Arch Surg. 1976;111(8):928. doi:10.1001/archsurg.1976.01360260096028.
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I think René Leriche can be credited with starting it all in 1940. In that year he reported having performed, three years before, a lumbar sympathetic ganglionectomy in association with resection of the abdominal aortic bifurcation for thrombosis of that segment.1 The patient's leg pain and impotence were reversed. Professor Leriche thereby became the patron of a cult that I shall call "sympathectomism."

Surgeons treating arteriosclerosis after Leriche's report adopted his procedure with varying degrees of enthusiasm. There were some who detected great clinical improvement, others who were unenthusiastic but performed the operation because they saw no other surgical procedure available, and they thought it might help. Almost everyone gave it a try.

Then, in the early 1950s, arterial reconstruction came along and our attitudes toward sympathectomy had to undergo a revision. As I see it, we are now divided into three groups. The first either has avowedly abandoned


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