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April 15, 1944


Author Affiliations

St. Luke's and Research and Educational Hospitals, Chicago.

JAMA. 1944;124(16):1153. doi:10.1001/jama.1944.02850160059028

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To the Editor:—  In The Journal, February 19, Dr. E. I. Evans described the method of intercostal anesthesia in the shocked patient and credited it to Bartlett (1940). This method has been described and illustrated in my short monograph on Local Anesthesia (Philadelphia and London, W. B. Saunders Company, 1928, p. 117). It was used during the first world war by a number of military surgeons, notably Franz. The block is especially useful in lateral, subcostal or paramedian incisions, where only one side needs to be injected and where the nerve supply from the other side can be excluded by a subcutaneous infiltration in the midline. It is a simple procedure which, combined with morphine-scopolamine, allows a rapid exploration of the traumatized abdomen. The case reports of Dr. Evans certainly testify for the usefulness of this method under battle conditions. If pentothal sodium could be eliminated it might add to

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