NOTES OF THE DAY

Gisborne Times, Volume XXXVIII, Issue 3584, 9 March 1914, Page 4

NOTES OF THE DAY

THE DANGER OF THE UNSKILFUL USE OF COCAINE.

According to ia cable message which wo have junt''roceived through - the. London Times—Sydney Sun Services, correspondents of the “London Times” report curious physical conditions caused, by injections of novooaino in dental operations. tJome patients, it would seem, complain of severe spasms of the chest and heart failure. As this is & matter of great public interest we may point out that it was clearly emphasised at the recent sittings of the British Association at Birmingham that there was very considerable risk, in the use of cocaine and. its derivatives at the liands of unskilled persons. It was reported by a committee of which the noted medico Dr. F. GHopkins was Cliairman (1) that the risk attendant upon the injection of cocaine is quite as great from the sep- ; tic as from the purely toxic side. Hence it happens that, apart from the numerous cases of cocaine poisoning which occur, a few of which terminate in inquests, there are a Large number of others which escape attention, the victims either suffering from prolonged impairment "bf health or dying from sequela; rarely traced to their true causes. Secondly, it was claimed that the injection of cocaine or its derivatives may lead to dangerous or fatal symptoms by (a) direct toxicity, (b) the introduction of septic organisms into the circulation through improper sterilisation ol injecting appliances, (e) lacerating and reducing the vitality and power of recovery of inflamed, tissues into which the analgesic solution may have been forced, with the result that sloughing or necrosis follows, and (d) “the injected fluid not only driving out the blood and lymph, hut also dispersing pathogenic- organisms into the tissues, and even into the general circulation” (Gibbs). In the course of the discussion that followed it is worthy of mention that Mr F. JBearsi' spoke on behalf of the British Medical Association. He .said they did not wish to deprive the public from tin 1 right to the alleviation of pain. They maintained, as professional men. that i* was, however, their duty to warn the public of the dangers attending the use of drugs by unskilled hands. There were three reasons for the restrictions: First, it was important to recognise whether the patient was in a lit state for the injection of a drug or the giving of an anaesthetic. No one suffering from lung trouble should be given cocaine. If the mouth was inflamed if should not be injected. Secondly, the operation being surgical should be undertaken with .surgical cleanliness and anatomical knowledge. Thirdly, some knowledge of drugs and their action on the body was essential. It would appear then that at Home ■ unskilled “dentists” and others have for some time past been in the habit of using cocaine or its derivatives even in cases where the state of health of anv patient did not justify their use. What is likely to happen —or rather, what should happen—is_ that .steps should l>e taken to restrict the use of 1 the drug by absolutely prohibiting its use on the' part of unregistered deni tists, etc.