataract.  I  could  not  understand  why  he  was  so 
unruly  during  the  operation.  He  seemed  to  experience  very 
much  more  pain  than  most  such  patients.  Two  weeks  later 
while  operating  on  another  cataract  patient,  I  used  a  boiled  co- 
cain solution  in  the  way  that  we  commonly  use  cocain,  and  at  the 
end  of  fifteen  minutes  began  the  operation.  His  sensitiveness  was 
so  great  that  I  stopped,  and  used  three  instillations  of  a  similar 
strength  cocain  solution  that  had  not  been  boiled.  Within  ten  min- 
utes the  eye  was  absolutely  insensitive,  and  the  cataract  was  re- 
moved without  the  slightest  twinge  of  pain.  This  observation  I 
have  repeatedly  confirmed,  and  I  am  convinced  that  while  the 
special  anaesthetic  properties  of  cocain  are  not  entirely  destroyed 
by  boiling,  they  are  so  reduced  that  the  boiled  solution  becomes 
practically  worthless.  The  best  way  to  prepare  the  solution  to  be 
used  for  such  purposes  is  to  boil  a  saturated  boracic  acid  solution, 
and  when  it  has  cooled  to  about  980  or  gg°  ¥.,  to  dissolve  in  it 
such  amount  of  cocain  as  the  surgeon  may  desire.  Even  if  an  abso- 
lutely sterile  cocain  solution  might  be  obtained,  it  would  not  be 
worth  while  taking  the  trouble,  as  there  are  no  eye-lids  absolutely 
free  from  bacteria.  Eyre,  and  also  Arnold  Lawson,  of  London,  ex- 
amined the  inner  surface  of  the  lids  of  fifty  normal  eyes  in  healthy 
persons,  and  found  three  to  five  different  kinds  of  bacteria  of  vary- 
ing virulence  in  all  but  two  or  three.  Gifford,  Omaha,  Neb.  (one 
of  our  foremost  bacteriologists  in  ophthalmic  science),  scrubbed  the 
