of the solution into one of the frog’s protruding eyes. After waiting a few
seconds, Koller touched the eye, testing the reflex. Initially there was no
drug effect, but after a minute, “came the great historic moment ... the
frog permitted his cornea to be touched and even injured without a trace of
reflex action.”^13 After testing rabbits and then a dog, the young interns
turned to each other. The solution was trickled into their own eyes, and
then with pin in hand, they touched their selfsame eyes with the head of a
pin. His assistant later recalled, “Almost simultaneously we could
joyously assure ourselves, I can’t feel anything ... with that the discovery
was completed. I rejoice that I was the first to congratulate Dr. Koller as a
benefactor of mankind.”^14
Soon the cocaine solution was used in actual eye surgery with great
success. The German Ophthalmological Society Conference was held a
few days later in Heidelberg, and Koller, seeking the claim of priority, sent
a colleague to present their new discovery. Most medical meetings, then,
as now, are characterized by presentations that are moderately mundane
and rarely scintillating. Occasionally, a paper is given, and reverentially,
the room of professionals marvels at the breakthrough. For good measure,
eye surgery was performed the next day in front of the conference
audience. An American, Henry Noyes (1832–1902), was in the room that
September day in 1884, and rushed home to publish a note on the use of
cocaine to achieve local anesthesia. In the October issue of the New York
Medical Record, Noyes described the use of cocaine, but concluded, “It
remains, however, to investigate all the characteristics of this substance,
and we may yet find there is a shadow side as well as a brilliant side in the
discovery.”^15
William Stewart Halsted read the 1884 report in the Medical Record,
and immediately pondered how to further harness cocaine. Halsted’s
practical savoir faire, honed over the years, led him to believe that he
could use the cocaine solution in a novel way. Instead of dripping it into
eyes or swishing it in mouths, Halsted perceived the real potential lay with
the use of the newly invented hypodermic needle. As a master anatomist,
with incredible knowledge of nerves, where they traveled and what they
innervated, Halsted at once conceived the notion of regional anesthesia.
This author, as a young medical student in his first anatomy lab, was
unsure how large nerves are in the human body. “Are they even visible
with the naked eye?” I asked myself. To my great surprise, the peripheral