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JAMA. 1910;LIV(17):1375. doi:10.1001/jama.1910.92550430001001p.
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The following report of an experience with the bimuriate of quinin and urea hydrochlorid may prove of some value to surgeons doing abdominal work, especially in cases in which general anesthesia is undesirable.

History.  —Strangulation of an old inguinal hernia occurred, March 10, in a negress, aged 64, who had, in addition, inoperable cancer of the uterus and rectum. The circulation was poor. There were arrhythmia, edema, considerable arterial sclerosis, beginning dilatation of the heart; slight cough, some pulmonary secretion and a parenchymatous nephritis.

Operation.  —Immediate operation was necessary and both physicians called in consultation thought that general anesthesia would almost certainly prove fatal. The operation was done under local anesthesia, induced by injecting a 0.25 per cent. solution of quinin and urea hydrochlorid. The tissues above the canal were moderately infiltrated with the solution, and there was no pain until after the canal was laid open, when the peritoneum was found


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