Letter from Virginia Apgar to F. W. Clement

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Dr. Clement had asked Apgar's advice about a puzzling case in which spinal anesthesia seemed to cause paralysis long after the operation. In this letter, she encouraged him to publish an account of the case, which was the first of its kind in which pontocaine was the drug used. She suggested the possibility that underlying neurological disease might have caused such a response, as there were cases on record where this had happened with other spinal anesthetics. The exchange illustrates the clinical problems encountered by anesthesiologists in the inter-war years, as well as their efforts to build up the knowledge base in their new specialty.