Holocain in ophthalmic surgery : its superiority over cocaine, its therapeutic value / by Hasket Derby.

  • Derby, Hasket, 1835-1914.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Holocain in ophthalmic surgery : its superiority over cocaine, its therapeutic value / by Hasket Derby. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    not used we are liable to meet with a troublesome amount of bleeding. For the removal of a foreign body from the cornea, holo- cain is decidedly preferable to cocaine, as it neither affects the accommodation nor enlarges the pupil, thus rendering its use possible in the case of people with a tendency to increase of ocular tension. In other operations on the cor- nea or iris, such as that of Saemisch for ulcus serpens or iri- dectomy for glaucoma, it is a well known fact that a degree of inflammation that prevents the absorption of cocaine will often yield to holocain, thus rendering the use of ether or chloroform unnecessary. Had cocaine alone been at our com- mand, general anaesthesia would have been the only resort. In the various operations on the muscles of the eye, no local anaesthetic has been found to give entire satisfaction. It can only be claimed for holocain in this connection that it is at least as efficient as cocaine, and can be used in cases where distressing constitutional symptoms have been produced by the latter. In probing the lacrymal passage I still make a prelimi- nary injection of cocaine, the poisonous effects of holocain, when administered internally, rendering it unsuitable for such a purpose. For the same reason no subcutaneous in- jection of the drug can be made. But'in the numerous cases where I have used it locally and superficially I have never seen the slightest general disturbance. To sum up, then, the advantages of holocain over cocaine : 1. It does not cause mydriasis, and may therefore be used without danger of bringing about increase of tension. 2. It does not affect the accommodation. 3. It brings about a greater degree of anaesthesia of the iris than does cocaine. 4. In cases of severe and painful inflammation which resist cocaine, holocain often proves efficient. 5. Unless swallowed or injected subcutaneously it pro- duces no constitutional effects. 6. It has no effect on the corneal epithelium. 7. It is strongly bactericidal in its action. Per contra, cocaine distinctly reduces the tendency to