GENITO-URINARY TRACT.—The injec tion of a few drops of a 2-per-cent. solu tion of cocaine renders catheterization easy and painless, provided there is no stricture. Operations on the bladder (lithotrity, litholapaxy, catheterization of ureters, etc.) are rendered painless through previous injections of cocaine. Weal: solutions (not strong, the 2 per cent.) must be used, as fatal poisoning has followed the injection of 5 drachms of a 5-per-cent. solution into the urethra.
Wittsack, of Frankfort, advises the use of lactate of cocaine in the treatment of tubercular cystitis. He instills a solu tion containing 15 grains of cocaine lactate and 75 minims each of lactic acid and sterilized distilled water, previously emptying the bladder, but not washing it out.
GYNtECOLOGY.—For application to the mucous surfaces of the vulva, vagina, and the uterine cavity, stronger solutions (10 per cent. to 20 per cent.) are used. Here, as elsewhere, the use of cocaine anmsthesia should be confined to minor operations (curettage, dilatation of cer vix, removal of uterine polyps, etc.). In operations extending below the surface parenchymatous injections should sup plement the applications to the mucous surface.
RECTIBI—The anwsthetic solution (5 per cent.) is here applied to the mucous membrane by means of pledgets of ab sorbent cotton saturated with the solu tion. Parenchymatous injections may also be needed. In major operations or in complicated ones, g-eneral anmsthesia is advised.
SKIN.—Iihe topical application of cocaine has been suggested for the cure of cracked and fissured nipples, but is not advisable, as through its use lactation may be interfered with. This latter suggests the use of a 5-per-cent. solution of cocaine made with equal parts of glyc erin and water as a solvent to inhibit lactation or cause its complete cessation. The glands are bathed four or five times daily with the solution and supported by means of a bandage.
In zona cocaine not only relieves the pains, but also causes a. regression of the eruption, bringing about its disappear ance in the course of a few days. Twenty-three cases thus cured. The affected surface is painted with equal parts of wool-fat and petrolatum rubbed up together with 1 per cent. of cocaine hydrochlorate, and dressed with linen spread with the same ointment. Bleuler (Nouveaux Remedes, No. 1, 1000).
Incidentally it may be noted that Geley, of Bordeaux, has found that cocaine has an antipyretic action when applied to the skin, provided the appli cations be made at a time when the tem perature is no longer rising. This action is analogous to that of guaiacol, though less marked.
Cocaine introduced by cataphoresis. Solution recommended consists of cocaine (the alkaloid, not the hydrochlorate), grains, dissolved in a drachm of guaiacol. If a little of this mixture upon a piece of blotting-paper is placed on the skin, and a, current applied through it, the co caine quickly penetrates, and local anms thesia can be produced in about four or five minutes. The positive electrode should be placed on the blotting-paper. It should consist of a flat disk of bare metal of suitable size. A platinum sur face is the best, but tin or any other metal 11 hich does not easily become cor roded will do ahnost as well. Care must be taken that the metal itself does not touch the skin at any point. The cur rent is then turned on until it reaches about 4 milliamperes for an electrode half an inch in diameter. At first front 10 to 15 cells are necessary to produce this current, for the solution has a high resistance; but soon conduction proves, and the number of cells may be reduced. II. Lewis Jones (Clinical Jour., Mar. 8, '99).