ANTERIOR CHORDOTOMY: FURTHER OBSERVATIONS ON PHYSIOLOGIC RESULTS AND OPTIMUM MANNER OF PERFORMANCE

Reports have been made on anterior chordotomy with reference to the location and disposition of the fibers of the spinothalamic tract¹; anterior chordotomy as a cure for the pain and vomiting of gastric crises²; the influence of the anterior columns on hyperreflexia³; the effect of chordotomy on existing motor abnormalities,⁴ and the effect of chordotomy on thermoregulatory sweating.⁵

PRESENT INVESTIGATION  The present report consists of an analysis of further studies, with particular reference to the physiology of the anterior and anterolateral columns and deductions concerning the location and manner of performance of chordotomy for optimum results.The material is presented according to the following outline:

1. Influence on sensory system

   1. Tickle and itch

   2. Girdle pain

   3. Visceral pain—importance of splanchnic mediation Testicular pain and renal pelvic pain Effect of complete transverse lesion on testicular and renal pain

2. Influence on motor system

   1. Shivering

   2. Superficial and deep reflexes

   3. Reenforcement