LOCAL ANESTHESIA. — Hirschbruck, to obtain local anaesthesia, injects a 2-per-cent. solution of cocaine grain of the salt) and then injects 15 minims of distilled water containing 3 per cent. of orthoform grain) in suspension, the syringe being constantly shaken when administering the latter. This process appears to be quite free from danger. Anaesthesia is induced in from five to ten minutes.
By mixing 5 to 10 per cent. of ortho form with a 10-per-cent. solution of salicylate of mercury, the pain accom panying intramuscular injections for syphilis is prevented or relieved. There is some local pain with nausea eight to ten hours afterward, but these troubles are never intense and last only a short time. No unpleasant effects were ever observed. Loeb (Monats. f. prak. Derm., B. 27, No. 1).
Employment of orthoform combined with Schleich's method in following man ner: An injection is first made after Schleich's method, which permits the painless incision of the tissues. The anaesthesia is then completed and ren dered more profound and durable by Powdering the wound with orthoform. This method has given very satisfactory results. Isidor Dreyfus (Munch. med.
p. 527, '98).
As orthoform and new orthoform can not be used hypodermically on account of the difficulty with which they dis solve, and as their salts are too irritant for that purpose, there has been person ally produced, by substitution, a sub stance sold under the name of nirvanin, which is not alone more permanent than cocaine, but also ten times less toxic; it is also antiseptic. In 2-per-cent. solu tions, injected hypodermically, it pro duces a prolonged regional ansthesia. Einhorn and Heinz (Miinch. med. Wroth., Dec. 6, '98).
In ninety-four operations performed under the effect of nirvanin. No un pleasant symptoms appeared in any of the cases. The best method of employ ing the drug is to make a 2-per-cent. solution with sterilized saline fluid. Teuchenburger (Munch med. Woch., Dec. 6, '93).
Practically painless injections of calo mel may be made by means of the simultaneous use of orthoform. The mixture was employed in a case of syphi litic glossitis, and, not only was anal gesia obtained at the time of the in jections, but on the fourth day, when there is usually a painful reaction, only slight local discomfort was evidenced. Danlos (Med. News, Mar. 4, '99).
In carious teeth with exposed nerve endings a piece of cotton dipped into a. saturated solution of orthoform and alco hol, packed not too tightly, will arrest the toothache in three or four minutes, and will hold its anmstbetic effect for several days if packing is not removed. Sprague (Amer. Therapist, Sept., 1900).
Orthoform may be taken internally in doses of S to 15 grains, as an internal anodyne.
Obsen•ations made in Leyden's clinic show that, besides its ancestbetic effect on raw surfaces, orthoform is absorbed by the intestinal canal, and is eliminated somewhat changed in chemical composi tion by the kidneys. It may be given in doses of from 15 to 20 grains per day, and it is said to relieve pain in cystitis and gonorrhoea. The urine does not readily undergo putrefaction during its administration. Editorial (Deut. med.
June 30, '93).
In affections of the stomach about 3 knifepointfuls of orthoform should be given in a glass of water. This is to be taken at a draught and the patient should then lie in various positions suc cessively, to insure contact of the mixt ure with the gastric wall at all points, unless any particular portion of the wall is the seat of pain, in which case the patient should lie in such a position as to bring about the prolonged application of the drug to the affected area. In ulcer of the stomach and in carcinoma (at the stage of ulceration) the analgesic effect was well marked. It is best ad ministered on an empty stomach, and is especially efficacious after the organ has been washed out. Kindler (Fortschritte der Med., No. 7, '99).