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The quinidine-like properties of procaine on the heart have been known for a long time, but the drug is so rapidly hydrolyzed in the blood stream that the action on the heart is rather unpredictable. Lately procaine amide (Pronestyl) hydrochloride has gained wide use in cardiac arrhythmias. Procaine amide is not hydrolyzed by the body enzymes as quickly as procaine, is therefore longer acting, and has been found to be active when administered orally. Procaine amide can be given intravenously with greater safety than quinidine and on occasion may revert a cardiac arrhythmia to normal sinus rhythm even after quinidine failure.1 L. C. Mark and co-workers2 and Goldberg and Cotten 3 have done excellent experimental work on dogs in cardiac arrhythmias and have proved the value of procaine amide in prevention and control of ventricular arrhythmias.Procaine amide was used successfully on human beings for the treatment of ventricular premature contractions and ventricular arrhythmias. Steams and co-workers4 were able to abolish ventricular tachycardia in 7 out of 8 patients, and Kayden and associatesr> reverted ventricu¬ lar tachycardia in 13 of 15 patients to normal sinus rhythm with procaine amide given intravenously. Main-zer6 found procaine amide used intravenously to be the drug of choice in the treatment of paroxysmal ventricular tachycardia during anesthesia, particularly for thoracic surgery.Side-reactions have been noted during the use of this drug and the more common ones are hypotension and widening of the QRS complexes. Severer reactions were chills and fever after oral use of procaine amide,7 and two cases of agranulocytosis 8 were reported due to the drug. Animal experiments have shown that procaine amide can produce ventricular fibrillation or atrioventricular block and can lead to cardiac arrest. Kayden and associatesB noted that one of their patients in whom ventricular fi¬ brillation developed died, and Kinsman and associates " noted that two of their patients died shortly after admin¬ istration of procaine amide, but their condition was so poor that no definite conclusions could be drawn as to the relationship of the drug to their demise. Miller and co-workers10 observed ventricular fibrillation followed by a short period of cardiac arrest when procaine amide was administered to a patient with complete heart block.Acierno and associates u noted increase in intraventricular block and subsequent cardiac standstill in one case of ventricular tachycardia treated with procaine amide ad¬ ministered intravenously, but this patient, too, was mori¬ bund when treatment was begun, and no definite conclu¬ sion could be reached as to causal relationship. On the other hand, the authors noted development of ventricular tachycardia after intravenous injection of procaine amide in a case of auricular flutter and preexisting bundle branch block. REPORT OF A CASEIn May, 1951, a 30-year-old Negro merchant seaman was found to have pulmonary tuberculosis, and in spite of therapy with streptomycin and p-aminosalicylic acid (P...