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To the Editor:
—There can be little doubt that tap water is not the optimal or even desirable solvent for anesthetic drugs. Braun showed as early as 1898 that, when salt solutions of various concentrations are injected intradermally, pain followed by anesthesia results. With sodium chloride solutions between 0.6 and 2.5 per cent, an indifferent zone exists in which neither irritation nor anesthesia of the dermal wheal is detectable. Later, with the help of freezing point determinations, the optimal, isotonic concentration of 0.9 per cent sodium chloride was advised. It has been erroneously thought that, by adding the procaine salt to this solution, a hypertonic concentration results. Procaine hydrochloride is freely dissociated in the salt solution, and when it mixes with buffer solutions of the tissues it completely dissociates into the procaine base and is lipoid soluble (Gros, 1910). Thus osmotic pressure of the procaine salt is negligible and the
USE OF SALINE IN SOLUTIONS FOR LOCAL ANESTHESIA. JAMA. 1933;101(26):2068. doi:10.1001/jama.1933.02740510060028
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