Alfred W. Adson

THE TREATMENT OF HYPERTENSION; MEDICAL VERSUS SURGICAL

Excerpt The title of our presentation was not intended to imply a conflict between the medical and the surgical treatment of hypertension. Rather, it was worded to express an attempt to evaluate th...

PHYSIOLOGIC EFFECTS OF EXTENSIVE SYMPATHECTOMY FOR ESSENTIAL HYPERTENSION: FURTHER OBSERVATIONS

Excerpt In previous communications we have presented our experiences with extensive sympathectomy for essential hypertension.1-5We are now reporting our experiences with a large number of patients ...

XXXIX. The Diagnosis and Surgical Treatment of Trigeminal Neuralgia

Trigeminal neuralgia is a disease which is characterized by darting, stabbing and lancinating pains of the face; it affects males and females alike, and is most common during the fourth, fifth and sixth decades. The seat of the disease is the Gasserian ganglion, but its etiology and pathology are still undetermined. The symptoms are manifested by intermittent attacks of paroxysmal pain radiating over one or more branches of the trigeminal nerve, each attack increasing in severity and duration until the pain is more or less constant. The present accepted forms of treatment consist of alcoholic injection of the trigeminal branches for palliative relief, and division of the posterior sensory root of the Gasserian ganglion for permanent relief. The latter, a major operation, once regarded as a hazardous procedure with uncertain results, has been perfected by various surgeons until today it is performed with safety and followed by cure. The incidence of postoperative

Diagnostic and Physiologic Studies in Certain Forms of Scleroderma

Excerpt Scleroderma is the term that has been applied to a syndrome characterized by induration, pigmentation, and sclerosis of the skin, associated with loss of weight, asthenia, arthritis, atroph...

Surgical Treatment of Vasospastic Types of Scleroderma by Resection of Sympathetic Ganglia and Trunks

Excerpt The permanent vasodilator effect following resection of sympathetic ganglia and trunks, with its subsequent physiologic changes, has stimulated us to find numerous clinical applications of ...

The Results of Sympathectomy in the Treatment of Peripheral Vascular Diseases, Hirschsprung's Disease, and Cord Bladder

Excerpt Sympathectomy in its various forms is growing in its field of usefulness as our knowledge of the physiology of the autonomic nervous system is increased. The altered function of this nervou...

The circulation in man in certain postures before and after extensive sympathectomy for essential hypertension

Abstract In a previous paper 1 we reported some of the physiologic effects on the circulation of extensive splanchnic sympathectomy and postural change in cases of essential hypertension. The studies to be reported in this paper were made on the same ten patients (Cases 1 to 10). In general, the same air-conditioned room and basic procedure, including the same dates of study, were employed in both instances. This part of the investigation was concerned with modifications of blood pressure and pulse rate by (1) a tight abdominal binder, (2) bilaterally inflated cuffs around the thighs, (3) an abdominal binder plus cuffs around the thighs, (4) exercise of the legs, and (5) the administration of paredrinol sulfate. The blood-pressure-raising effects of some of these agents were compared to similar effects of the cold-pressor test. Controlled observations preceded each of the investigations. Each study was done before and after extensive sympathectomy, and, in most instances, while the patients were in the horizontal and in the 60-degree head-up postures.

The rate of the circulation in the arteries and veins of man: II. Studies of hypertension, of orthostatic hypotension, and of the effects of sympathectomy

Abstract The solution used and the manner of measuring the speed of circulation in both the arteries and veins of man have been described in a previous communication. 1 In brief, the procedure consists in determining the time elapsing between the intravenous injection of a solution containing magnesium, calcium, and sodium salts and the occurrence of a sensation of warmth in the tongue, perineum, hands, and feet. The value and faults of the method have been described previously. The speed of flow of blood in the arteries carrying blood to the feet was estimated by subtracting the “arm-to-tongue” time from the “arm-to-foot” time, and in the arteries carrying blood to the hands by subtracting “arm-to-tongue” time from the “arm-to-hand” time. Although our results are not in exact agreement with those published by Spier, Wright, and Saylor, 2 who introduced the use of this solution for the determination of the circulation time, we and they have established normal values for the circulation time throughout the vascular system. 1 It is the purpose of this publication to report our studies of speed of blood flow in essential hypertension, and to demonstrate the effect of sympathectomy and orthostatic hypotension on the speed of flow in peripheral arteries.

Preliminary Results of Resection of Sympathetic Ganglia and Trunks in Seventeen Cases of Chronic Infectious Arthritis

Excerpt Resection of lumbar sympathetic ganglia and trunks for the relief of so called chronic infectious arthritis (rheumatoid arthritis, arthritis deformans) of the lower extremities was first em...

The selection of cases of thrombo-angiitis obliterans and other circulatory diseases of the extremities for sympathetic ganglionectomy

Abstract Sixty-seven cases of thrombo-angiitis obliterans have been studied to determine the prognostic value and relation of the peripheral vasodilatation attained with systemic fever to the increase of surface temperature following sympathetic ganglionectomy. A close approximation is shown. This correlation is higher in the feet than in the hands. Other factors in the selection of cases of this form of vascular disease for operation are important, particularly those of the integrity of the coronary arteries, the rate of progression and stage of the disease, and the ability to demonstrate healing and relief of pain by medical measures. About one-third of the cases are suitable for operation. Preoperative determinations of the vasomotor component are less essential in the pure vasomotor disorders and in arthritis. Maximal grades of vasodilatation will result if the operation is complete.