RAYNAUD'S DISEASE OF THE UPPER EXTREMITIES: CURE AFTER THORACIC SYMPATHECTOMY

When Raynaud first described the disease subsequently named after him, he expressed an opinion that the circulatory disturbance in this disease was due to a vascular spasm. Recent microscopic study of the capillaries of the terminal phalanges of the involved extremity showed that the original suggestion of Raynaud is correct, and that the anatomic substratum of the disease is a prolonged vascular spasm due to irritation of the vasoconstrictors. Surgical treatment of this disease then suggested itself. It consists in an interruption of the path of the vasoconstrictors and in such a way in an abolition of the competition that the vasodilators have to meet. Deficient knowledge of the anatomy of the sympathetic vasotonic system up to recent years blocked the way of the evolution of surgical treatment of this disease. The periarterial sympathectomy of Leriche failed to effect a cure because of the fact that the sympathetic nerve system