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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    bestowed upon us : and, while they should teach us caution, they by no means forbid its free but prudent use. The local or general accidents which have been attributed to cocaine have been: superficial cloudiness or desquamation of the cornea; vertigo or other cerebral symptoms, occur- ring in aged or enfeebled persons; and panophthalmitis. In nearly if not all of the reported cases, solutions of 4 or 5 per cent, have been used. It is quite possible that the high price and scarcity of cocaine preparations soon after the first sudden and enormous demand for them, may have led to accidental or intentional adulterations having irritat- ing qualities; or the lack of freshness of some solutions, or their needlessly repeated application, may have affected the cornea in a few instances. Vertigo or other temporary cerebral disturbances were by no means unknown in timid, aged, or feeble persons, during the performance of cataract extraction, with or with- out etherization; before the advent of cocaine. Acting as this apparently does only on the terminal nervous fibres, it seems unlikely that it should give rise to ophthalmitis; the origin of which it would be perhaps more rational to refer either to an epidemic ophthalmitis after operation, such as had frequently been observed before the introduction of cocaine ; or, possibly, in one hospital where a number of cases occurred whilst other institutions in the same city were exempt, to the use of hygroscopic gelatine discs con- taining cocaine,—-which might have been a nidus of germs; or, in the case of another practitioner, to staleness of the solution employed, — this gentleman experiencing no fur- ther mishaps after he substituted fresh solutions, although he used those of 8 per cent. I have many times made use of 4 per cent, or sometimes stronger solutions of cocaine; yet, neither in my own practice nor within my personal knowledge, have I ever known harm to result from so doing; although, as a rule, I now prefer a 2 per cent, solution, as being sufficiently effective. We know, how-