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January 29, 1887


JAMA. 1887;VIII(5):138-139. doi:10.1001/jama.1887.02391300026009

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Dear Sir:  —I desire to give my experience in the use of injections of cocaine in minor surgery, for producing complete local anæsthesia by injecting into the part, through a fine needle, one or two drops of a four per cent. solution of cocaine. For this purpose I use the thinnest steel needle procurable— a very delicate needle sold by Tiemann & Co., which they bill as "Green's."My experience leads me to think that some of the surgeons using cocaine for local anæsthesia inject more than is necessary. Its local action, as I have observed it, is anæsthetic and anæmic. When injected it causes much more local congestion and irritation of the integument than morphine. It greatly aids morphine to relieve any form of neuralgia, especially facial, and migraine. Is it the hydrochloric acid that chiefly causes the local irritation? Is the plain drug cocaine less irritating than the

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