Solutions of hydrochlorate of cocaine have been employed topically in excision of the tonsils, cauterizing the turbinated tissue of the nose, painting chancres previous to the application of nitric acid or other caustics, opening abscesses, removing polypi, and many cases of iridectomy and operation for cataract, squint, and the removal of foreign bodies from the eye. For the eye an aqueous solution of the hydrochlorate of cocaine of mostly 2, but sometimes 4, per cent. is used, and for other purposes from 4 to 20 or even 50 per cent.; of the weaker solutions it is necessary to repeat the application three to five times, at intervals of three to five minutes. No operation should be commenced within at least ten minutes of the first application. Injurious effects, either local or constitutional, rarely follow its use. Its action commences in three minutes, increases from ten to twenty minutes, and mostly disappears within half an hour. The anæsthesia may be prolonged by applying an Esmarch’s bandage round the site of injection. _Uses of Cocaine, and cautions on its employment; a summary of the experiences of fifty-two surgeons in the United States._ In minor surgery—is of value in all operations where circulation can be temporarily arrested in order to prevent undue absorption. A fresh solution should be employed, of strength not exceeding 4 per cent. Caution is required when the circulation cannot be controlled. Is of little use as a local anæsthetic in anal work, such as fistula. In genito-urinary surgery must be used with care, as it is in this class of cases that untoward effects have been most marked; the solution should not remain in contact with mucous surface more than a few moments. In gynæcological work it is of limited service, as general anæsthesia is mostly to be preferred. For ophthalmic surgery, Cocaine is the anæsthetic _par excellence_; in no other department of surgery is its use so widespread and its application so entirely satisfactory. It is suitable for all operations on the eyeball, except iridectomy for acute glaucoma, and enucleation; as it causes dryness of the epithelium it should not be used long prior to operation. Is of great value in nasal, aural, and throat operations.—Th. Gaz. Aug. 1891, 518. =Chloroform and Cocaine Anæsthesia= (_combined_).—Chloroform is given, 1 to 3 drachms, with an Esmarch’s mask, and from ½ to ¾ grain of cocaine, in 3 to 5 per cent. solution, injected into the part. Less chloroform suffices, vomiting is rare, and depression on waking slighter than chloroform alone produces.—L ii./88,220; B.M.J. ii/88,903. Th. Gaz. Sept. 1888, 630; Oct. 686; Dec. 849. Equal parts of an 8 per cent. solution and liquor atropinæ sulphatis form an effective remedy for all painful and inflamed conditions of the eye; and half a grain of pilocarpine nitrate, added to 1 drachm of a 4 per cent. solution, produces anæsthesia without in the least disturbing the accommodation.—Whitla.