I began the practice of otolaryngologic surgery in the late Dr. Emil Mayer's clinic over twenty-five years ago and had the benefit of Dr. Mayer's careful and thorough instruction in his specialty. I also had close hand knowledge of the work on the toxic effects of local anesthetics done by Dr. Mayer and his associates1 for the Council on Pharmacy and Chemistry of the American Medical Association. With the precepts and recommendations of Dr. Mayer and his committee in mind, I did many intranasal operations with cocaine anesthesia without a mishap and almost reached the state of mind where I thought "This can't happen here." Well, it did happen. During the course of a submucous resection of the nasal septum, symptoms of acute cocaine poisoning developed. The patient recovered after desperate and intensive work, but the experience was so harrowing that I was impelled to make another study of Dr.
MAX UNGER. PRECISION AND SAFETY IN INTRANASAL COCAINE ANESTHESIA. Arch Otolaryngol. 1938;27(5):618–621. doi:10.1001/archotol.1938.00650030635008