Opinions are at present divided as to whether the anæsthesia produced by Cocaine is the result of vasomotor disturbance—the small vessels are caused to contract by its application, and the nervous filaments are doubtless anæmic—or whether Cocaine acts directly as a paralyser on the nervous endings, whether of sensibility, or touch, or of special sense, since it removes the power of taste and smell, as well as the perception of touch and pain. When Cocaine is administered in such a dose and manner as to affect the whole system, the brain seems to become excited, the heart stimulated, and blood and pressure increased. Poisonous doses kill by asphyxia, the breathing becoming arrested and the heart failing in diastole; but this has not yet been observed in man, the dose necessary to produce this effect being very large; 20 grains have been taken without very serious result. It diminishes all the secretions, and, although the intestinal movements are slightly stimulated at first, larger doses or continued use cause sluggish action, dyspepsia, and constipation. Tissue change is lessened, and the amount of urea is similarly diminished; the temperature seems to be somewhat higher than normal; albuminuria has been found to follow its use, and sugar has been found in the urine. The kidneys are probably the special means of its elimination. With regard to its action on muscular fibre nothing is known, observers being completely at variance in their opinions.—Buxton, in Ringer’s “Therapeutics,” 12th edition.