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January 13, 1940

SURGICAL PROCEDURE FOR ANGINA PECTORIS-Reply

JAMA. 1940;114(2):178. doi:10.1001/jama.1940.02810020082024

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Abstract

I should like to point out that the gray rami (postganglionic fibers) which are sectioned by the operation do not in any way contribute to the nerve supply of the coronary arteries, myocardium or other involved structures; they are strictly composed of sympathetic (postganglionic) fibers to the peripheral structures for the innervation of sweat glands or somatic blood vessels. James White (The Anatomic Nervous System: Anatomy, Physiology and Surgical Treatment, New York, Macmillan Company, 1935, p. 25) states: "In contrast to the white rami which connect the central pathways in the spinal cord with the sympathetic ganglia, the gray rami carry unmyelated neurons to the peripheral structures." This quotation is also in general accord with all well known authorities on the subject. It should therefore be clear that postganglionic fibers to the coronary vessels are never found in gray rami; they either reach the coronary vessels from the sympathetic ganglions

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