Page 359 - My FlipBook

COCAINE. 357

on account of its supplying the alveoli and gums ; but greater
success appears to result from injecting the gum on each side of
the tooth. Dr. Raymond recommends charging the syringe with
thirteen minims of a four per cent, solution of cocaine, and to
direct the needle-point on a line extending about midway be-
tween the angle and the coronoid process of the inferior maxillary.,
passing through the internal pterygoid muscle, and, using the
finger on the external oblique line as a guide, to carry the needle
point along inner surface of ramus until the nerve is reached,
where it enters the inferior dental foramen, for operations on the
inferior molar teeth.
Dr. Raymond also suggests the following method of preparing
and applying cocaine: Obtain a quantity of the soluble alkaloid,
and mix it at the time of using it (as it deteriorates when long
kept). The requisites are a minim glass, pair of scales, some
filtering paper, and a little water that has been boiled. It is
necessary to have an easy-working syringe, with a perfectly
smooth, sharp needle. Care must be taken to exhaust the air
from the syringe when charged ready for use. This can be done
by drawing in more of the solution than is needed, and pressing
it out to the required number of minims. Hold the needle point
up, so as to allow the air to get above the solution, then press
the piston.
The needle of the hypodermic syringe should be fine, sharp
and clean, and rendered thoroughly aseptic previous to its em-
ployment, which may be accomplished by drawing up through it
a few drops of any good antiseptic solution, such as strong car-
bolic acid, and the solution should be freshly prepared for each
operation as the salts of cocaine rapidly decompose ; or the
needle of the syringe can be immersed in, and the barrel filled
with, boiling water rendered alkaline by the addition of a small
quantity of bicarbonate of soda. The salt should be dissolved in
slightly warm water, and the strength of the solution vary from
5 to 20 per cent. A five per cent, solution is made by dissolv-
ing ^ grain of cocaine in lo minims of water. Previous to the
injection, the gum should be dried about the tooth, and a folded
napkin so placed as to exclude the saliva. All air must be ex-