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356 DENTAL MEDICINE.

peating the application if necessary, is recommended by Dr.
Thompson. Dr. A. W. Harlan recommends a solution com-
posed of cocaine hydrochlorate ten grains, in sulphuric ether,
ninety minims, which is to be applied for four or five minutes,
for the painless extirpation of an exposed pulp.
Dr. Harper recommends the following method for removing
pulps of teeth by the use of crystals of cocaine : " Take a
drop of the oil of cloves and add enough cocaine to make a
thick paste and introduce it into the pulp, after having first put
the rubber dam on the tooth ; then with a broach slowly work it
down ; with a bur open up the opening slowly, and in ten or fif-
teen minutes the pulp may be removed from any of the anterior
teeth." Where arsenic has been applied to the pulp and the
patient returns with pain, relief will be obtained from the appli-
cation of cocaine.
Herhst's Obtundent consists of a saturated solution of cocaine
hydrochlorate in chemically pure sulphuric acid, to which sul-
phuric ether is added to the point of saturation, the excess of the
ether floating upon the surface and evaporating. Several appli-
cations are necessary to produce anaesthetic eff^ects, and seventy
grains of cocaine hydrochlorate are required to saturate two
drachms of the sulphuric acid.
Cocaine, owing to the unsatisfactory results which have at-
tended its use as a topical application, is now generally applied by
hypodermic injection, for the extraction of teeth. Owing to the
necessity for introducing the agent deeply into the tissues, Dr.
Walb's method is to inject a two per cent, solution of the hy-
drochlorate of cocaine hypodermically over the root of the tooth
to be extracted, the injections being usually made on each side
of the gum, above the root of the tooth, and as many as the
number of teeth to be extracted mav indicate; the same method
is employed for obtunding hypersensitive dentine, and in remov-
ing pulps. The full anaesthetic effect is developed in from five
to ten minutes, and continues ten or fifteen minutes. It has also
been suggested to hypodermically inject the solutions of cocaine
upon both the lingual branch and the inferior dental branch of
the inferior maxillary nerve, the former being preferred by some.