Eucaine as a local anaesthetic in the surgery of the throat, nose, and ear : preliminary communication / by W. Jobson Horne and Macleod Yearsley.

  • Horne, Walter Jobson.
Date:
1897
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Licence: Public Domain Mark

Credit: Eucaine as a local anaesthetic in the surgery of the throat, nose, and ear : preliminary communication / by W. Jobson Horne and Macleod Yearsley. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Dr. A. L. Fuller ’ used eucaine (by the endermic injection of 20 minims of a lo per cent, solution) with complete suc- cess for the removal of a mole. He mentions also a case in which it was used to anaesthetise a tuberculous ulcer for curetting. Parlaghy, of Paris, is reported to have demon- strated the powers of eucaine before several physicians in the Assistance Publique de Paris, who proclaimed it an ideal anaesthetic. Other dental surgeons who have experimented with it are Kiesel, Warnekros, and Wolff, of Berlin, their verdicts are uniformly favourable. We shall have occasion to refer again to Kiesel’s work. Eucaine is the methylester of benzoyl-n-methyl-tetra methyl-gamma-oxy-piperidine-carboxylic acid. Its physical characters were thus defined to the Berlin Pharmaceutical Society by G. Merling. Eucaine base crystallises from ether or alcohol In large glistening prisms, which melt at 104° C. Eucaine hydrochloride crystallises from methyl alcohol solutions in large glistening efflorescent prisms contain- ing two molecules of methyl-alcohol, and from watery solutions in glis- tening leaflets containing one molecule of water of crystallisation and permanent in the air. Eucaine hydrochloride dissolves in about ten parts of water at room temperature. Vinci carried out certain physiological experiments with eucaine on mice, rabbits, and {dogs. He found that the in- stillation into the eye of a rabbit or dog of a 2 to 5 per cent, solution produced complete anaesthesia in one or two min- utes, which lasted on an average ten or twenty minutes. A slight hypenemic action was thereby developed, sometimes accompanied by slight symptoms of irritation of the con- junctiva. Eucaine acts upon the central nervous system at first as an excitant, later on in toxic doses producing paraly- sis. Small doses of eucaine increase the reflex excitaoilityof mice and rabbits. Doses of i grain per kilo body weight cause tonic and clonic convulsions, which last several seconds and recur at moderate intervals. An increase of the dose causes paralysis, under which the animal dies. Should the dose be resisted, the paralysis following upon the convulsions totally disappears. Vinci found that the pulse is gradually slowed by subcutaneous and intravenous injections of small and moderate doses to the extent of 20 to 30 beats per min- ute. There is no increase of blood pressure. Berger’s investigations corroborated those of Vinci upon all important points. The former demonstrated the action of eucaine to be analogous to that of cocaine, with the follow- ing important differences: 1. Eucaine is less toxic. 2. It slows the pulse. 3. It does not affect the pupils. Dr. Charteris, Professor of Materia Medica and Therapeutics at the University of Glasgow, read a paper before the Royal Society of Edinburgh, in which he described experiments corroborating those of Vinci and Berger. Before concluding this short review of the work done by others we should like to quote the following remarks of Kiesel® summarising the advantages of eucaine : I. The heart is not influenced in any way; with nervous patients I have often had the opportunity of observing that the pulse beiore the opera- tion liad risen to lao or 130, whilst after injection it rapidly fell to its normal rate without irregularity, and maintained its normal character. * International Journal of Surgery, ix, p. 259. 8 ZahiMrztliche Rundschau, 1896, No. 196.