Cocaine in ophthalmic medicine and surgery / by Henry W. Williams.

  • Williams, Henry W. (Henry Willard), 1821-1895.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Cocaine in ophthalmic medicine and surgery / by Henry W. Williams. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    tinned to react to the influence of light and to efforts of convergence of the eyes; so that there was at no time the dimness of vision for small objects which attends mydriasis resulting from the use of atropia; but merely a paresis of the accommodation. I furthermore observed a marked anaemia of the conjunctiva, especially in its palpebral portion. In no case did the cocaine give rise to other symptoms of irritation. The wide opening of the lids, supervening at the same time with the anaesthesia of the cornea and conjunctiva, I attribute to the absence of that sensitiveness which, in the normal state, determines the closing of the lids to a certain point. If, after the disap- pearance of this first anaesthesia, the instillations of cocaine are repeated, a cumulative effect is to some extent gained, and the duration of complete insensibility may be doubled. There is no doubt of the penetration of the cocaine, by slow absorption, to the interior parts of the eye ; as after instilling a 5 per cent, solution once in five minutes for half an hour, I found the sensitiveness of these parts to strong pressure greatly diminished. 141 have used a 2 per cent, solution upon a large number of patients affected with conjunctivitis, and with eruptions and ulcers of the cornea. Within a few minutes they have invariably experienced a notable amelioration of their subjective symptoms, the pains were relieved, and the photophobia had greatly lessened. This improvement continued for two or three hours. There is every reason to believe, though as yet I have not had opportunity to verify this, that a repeated application of the remedy at the proper intervals would permanently relieve, or, at least, greatly diminish, the symptoms. I have had the same success in painful erosion of the limbus corneae. Even in the extreme pain accompanying inflammation of the iris, I think the efficacy of cocaine can be relied on; for the extension of its effect to the iris and the ciliary body appears to me to be demonstrated. Its contractile action