I

April 26, 3.938

   Thank yaa 80 gYftoh  OF your lettar of Xamh 28th.  The
oaaJe you desoribe la most fntereeting, and the flrst of ita
kind in whicih pantaoreine WBP the drn~ mad. Sirn3Zar a8.wm
have brben reported with all other dags wed In spinal aneathe-

rooeine and ite varlous oomblnatlons, naperoaine,
  Ma$ I enggset that you publish thla ~ase soon,


                    ef' oonr~e dlffionlt 00

ra 'like it may dome to lisht?

The Baeahnnisrn of the aarcllyeie

explezin. Your taaohnio 84ems infallible. DamaRe to the aord
or its rneninms from the dm8 ltaslf ie possible, but it 8houlb
happen oftener,  I do not know of any experiments1 work don6
with effeat of pontocraine bn the cord,  e.8 haa been done with
prooaine and durocralne. It ahwd.4 be done, One poselbillty
we overlook tbo often, fa the presencte of oentral nervom
syetem disease before a3estheela4 A nambtar of 08se8 are on
reoora In whfoh preexistinp C,N,S. d%eeess haa been made muoh
worm by spinal anesthesia, irrsspsotivs of the drnp nae?.
Autopsy mipht have aecrlded this point in your a8aer

  Tho snalyalcl of! LlOO pantociain@ spinal anmtheeias et
the Iresbyterisn Boerpital is in preparation at pm88nt, a1
is alero a ehort pspw on the "&ate Effeots of Oxygen Want In
Spinal dnesthaaia."  I ehal% be plard to send you reprinte,
when they alp6 pubZi~h~d.

Sinoerely youre,

4

.Direofor, Division of Aneetheeria