Bibility  of  the  akin  may  be  lowered  by  ether  or  rhigolene
spray.  A  piece  of  cotton  cloth  moistened  with  chloroform
and  held  on  the  skin  a  few  minutes  is  nearly  as  eflFective
as  the  spray,  and  much  more  convenient

"When  an  agent  is  used  that,  like  chloroform,  is  very
painful  in  the  effect  which  follows  as  well  as  attends  the
injection,  a  small  amount  of  cocaine  can  be  thrown  under
the  skin  of  the  part  to  be  operated  upon.  The  antagonisms
of  the  various  remedies  must  be  borne  in  mind  when
about  to  use  cocaine.  It  is  antagonistic  to  morphine,  to
atropine,  to  physostigmine  or  eserine,  and  some  others.
LOCAL  AND  SYSTEMIC  EFFECTS  OF  SUBCUTANEOUS
INJECTIONS.
All  agents  injected  under  the  skiu,  even  water,  produce
some  irritation  at  the  point  of  puncture.  Smarting,  burn-
ing, followed  by  rudneas,  and  a  more  or  less  extensive
swelling  or  wheal,  are  the  usuid  phenomena.  Very  acute
pain  is  caused  when  a  nerve  is  punctured.  \\'7ien  a  few
drops  only  are  injected,  there  may  be  some  trivial  redness
to  indicate  tlie  point  where  the  needle  enU^red^  and  no
after-swelling  or  irritation.  The  resulting  wheal,  when
considerable  fluid  is  injected,  regcinblca  tlie  Bwelling  of
urticaria  or  of  erythema  nodosum.  An  indurated  uodule
may  form,  to  suppurate  slowly,  and  discharge  after  some
weeks  or  even  months.  In  such  a  cose  more  or  less
sloughing  usually  occurs,  including  the  areolar  tissue  and
a  portion  of  the  skin,  a  depressed  cicatrix  resulting.
Sometimes  a  frank  abscess,  sometimes  an  induration,  and,
not  infrequently,  u  cyst  are  produced  by  the  injection.
