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Ernest A. Ryan, M.D., Ph.D., F.R.C.S.(C); E. Earle Shouldice, M.D.
JAMA. 1953;152(16):1554. doi:10.1001/jama.1953.03690160054022.
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To the Editor:  —We would like to add our support to H. S. Davis and R. Bryee-Smith (J. A. M. A.152:477 [May 30] 1953) in their challenging of the conclusions reached by Criep and Ribeiro in their article "Allergy to Procaine Hydrochloride with Three Fatalities" (J. A. M. A.151:1185 [April 4] 1953). We agree with Davis and Bryce-Smith that other more likely causes of death in these cases have not been ruled out. Also an extensive experience with the use of procaine hydrochloride (Novocaine) as a local anesthetic in over 9,500 hernia operations at Shouldice Surgery, Toronto, Canada, without any evidence of an allergic reaction of minor or serious nature to the drug makes us believe that any such allergic reactions, if they occur at all, must be very rare. The usual dose of local anesthetic used in each hernia operation is between 150 and 200


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