Thrombo-angiitis obliterans (Buerger's disease) affects predominantly young male adults. Anatomically the condition is characterized by a progressive thrombosis of the peripheral arteries and veins. The clinical picture is characteristic. In a more or less regular sequence there appear coldness of the digits, intermittent claudication, postural color changes, diminution or loss of pulsation in the peripheral arteries, localized pain during periods of rest, trophic changes in the digits leading to gangrene, and, sooner or later, involvement of the opposite extremity. The milder forms are amenable to conservative treatment consisting of rest in bed, contrast baths, postural exercises, careful application of heat, and vaccine protein therapy. In a considerable percentage of cases the condition is progressive. For these, sympathectomy merits consideration.
Herrick, Essex and Baldes1 demonstrated in carefully controlled experiments that, following lumbar sympathectomy in a dog, the flow in the femoral artery on the sympathectomized side was about twice as
SYMPATHECTOMY FOR THROMBOANGIITIS OBLITERANS. JAMA. 1935;104(26):2353-2354. doi:10.1001/jama.1935.02760260041013