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RAYNAUD'S DISEASE OF THE UPPER EXTREMITIES:  SUCCESSFUL TREATMENT BY RESECTION OF THE SYMPATHETIC CERVICOTHORACIC AND SECOND THORACIC GANGLIONS AND THE INTERVENING TRUNK

ALFRED W. ADSON, M.D.; GEORGE E. BROWN, M.D.
JAMA. 1929;92(6):444-449. doi:10.1001/jama.1929.02700320014007.
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It has been demonstrated conclusively that permanent vasomotor changes result from lumbar sympathetic ganglionectomy and ramisectomy. These changes consist in increased circulation of blood in the feet with resulting increase in surface temperature. Other permanent changes in the feet that follow operation on the lumbar sympathetics are the disappearance of sweating and loss of the pilomotor reflex.

The temperature change following ramisectomy was observed first by Royle,1 was demonstrated later by us,2 and was proved conclusively by accurate quantitative measurements. Our first studies were made on patients with spastic paralysis of cerebral origin, who were operated on with a view to relieving the spasticity. The results of operation on such patients will not be discussed here, as the demonstration of marked vasodilatation following this procedure led us to apply the operation in diseases accompanied by vasoconstriction.

To substantiate our argument as to the permanence of temperature changes, we

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