Cocaine as a Local Anaesthetic

J. H. E. Brock, C. J. Arkle
1884 BMJ (Clinical Research Edition)  
Dec. 6, 1884.] T)t* B &CWMAL . he Western Infirmary failing so long as the public are satisfied with its management, and know that there is Ino extravagance or waste. Classes at the University are now in full operation, and in the medical facuilty there comes the complaint of want of room in several departments, owing to the number of students. This is especially felt in the anatomy section, Professor Cleland having more than 300 studenits attending the dissecting-room. Report says that it is
more » ... ecessary to go back to the early part of the century to find a parallel for such an influx of students, when the Peninsular war gave prospect of employment, members flocked to obtain the necessary surgical qualifications. It has been decide(d to undertake some extenisions in the anatomy department without further delay. The annual dinner of our faculty was held last week, and passed off remarkably well. The genial pr-esident, Dr. Fergus, was well supported by the Glasgow part of the profession, and there were several visitors and guests, among them beinig Dr. Struthers, of Aberdeen, and Dr. George Balfour, of Edinburgh. Naturally, the altered position of the faculty as a licensing body was the prominent feature of the evening's speeches, and there was a very general feelinig that the late successful negotiations were a subject of congratulation. It is undtlerstood that Dr. Leishman has resigned his connection with the Sick Children's Hospital, and that the directors will shortly proceed to fill up the vacancy. Dr. Leishmain's retiral from the positionl he has so acceptably filled for nearly two years is a matter of regret to all, and a decided loss to the clinical teaching at the hospital. Dr. Maclehose, formerly house-surgeon in the Western Infirmary, has been appointed to succeedI the resident medical officer, Dr. Walker, when his term of office expires at the enid of the present year. MANCHESTER. [FROM OUR OWN CORRESPONDENT.] The Iloyal Salford Hosp)ital. -Lectur-e at the Royal Albert Asylum. -MVanc hester WFater Supply.-Mlledical Societies.-Collective Investigation. THE fifty-seventh anniual meeting of the trustees of the Salford and Pendleton Royal Hospital and Dispeensary took 1)lace on November 26th. The most important event in connection mwitlh this charity, during the coining year, is the proposed additions to its accommodation, which will raise the numiiber of beds froiii 50 to over 100. Standing as it does, in a poor and densely polpulated manufacturing district, this increased accomimodation is an absolute neeessity ; and what is also a matter of some importance, it will enable the authorities to cla,m recognition, from the examilining Boards, for their hospital as a place of clinical instruction for medical students. During the past year 579 in-patients, and upwards of 11,000 out-patienlts, including accident andl home patients, were attended to in connection with the institution. On November 22nd, Dr. Shuttlewortli delivered a clinical lecture at the Royal Albert Asylum for ldiots and Imlbeciles at Lancaster, to a class of senior students from Owens College, who availed themselves of hiis invitation to visit the itisticution and see the inimates at work. Several medical men, from Lancaster neighbourhood, also attended. The lecture was illustrated by typical examples of the various forms of idiocy, and the visitors passed through the class-rooms, and workshops, and saw the variouis methods employed in the education and training of backward children and imbeciles. This institution is the only one of its kind in the north of England, and although capable of accommodating nearly 600 children, it is qluite inadequate for the wants of the population in the northerin counties. The water-famine which has tlhreatenied this dist-ict for the last few montlhs lhas passed into a subacute stlage, aiid threatens to become acute. Already we are exposed to the inlconivenienice of ain iintermittelnt water-supply, which is felt all the mnore severely from the fact that, for manly years, Manchester has had ail excellenit conltinluous supply, and cisterns for the storage of water have loig since beeni banished fromn the houses. The reservoirs, whiclh are situated in the Longdenidale valley, and which yield in ordinary titnes thirty-two million gallonis (laily, of which upwards of eighteen, millions are supplied to the Manchester district, are reported to contain only fifty days' supply on short allowance, and shouldl the drought or a frost prevail, the outlook is serious enough. Proposals are being made to relieve temporary necessities by tapping the niew red sanidstone which underlies part of this distr'ict, by means of artesiani wells and establishing pumping stations. At the medical anid kindred societies there is nmuch active work going on. Dr. P. H. Mules rea(l an initerest'iDg paper at the fortner society recently, on Tuberculodis of the Eye, illustrated by microphotographs exhibited by means of the lime light. Dr. A. Hill Griffith followed with another ophthalmic paper on the Field of There has been some talk in medical circles about another case, which was tried a few days ago at the Winter Assizes. A man was brought up charged with embezzlement ; and the most important witness was unable to appear and give evidence, by reason of his being temporarily mentally deranged. Medical evidence -was called to prove this. Mr. Justice Day, who tried the case, asked on what grounds the medical opinion was founded, and was informed that the gentleman in question had once tried to commit suicide by cutting his throat. Whereupon the judge remarked that he failed to see how any medical man could discern whether a man is or is not temporarily insane ; that two days ago he was told that the witness was suffering from softening of the braiin, whereas now it was said to be temporary insanity, and that to his mind that evidenice conveyed the notion of a desire to keep the witness back. He added that he thought it not improbable that the gentleman would be sound eniough in his mind immediately the trial was over. Visitors to the Associationi meeting *in Liverpool last year, who visited the Cheshire side of the Mersey, will be sorry to learn that Bidston Hill is to be built upoIn, the questioni being niow definitely settled. For many years it has been a popular resort, as being not only very easy of access, but wonderfully picturesqlue and charmilng in its naturalniess and rugged graudeur. But the charm of the place will soon be gone for ever; and, what is more important, the inhabitants of several large towns will be deprived of their most valued healthresort. Among 8ther so-called "improvements," three railway stationis of the new Wirral Railway are to be erected at different points near the base of the hill. Great satisfaction is felt at the appointment of Mr. Hamilton to be the Chairman of the Hospital Sites Committee of the City Council. CORRESPONDENCE, COCAINE AS A LOCAL ANAESTHETIC. SiR,-In consequence of the large amount of attention which cocaine is attracting at the present time, owing to its success as an aniesthetic to the cornea and mucous membranes, it was suggested to us by Dr. Ringer that its effects, both locally and constitutionally, should be tested by hypodermic injections. Acting under his advice, we have made the following series of experiments with a solution of one grain of the hydrochlorate of cocaine in twenty minims. The drug was supplied for the purpose by Mr. Martindale, of New Cavendish Street. The method of procedure was the following. In every case, the injection was adminiistered to each of us, and, with one exception, the results were exactly similar in both. We commenced by injecting one-seventh of a grain into the forearm and arm; then one-fifth of a grain into the thigh and leg; one-twentieth of a grain into the dorsum of the first phalanx of the little finger; and, lastly, half a grain into the forearm. The effects which were common to all the injections were, smarting, followed by numbness; redness round the point of injection ; in from two to three minutes, sensation to touch was diminished, to pain and temperature completely abolished. In every experiment except the last, when half a grain was injected into the forearm, the anansthetic area was more extensive immediately above the point of injection than below. The extent of surface on which the above effects were produced was about half an inch above and a quarter of an inch below the point of injection; while for about half an inch around this area there was a slight diminution to tactile, painful, and thermal impressions. It was found that an injection of only one-twentieth of a grain into the dorsium of the first phalanx: of the little finger produced re-
doi:10.1136/bmj.2.1249.1161 fatcat:pqck46aqkzfy3cvttbvfdtrhdm