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December 1949


Author Affiliations

From the Surgical Service of the George Washington University Hospital and Gallinger Municipal Hospital.

Arch Surg. 1949;59(6):1234-1243. doi:10.1001/archsurg.1949.01240041248003

THE VALUE of sympathetic block with procaine hydrochloride and of lumbar ganglionectomy in the treatment of acute arterial occlusion due to accidental arterial laceration, embolism, thrombophlebitis and its sequelae, Raynaud's disease, hyperhidrosis and certain instances of Buerger's disease is now well established. The use of sympathectomy for arterial deficiency due to arteriosclerosis, however, has not been generally accepted because of the extensive and irreversible changes which occur in the arteries in this disease and the frequency of failure of this type of treatment in poorly selected cases.

In 1931 Flothow1 reported 8 cases of arteriosclerosis of peripheral vessels in which improvement was obtained by injection of alcohol into lumbar sympathetic ganglions. Two of the patients had actual gangrene of one or more toes. In 1 of these the pain was relieved and the temperature of the skin raised 10 C. (18 F.). Although amputation was necessary at a later

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