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June 16, 1945

ALCOHOL INJECTION OF LUMBAR SYMPATHETIC TRUNK: IN CASES OF PERIPHERAL VASCULAR INSUFFICIENCY WHEN SURGICAL SYMPATHECTOMY IS CONTRAINDICATED

JAMA. 1945;128(7):479-482. doi:10.1001/jama.1945.02860240005002
Abstract

The advantages of interrupting the sympathetic nerve supply to an extremity in which there is a circulatory deficiency due to vasospastic disease such as thromboangiitis obliterans or Raynaud's disease has been generally accepted, as a result of the pioneer work of Leriche1 and the subsequent investigations of many American physicians.2 The literature on this subject has been reviewed adequately at frequent intervals by White3 and does not require general discussion at this time.

Unfortunately, some of the earlier publications dealing with peripheral vascular impairment of the extremities place too much emphasis on the differentiation between vasospastic disease and organic obliterative disease, and, as a result, many physicians regard the circulatory insufficiency of old age associated with arteriosclerosis as being an irreversible mechanical occlusion of the blood supply to the extremities. Ochsner and DeBakey4 have emphasized the importance of realizing that even extreme cases of degenerative organic

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