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Hugh Smith Jr., M.D.; Hugh Smith, M.D.
JAMA. 1954;155(9):858-859. doi:10.1001/jama.1954.03690270054028.
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To the Editor:  —We wish to report briefly the following alarming experience with the use of reserpine (Serpasil), one of the Rauwolfia serpentina derivatives. A 43-year-old white man had a stable uncomplicated hypertension with a blood pressure level of 160-170/105-115 mm. Hg. He had never had any pain suggestive of angina pectoris. After careful evaluation in the office revealed no other significant abnormalities, he was given reserpine one-half of a 0.25 mg. tablet (0.125 mg.) three times a day after meals. When he was seen 10 days later, he gave a classic description of angina pectoris involving primarily the right arm and forearm and substernal area with crushing pain coming on about 45 minutes after the taking of each half of a tablet. These symptoms were more pronounced the longer after his meals that he took the tablet. He had found that the discomfort lasted only a short while if


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