Veterinary MedicineAnesthesiologyToxicologyAnesthesiaGeneral AnesthesiaLocal AnesthesiaAnesthetic ComplicationsLocal Anesthetic ToxicityLocal AnestheticsAnesthetic Drug SafetyAnesthetic OverdoseCocaine ToxicityLocal Anesthetic Safety
Since the publications of the Committee for the Study of Toxic Effects of Local Anesthetics<sup>1</sup>in 1924 I have been in receipt of many communications. All expressed their appreciation to the Board of Trustees and the Therapeutic Research Committee of the Council on Pharmacy and Chemistry for instituting and supporting the investigation. Without making any special effort to secure reports of further fatalities, I have learned of fourteen additional deaths, none recorded in medical journals. With one exception these occurred in a limited but very populous area of about 6,000,000 inhabitants during 1925, 1926 and 1927. The local anesthetics used were: cocaine, three; cocaine-procaine, two; procaine, eight; butyn, one. The cocaine-procaine fatalities were recorded as procaine, but the history obtained showed that cocaine had been used first. In at least two of the procaine fatalities the patients seem to have been practically moribund before operation was attempted. Of remarkable interest