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August 1946


Author Affiliations

From the Department of Surgery, University of Illinois College of Medicine, St. Luke's Hospital and Research and Educational Hospitals.

Arch Surg. 1946;53(2):111-163. doi:10.1001/archsurg.1946.01230060114001

IN A previous report from the University of Illinois College of Medicine, de Takáts, Heyer and Keeton1 presented the classification, the preoperative study, the selection of cases and the surgical procedures employed, together with the results of follow-up studies of hypertensive patients. Of the methods for splanchnic nerve section, the transdiaphragmatic method of Smithwick2 gave by far the best results. The selection of patients with early hypertension and the use of this improved technic seemed to us the two important factors in the obtaining of good results. An attempt was also made to analyze the mechanism of relief in hypertensive patients after splanchnic section. Aside from the actual lowering of blood pressure, a slow, gradual improvement of cardiac and renal function, a postural hypotension with consecutive decrease in effective circulating blood volume and a decrease in reflex nervous irritability due to adrenal denervation were mentioned as contributing to