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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    out a small ulcer which I believed to be an epithelioma at the margin of the anus. I injected about ten minims of the four-per-cent. solution under the ulcer, stretched the sphincter with a speculum, distending to a circumference of about six inches, and excised the ulcer and a few fibres of the underlying muscle quickly—with pain, it is true, but a pain easily tolerated, and not causing the patient to shrink or pull away from the instruments either during the opera- tion or the subsequent manipulations to arrest hemorrhage. Two of my cases did badly : one, a broken-down hospital patient, had considerable suppuration follow the removal of a lipoma, as large as an almond in the shell, from his fore- arm ; and in another case, that of a medical student appar- ently healthy, diffuse suppuration of the forearm, with mild lymphangitis and the subsequent formation of many small cutaneous abscesses in the neighborhood, followed the ab- latin of a small wart, a third of an inch in diameter, under which I injected five minims of the four-per-cent. solution. That the cocaine was at fault in this case I cannot affirm. The six-per-cent. oleate I have used with temporary ad- vantage (but no permanent effect) in relieving anal pruritus and the itching of eczema. I believe that in cocaine we have an agent of great pres- ent value and of much future promise. ArPENDlX.—Dr. T. N. Otis kindly permitted me to in- sert the following statement, taken from a letter, into this pamphlet : I think that an important point is in the necessity which I have found of waiting fully fifteen or twenty min- utes after the introduction of the cocaine before attempting operative procedures. To-day, in a rare case of spasm in the penile urethra, at two and a half to four inches from the orifice, the spasm did not give way until twenty min- utes after the introduction of a four-per-cent. watery solu- tion, and then only after the glans had become shrivelled and cold. Up to that time only a No. 4 French bougie could be passed ; after that a No. 28 was passed, and with- drawn without holding. [H. K.]