SURGERY AND DISEASES OF THE NERVOUS SYSTEM
Sympathetic Ganglionectomy and Perivascular Neurectomy.
—Adson44 reports an operation which consists of bilateral lumbar sympathetic ganglionectomy, in conjunction with the removal of the sympathetic trunks from above the level of the second lumbar to below the level of the fourth lumbar sympathetic ganglion, with division of all the gray rami, and perivascular sympathetic neurectomy of the common iliac arteries, in order to interrupt all stimuli passing over the sympathetic nerves to the vessels of the lower extremity. Brown, in reporting the results of Adson's work, says that in the cases of spastic paraplegia and Raynaud's disease in which organic disease of the vessels was absent, there was clinical evidence of increased flow of blood and absence of sweating in the feet. Calorimetric studies following operation revealed increases in the rate of elimination of heat from the feet. The superficial temperature was