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512 DENTAL MEDICINE.
Therapeutic Uses.—Dr. D. B. Kyle regards phenate of cocaine
to be as good a local anaesthetic as the muriate of cocaine, and
devoid of the dangerous systemic effects of the latter. The phe-
nate of cocaine has been employed successfully in cases of
cardiac disease and albuminuria, conditions which contra-indicate
the use of muriate of cocaine. It is also claimed to be equal to
any carbolized solution for its antiseptic properties. It can be
safely used on cut surfaces. Another advantage claimed for the
phenate over the muriate of cocaine is that it coagulates the al-
bumen in the tissue, preventing the absorption of the cocaine,
thereby prolonging the anaesthetic effect, although the length of
time necessary to produce anaesthesia is somewhat longer than
that required for the hydrochlorate of cocaine. Phenate of
cocaine is employed locally, internally, hypodermically, and in
powder.
Dose.—The dose of phenate of cocaine is from J^ to ^ of a
grain. Hypodermically for operations involving the deeper
tissue, the eight or ten per cent, solution will usually produce
sufficient anaesthesia, although it may be applied locally in a fifty
per cent, solution, the strength in which it is sold in alcoholic
solution for convenience of dilution. In solution of the strength
of 50 per cent, it will coagulate albumen, and when topically ap-
plied to a mucous surface, such a strength may cause a slight
slough, which may be avoided by applying glycerine to the dried
surface before applying the phenate of cocaine. The 50 per
cent, solution may be diluted to any extent desired by adding to
it equal parts of alcohol and water. When diluted to a 25 per
cent, solution its power to coagulate albumen is overcome.
Dental Uses.— Phenate of cocaine is employed as a local anaes-
thetic for the extraction of teeth, and when employed in a 50 per
cent, strength or diluted, it is applied to the gum, previously
dried, about the tooth, on a pledget of cotton, which is allowed
to remain for from three to five minutes, and repeated if the
anaesthesia is not sufficient. As in the use of all other local
anaesthetics applied to the mouth, the patient should be cautioned
not to swallow during the operation, to avoid the benumbing
effect on the throat. Phenate of cocaine is also used locally