If a 40-per-cent. freshly prepared so lution of cocaine is applied from one to one and a half bours to the unbroken skin, there results a local anmsthesia. Circumcision accomplished without pain by the simple external application of a. 40-per-cent. solution of cocaine. Before the operation the parts were carefully cleansed of all sebaeeous and oily mat ter, and well dried after the thorough use of an antiseptic. Then a solution of cocaine was applied to the line of in cision by means of a pledget of ab sorbent cotton. The saturated cotton was kept in contact with the parts for twenty minutes, when it was removed and the part allowed to dry for ten minutes. The cocaine was then reap plied, and this was continued for from one to one and a half hours. The skin may be quite as effectually anmsthetized by this method as by hypodermic injec tions of cocaine, it only being necessary to keep the solution sufficiently long in contact with the parts. After such an application of cocaine numbness will persist in the skin for from four to five hours. W. P. Beach (Brooklyn Med.
Jour., July, 1901).
Cocaine should not be given for over coming pain in the eye, because its effect is only temporary. The patients drop it in the eye too often, and cor neal injuries result. For operation or with conjunctival injection the author uses cocaine, with suprarenal extract, and morphine hypodermically. Schleich's infiltration anfesthesia is not recom mended for operations on the eyelid. Cocaine is useful for photophobia and mydriasis. ln place of cocaine for con trolling the pain, warm or cold com presses, leeches, or dionin are ordered. Fuchs (Wiener klin. Woollen., Sept. IS, 1902).
ETE.—For use as an anresthetic in the eye cocaine in solution of from 1 per cent. to 4 per cent. in strength may be em ployed, 1 to 5 or more drops being in stilled. All operations of a painful char acter, the pain of an acute inflammation, or that caused by the presence of a for eign body are indications for cocaine. Its use in keratitis is not advised in that it has produced permanent opacities in the cornea.