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June 20, 1931


JAMA. 1931;96(25):2085-2091. doi:10.1001/jama.1931.02720510005002

A preliminary report on nupercaine was made by us1 in February, 1930, based on a review of the literature available and on four months' use of the drug. This supplemental report is based on our further personal experience and on the hundred odd papers that have appeared since Miescher synthesized it from the quinoline nucleus.

Various pharmacologic studies have demonstrated the high absolute toxicity of nupercaine in animals, and, as pointed out in our preliminary report, when reasonable doses have been exceeded, largely through gross carelessness, a similar toxic action has been demonstrated in human beings. This toxicity is compensated for by the unusual anesthetic efficiency of the compound. From experiments on guinea-pigs and rabbits, Uhlmann2 concluded that nupercaine was five times more toxic than cocaine, intimating that such a ratio between the two drugs should exist in their clinical use. The incorrectness of such an assumption has

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