Cocaine is widely used as a local anaesthetic in the nose. However, it is potentially toxic, a known drug of addiction, and its spray delivery devices can theoretically transfer infection. This two-part study investigates a less toxic alternative, 5% lidocaine and 0.5% phenylephrine ('co-phenylcaine') solution, presented in a disposable spray. In the first part, the efficacy of co-phenylcaine was assessed in 25 healthy volunteers. Serial acoustic rhinometry showed a significant, sustained nasal decongestion after co-phenylcaine administration. Visual analogue scale (VAS) scores in response to a painful nasal stimulus confirmed a significant anaesthetic effect. In the second part, co-phenylcaine was compared with 10% cocaine spray in a randomized double-blind trial in 74 patients undergoing out-patient transnasal fibrescopic laryngoscopy. VAS pain ratings and nasal inspiratory peak flow recordings showed no difference between the two solutions. No adverse effects were noted. It is concluded that co-phenylcaine is an excellent alternative to cocaine nasal spray.

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THE BRITISH MEDICAL .OURNAL.was then put on infuision of jaborandi (one drachm to six ounces), and this treatment was continued for forty-four days. The dose was from time to time increased till he took several times daily a dose enough to produce in healthy people very profuse perspiration a-nd salivation. As will be seen, the jaborandi hacl no effect on the quantity of urine; but his mouth was moister and more comfortable, and, though the jaborandi never produced copious perspiration, it kept the skin comfortable, and, after exercise or eating, or hot drinks, he perspired rather freely. The sweating of the feet soon ceased after taking jaborandi. The medicine did not make him spit. After it had been clearly proved that the jaborandi was useless, he was put on ergot for the thiud time with considerable success. The results of the treatment will be seen in the following table. Quantity of urineQuantity of urine Date.

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