Cocaine and its use in ophthalmic and general surgery / With supplementary contributions by F. H. Bosworth [and others].

  • Knapp, Herman, 1832-1911.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Cocaine and its use in ophthalmic and general surgery / With supplementary contributions by F. H. Bosworth [and others]. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    pears. The last trace had disappeared on the next day only. [To try whether cocaine could produce a maximum dila- tation, I have instilled a 3 % solution into the eye of a child for one hour and forty minutes every five to ten minutes, and during the last ten minutes every two minutes. The pupil became very large, but contracted to a certain degree, when exposed to light. The reaction was slow and limited, but distinct and invariable during the time of experimenta- tion, and some hours later.] The range of accommodation is shortened by recession of the near point from the eye, the far point not being appreci- ably influenced. The shortening of the range of accommo- dation in me and my son (15 years old) was equivalent to ■j'ij- (iD); in a lady of thirty-two it was somewhat more. Co- caine, therefore, reduces the accommodation, but does not paralyze it. It maybe preferable to other mydriatics if we want to dilate the pupil for ophthalmoscopic examinations of the interior of the eye, but it will probably not be pow- erful enough for determinations of refraction. It is a mydriatic which, even in producing a considerable dilatation of the pupil, takes away only a fraction of the power of accommodation. The accommodation is restored much sooner than the normal size of the pupil. In i£ hours to i£ hours we could read again as easily as before, though our pupils were still enlarged. Cauterization of a 'cocainized' conjunctiva.—The con- junctiva of my right eye was a little congested, and at 10130 P.M., while writing this communication, I dropped a drop of a four-per-cent. solution of hydrochlorate of cocaine on the inner surface of the lower lid. Fiften minutes later I noticed that this inner surface had become pale, paler than that of the left eye, which had been the paler before. I dropped another drop in, holding my head back so that the whole conjunctiva was moistened by it. Then I painted, before a looking-glass, a good-sized camel's-hair brushful of a two-per-cent. solution (gr. x. ad § j.) of nitrate of silver into the eye, the lower lid being everted. I left the liquid in place about twenty seconds, then it began slightly to