;NEURALGIA. — Sciatica, pleurodynia, etc., and all forms of muscular rheuma tism are best treated by hypodermic in jection. For all, except neuralgia of the head and face, '/, to 1/, grain should be I injected over the seat of the pain; for I the two latter, the injection should be made into the arm.
In lumbago, sciatica, pleurodynias, all forms of muscular rheumatism, V., to V, grain of cocaine injected over the seat of pain followed by excellent results. In neuralgia of bead and face injection should be into arm. Injections continued as loug as the pain lasts. G. H. Sea grave (Brit. Med. Jour., Feb. 8, '96).
The result is marked in nearly all cases. The pain disappears almost en tirely for several hours, when, if it re turn, it is in a milder form. Injections should be continued as long as the pain lasts.
Cocaine anmsthesia is contra-indicated in all irregular and all great operations, as well as in abdominal surgery. Its principal use is in weakened subjects affected by organic taints or otherwise. The cocaine should not be allowed to enter the general circulation.
Local Anmsthesia.—Several methods of producing local anmsthesia by the hy podermic use of cocaine have been sug gested other than the simple one em ployed in medication with other remedies.
The painless method is one in which, after the part to be injected has been sub jected to antiseptic cleansing, the part is sprayed with rhigolene or ethyl-chloride until insensibility to pain is induced. The point of the needle is introduced just below the epidermis and a drop or two injected into the tissues. This produces an area of insensibility within the edges of which other injections are made, gradually increasing the extent of the area of insensibility. Corning, who suggests this method, advises the injec tion of the subepidermal region first, and subsequently the deeper tissues.
The endermic method consists in first producing a small blister, withdrawing the serum therefrom with a syringe, and replacing it with a solution of cocaine.
This method has no practical value in surgery.