Page 357 - My FlipBook

COCAINE. 355

dentine. For the extirpation of pulps of teeth, it is recom-
mended first to anaesthetize the pulps superficially, with a paste
of cocaine and glycerine, and then to introduce, by means of a
syringe, a twenty per cent, solution of cocaine directly on the
exposed portion of the pulp, when it can be removed with a
nerve extractor without causing any pain. Dr. John S.
Marshall, from his experiments with the pills of citrate of co-
caine, found that under favorable circumstances, the citrate, in
such a form, produces anaesthesia, when applied to sensitive
dentine, in from five to ten minutes, and that the obtunding
effect is of a duration sufficient for the preparation of the cavity.
He was also able to extirpate the pulp of the tooth, after the
citrate had been applied, in from three to twelve minutes. In
using the citrate in the form of pills, one pill is introduced into
the sensitive cavity, and, after being secured with a pledget of
cotton, moistened in tepid water, is permitted to remain from
five to twelve minutes. Dr. Marshall suggests the use of
granules, containing one-sixteenth of a grain of pure citrate of
cocaine, instead of pills containing glycerine and saccharine
matters. A solution of the salts of cocaine has also been sub-
cutaneously injected, with favorable results, for the relief of the
pain resulting from periodontitis and hypercementosis ; and Dr.
Hillischer recommends the rubbing in of cocaine, either in sub-
stance or in concentrated solution, after the epithelium has been
macerated with tincture of iodine, to promote absorption, and
thus relieve the pain of chronic periodontitis ; also the repeated
application of the concentrated solution to relieve the ulcers of
thrush, aphthae, etc. In the surgical treatment of alveolar
pyorrhoea, the pain may be relieved by first applying dilute alco-
hol to the gums, by means of a camel's-hair brush, and then in
the same manner, a ten per cent, solution of cocaine, repeating
the application of the cocaine once or twice during the space of
five minutes. The slowness of the action of cocaine is a great
objection to its use as an anaesthetic.
The four per cent, or five per cent, solution applied to a tooth
unprotected by a rubber dam (as the rubber prevents the anaes-
thetic action of the agent), for the space of twenty minutes, re-