Cocaine in hay fever : a lecture delivered at the Chicago Medical College / by Seth S. Bishop, M.D., surgeon to the South Side Free Dispensary, and to the Illinois Charitable Eye and Ear Infirmary; member of the American Medical Associaton.

  • Seth Scott Bishop
Date:
1886
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Licence: Public Domain Mark

Credit: Cocaine in hay fever : a lecture delivered at the Chicago Medical College / by Seth S. Bishop, M.D., surgeon to the South Side Free Dispensary, and to the Illinois Charitable Eye and Ear Infirmary; member of the American Medical Associaton. Source: Wellcome Collection.

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    and pain return soon after an operation it may be obliterated again by a fresh application. Very soon after cocaine has been applied, the membrane looks . pale and turns almost white, so ansemic does it be¬ come. It retracts in a marked manner even if it were swelled before the application. But I have re¬ peatedly observed a still further effect which I have not seen mentioned in any account of the action of cocaine. Although its primary action produces an¬ aesthesia and anaemia of the membrane, there occur secondary effects which will materially impair or de¬ stroy its usefulness in some cases. These secondary effects are great swelling and hyperaesthesia of the parts treated, and these symptoms are even more prominent than they were before the drug was applied. This unhappy result I observed in the treatment of a severe form of hay fever, and in consequence of the augmentation of all the symptoms after the effects of the cocaine wore off, I was compelled to abandon that treatment. Several cases have come to my knowl¬ edge in which this action of cocaine has ensued. It seems to act upon the vaso-motor nerves, independ¬ ently of the central nervous system. The blood-ves¬ sels are at first constricted, then dilated, and generally resume their normal calibre. In the exceptions which I have mentioned the dilatation remained for hours, and in one case persisted for a number ot days, accompanied with varying degrees of hyperaes- thesia. The latter symptom was very acute for sev¬ eral hours succeeding the anaesthetic effects, but gradually diminished until the membrane became no more sensitive than it was before the treatment. 1 he secondary swelling closed the nostrils so completely that no air could be forced through them. In sleep it was necessary to breathe through the mouth, which occasioned extreme dryness of the throat. 1 he breath had to be held while eating, and with every • act of swallowing the air was forced into the Eusta- chian tubes, and even particles of food seemed to
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