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Hamilton S. Davis, M.D.; Roger Bryce-Smith, D.A.
JAMA. 1953;152(5):477. doi:10.1001/jama.1953.03690050101031.
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To the Editor:  —The conclusion reached by Criep and Ribeiro in their article "Allergy to Procaine Hydrochloride with Three Fatalities" in The Journal (151:1185 [April 4] 1953) cannot go unchallenged. From a theoretical viewpoint, it is unlikely that three fatal plus "several other severe nonfatal" reactions would occur in one clinic in one year on an allergic basis. The incidence of true allergy to procaine is accepted as being extremely low, if in fact it occurs at all.Although the use of procaine in bronchoscopy, except for bilateral vagus block, is somewhat surprising, we are even doubtful about what the authors mean by "the usual routine" with reference to technique and dosage. We doubt the assumption that the three deaths described were allergic in nature. The authors seem to have ignored other commoner explanations, such as bronchospasm in an asthmatic secondary to a foreign body (iodized oil) in the


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