1885 v. 28 - Lane Medical Library Digital Document Repository

Cocaine Chloride. 17
cornea within a few minutes. The anaesthesia lasts from ten to
fifteen minutes after it has become complete, and passes gradually
away. Application of a pure aqueous solution of this drug produces
no pain. Added to its effect as a local anaesthetic, it produces
a medium dilatation of the pupil in about twenty-five to
thirty minutes; unlike the mydriatio effect of atropia, however,
the pupil though dilated, continues to react promptly to light,
and on converging the eyeballs—thus doing away with the very
disagreeable sensation of being blinded, so often experienced by
atropised eyes. Besides this, no paresis of the muscle accommodation
occurs, as when atropia is used. The patient, therefoi-e, is
not deprived for several days of the power of reading or writing,
nor of seeing near objects; the cocainized eye can be used all the
time with perfect comfort—the near point being removed from sight
only in a trifling degree. The dilation of the pupil is complete in
one hour, and passes away in twenty-four hours. Soon after the
drug has been applied a slight protrusion of the eyeball may be
noticed, and the lid aperture is wider open than usual.
Another very remarkable action of cocaine was first observed
by Dr. Bosworth, of New York, and communicated to the N. Y.
Medical Record. He observed that when using it for anaesthetic
purposes, on the mucous membrane in the nasal cavity, there ensued
in about half a minute a very noticeable contraction of the venous
sinuses underlying the part which it reaches. These sinuses become
so rigidly contracted that all the blood which they may have
contained is absolutely expelled, and the membrane clings closely
to the bony structures, which then become visible in absolute outline.
Bosworth summarizes his interesting observations by remarking:
" While we have in the cocaine a local anesthetic of very great
value, we also have a therapeutic agent of inestimable importance,
and which we have every reason to believe will be efficient.
"1st. To control the exacerbation of hay fever.
" 2d. To relieve the most distressing symptoms of acute coryza
and curtail its duration.
" 3d. To control the painful and distressing reaction which results
from the use of caustics or instruments in the nasal cavity.
" 4th. To completely empty the venous sinuses of the nasal mucous
membrane, and thereby afford a thorough ocular inspection
of the cavities.
" 5th. To largely eliminate from our minor operations in the