In the past fifteen years, sympathectomy has been carried out for essential hypertension in several thousand patients. Notwithstanding the analysis of much of this material, not even an approach to unanimity as to the value of the operation has been attained. Opinions vary from the belief1 that sympathectomy is indicated in a high proportion of patients with essential hypertension to the view2 that the operation is of little more value than symptomatic management.
Almost all the larger series3 of sympathectomies have been reported by surgeons who performed the operation on patients referred by different physicians. This paper is based on patients selected for operation by a single internist and followed by him after operation. The report thus represents an evaluation of sympathectomy from the point of view of a physician who is at the same time treating other—many more—hypertensive patients without operation and has thus a control in