We have recently observed a recurrence of vascular spasm after complete sympathectomy in a number of cases of Raynaud's disease; in two instances the recurrence appeared within two weeks after the operation. In 1905 Elliott1 showed that in animals structures innervated by the sympathetic nervous system become sensitized to epinephrine after denervation, and the theory was recently emphasized by Rosenblueth and Cannon.2 We have carried out a series of experiments on human beings and on animals, the results of which are given in this communication and which we believe show that recurrence of vascular spasm after complete sympathectomy, in man as well as in animals, is probably due to sensitization of the sympathectomized extremities to epinephrine.
Sympathetic ganglionectomy for vascular disease of the extremities has been performed in seventy-five cases by the members of the clinic for circulatory diseases of the Massachusetts General Hospital. The great majority of
SMITHWICK RH, FREEMAN NE, WHITE JC. EFFECT OF EPINEPHRINE ON THE SYMPATHECTOMIZED HUMAN EXTREMITY: AN ADDITIONAL CAUSE OF FAILURE OF OPERATIONS FOR RAYNAUD'S DISEASE. Arch Surg. 1934;29(5):759–767. doi:10.1001/archsurg.1934.01180050064006
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