Download PDF - Wood Library-Museum of Anesthesiology
Download PDF - Wood Library-Museum of Anesthesiology
Download PDF - Wood Library-Museum of Anesthesiology
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2. Before the advent <strong>of</strong> cocaine atropine was consideredto be a reliable, slowly acting local anesthetic, forexample in the treatment <strong>of</strong> painful inflammations <strong>of</strong>the cornea, fissure in ano, cardialgia secondary togastric ulcer, etc.3. Uhlike atropine, which has a slightly stimulatingaction on the eye (hyperemia, or even inflammationwhen used in eye drops), homatropine has been foundto be entirely without stimulating properties*4. Homatropine is formed from mandelic acid and tropineunder the same conditions as atropine is formed fromtropic acid and tropine,5. Mandelic acid is intermediate between tropic acid andbenzoic acid:C 6 H 5 »CH»(CH 2 OH)*COOH C^CHOH-COOH CgH^COOHtropic acid mandelic acid benzoic acidI found that atropine had a weak though distinctparalyzing action on peripheral sensory fibers, but that inthe case <strong>of</strong> homatropine the action was quite obvious.On the other hand I determined that ecgonine, obtainedfrom cocaine by Dr. Lossen, who very kindly gave me asupply, was entirely devoid <strong>of</strong> anesthetic action. It wasthus obvious that the anesthetizing principle in cocainecould not be ecgonine as such, but that activity depended onits combination with benzoic acid.We therefore propose provisionally - but entirelytentatively - that the conjunction with benzoic acid is theeffective factor. We take into account that the conjunction** In experimental tests one must allow for the greaterdiffusibility <strong>of</strong> homatropine. Compared with atropine,homatropine is removed much more quickly from the site <strong>of</strong>application by the blood stream. Consequently, if onefails to eliminate the effect <strong>of</strong> the circulation, onemay <strong>of</strong>ten conclude erroneously that atropine is the moreactive drug. Experiments on frogs must therefore beperformed with prior removal <strong>of</strong> the heart, as well asthe brain.