Poison.ing by Cocaine. — ACUTE POISONING.—When cocaine is given in poisonous doses the symptoms no ticed are an exaggerated sense of mental and physical well-being, loquacity and mental incoherence, profuse diaphoresis, fall of temperature; shallow, irregular breathing; dilated pupils, disturbed vision, nausea, feeble pulse, and finally collapse.
Epileptiform convulsions have also been noted with disordered circulation and respiratioia; the convulsions, both tonic and clonic in type, are of cerebral origin.
Smallest hypodermic dose observed to produce faintnes.s and nausea was Vio grain: in the CaSC of a man aged 65. Old people ate especially susceptible, and it is advisable in every case to have brandy and amyl-nitrite at hand. J. Jackson Clarke (Lancet, Jan. IS, '96).
Case of acute coeaine poisoning,, injection of 3/, grain of the drug for relief of severe pain being given. Within live minutes the pain had all disap peared. The next day grain only was injected; within three minutes there was a faint feeling, with collapse, followed by rapid heart-action and respiration; after ten minutes clonie contractions with widened pupil, bulging, globes, and other severe symptoms. These pa8sed off, and by the next day the man was out. The pain, which had been of long
standim..! in the region of the hip-joint, did not return. Bergmann (Aliinchener med. Woch.. Mar. 20, 1900).
Instance of the toxicity of cocaine. A strong man, aged 46, was seized with severe epistaxis, which recurred in .spite of treatment. The bleeding came from a spot in the floor of the left nostril. TWO applications of a 10-per-cent. solution of cocaine were made to this, resulting in an alarming attack of an epileptiform nature. the clonic spasms continuing for nearly ten minutes. The epistaxis ceased during the convulsions, and did not re cur. Kohn (Med_ Record, Mar. 24. 1900).
Case under treatment for the mor phine habit, who was known to be very susceptible to cocaine, received by the month, 30 milligrammes (nearly grain) of that substance. The pulse. which was normally weak and never faster than SO, rose to 104 and became hard and tense. A noticeable feature was the enlargement of the outline of the heart, with marked palpitation, which occasioned much alarm to the patient. The ease terminated in recov ery. J. Hofmann (Therap. Monats., "No. 11, 1901).
Thus we have two phases of acute poisoning; one with symptoms of de pression, the other convulsive in type.