"Unjustified" Use of d - Tubo - curarine Chloride

Sudden Death after Intravenous Injection of Mercurial Diuretic SIR,-A.G. Oettle's case of sudden death after intravenous "neptal " (Oct.4, p. 530) prompts me to a few remarks.Such disasters cannot always be avoided-e.g., if they happen after the first injection to a patient, where there is no reason to expect untoward reactions.Such cases, fortunately, are extremely rare.More often, faulty.choice of the case and an overdose are the cause of toxic reactions.The following rules should help to restrict fatal or toxic reactions.Mercury administration must never be given in excess of the excretory power of the kidneys.Low con- centrating power and poor response to a previous injection are warning signals.The minimal injection-free interval should be three days, except in acute emergencies.Digitalis, strophanthin, urea, and ammonium chloride help to make this possible.The