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September 17, 1887


JAMA. 1887;IX(12):383. doi:10.1001/jama.1887.02400110031010

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Dear Sir:  —When I first began the use of cocaine my plan was to have 6 or 8 ounces of a 4 per cent. solution prepared and keep it in my office, applying when necessary, until it was exhausted. I soon began to notice that at times its effect would be perfect, at other times seriously disappointing. On one occasion a patient came in for the introduction of a bougie. I injected a small quantity of the solution (which was the last of my bottle) into the urethra, retaining it some minutes, and then carefully introduced the instrument. He complained of great pain, feeling no relief from the cocaine. Two days later he returned for the same operation. In the meantime my bottle had been replenished with a fresh solution, which I injected as before, when I introduced the instrument, without pain, the patient expressing himself as not feeling it

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