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August 1929

ANGINA PECTORIS: RELIEF OF PAIN BY PARAVERTEBRAL ALCOHOL BLOCK OF THE UPPER DORSAL SYMPATHETIC RAMI

Arch NeurPsych. 1929;22(2):302-312. doi:10.1001/archneurpsyc.1929.02220020118007
Abstract

ANATOMY AND PHYSIOLOGY OF CARDIAC NERVES  Following the work of Langley,1 it is generally believed that the sympathetic sensory and motor nerve supply to the heart and ascending aorta is derived from the upper dorsal segments of the spinal cord. Both afferent and efferent fibers cross from the cord to the prevertebral sympathetic ganglia by the white rami communicantes (fig. 1). The cervical nerves possess gray rami only, and therefore are not concerned with cardiac pain, while from the sixth dorsal down the sympathetic fibers enter the splanchic nerves to the abdominal viscera. There is still no unanimity of opinion, however, as to how the cardiac motor and sensory fibers get from the upper dorsal sympathetic trunk to the heart and therefore how best to interrupt them surgically.Following the ideas of Francois Frank, most surgeons have operated on the cervical sympathetic trunk. Jonesco thought that its complete removal

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