Cocaine and the eye: a historical overview.

Cocaine was brought to Europe after the discovery of America. In the 19th century, the active component of coca leaves, named cocaine, was extracted and several researchers started experimenting with the substance, describing many physiological and pathological effects of its action. The first scholar to practically demonstrate the possibility of using cocaine solution in medicine, mostly ophthalmology, was Carl Koller. Following this remarkable achievement cocaine became the substance most frequently applied for different types of anaesthesia. Halsted and Hall reported the first successful nerve block of the interior dental nerve with 4% cocaine solution. In 1892, Schleich published the results of his studies in which he used a 0.1-0.2% solution of cocaine hydrochloride intra- and subcutaneously, introducing the so-called infiltration anaesthesia. At the end of the 19th century it was, however, demonstrated that cocaine possessed many undesirable effects, including addiction, which triggered off interest in other, less toxic, anaesthetics.

[Digital nerve block anaesthesia: historical development and two cases of finger-tip necrosis, a rare complication]. / Fingerblock-Anästhesie - Uber die geschichtliche Entwicklung und zwei Fälle einer Fingernekrose als seltene Komplikation.

Two cases of finger-tip necrosis following digital blocks are presented. These are rare complications of this technique. Pathogenesis and treatment options are discussed and the literature reviewed. Circulatory problems can be avoided by using adrenalin free anaesthetics, infiltrating at the metacarpal level with small volumes, and using upper-arm tourniquets instead of rubber bands at the phalangeal level.

[French scientific contributions to anesthesia. Curares and the neuromuscular junction]. / L'apport des scientifiques français a l'anesthésiologie. Les curares et la jonction neuromusculaire.

In France, a number of scientists from the fields of chemistry, physiology and surgery have been interested in anaesthesiology. Claude Bernard, who published in 1872 the most exhaustive studies on anaesthesia, was also interested from 1844 in drug curare. He created a methodology, studied pharmacology, including pharmacokinetics and demonstrated the specific action on motor nerves while muscle retained its irritability. It was however A. Vulpian who put forward the idea that curare does not affect the nerve itself but may act on a "linking substance" between nerve and muscle. In these times (1862), Rouget described the end apparatus at the nerve-muscle junction in a way which was finally accepted by German authors. Fifty years later, Couteaux achieved the microanatomic study of the end plate (1909). More recently (1972), Changeux and his team isolated the acetylcholine receptor from the electric organ of the torpedo fish.