Unilateral and Bilateral Resection of the Major and Minor Splanchnic Nerves

Craig, Winchell McK.; Brown, George E.

doi:10.1001/archinte.1934.00160160096006

Cited by 20 publications

(3 citation statements)

References 6 publications

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“…In subjects with hypertension they state that binding an extremity produced a higher and more sustained elevation of blood pressure than in normal individuals, and conclude from these results that hypertension is due to vasoconstriction in the splanchnic area. Splanchnic section has been performed (9,10) in patients with hypertension on the basis of the same assumption, and lowering of the blood pressure has been alleged to follow such operations. Critical examination of the above experiments, however, fails to furnish any conclusive evidence that the increased vascular resistance is confined to the 63 splanchnic area.…”

Section: Literaturementioning

confidence: 99%

The Nature of the Peripheral Resistance in Arterial Hypertension With Special Reference to the Vasomotor System

Prinzmetal¹,

Wilson²

1936

J. Clin. Invest.

160

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From the physiological point of view elevation of blood pressure may be due to an increase in cardiac output, in the volume or viscosity of the blood or in the resistance of the peripheral vessels. Since cardiac output is not increased in hypertension (1, 2, 3) and the viscosity (4) and volume (5) of the circulating blood have been shown to be normal, there remains only the increased resistance in the peripheral circulation.From an analysis of the literature it appears that investigations on the exact nature of this increase in peripheral resistance are comparatively few in number and have led to conflicting results. It is the purpose of this paper. to deal with the following questions. A. Is the increased peripheral resistance generalized throughout the systemic circulation or confined to the splanchnic area?B. To what extent are the vessels responsible for the increased peripheral resistance capable of dilatation ?C. What part is played by the vasomotor nerves in the maintenance of the increased peripheral resistance; i.e. if arterial hypertonus is present can it be attributed to an increase in sympathetic vasoconstrictor impulses?We have attempted to answer these questions by studies on the blood flow in the arm under various conditions, using the arm plethysmograph as described by Lewis and Grant (6), and to determine whether the nature and distribution of the increased resistance is the same in the different forms of hypertension, which have been designated benign, malignant and secondary (" renal") hypertension. LiteratureIn view of the known physiological importance of the splanchnic circulation it is essential to determine whether the development of hypertension in man is especially due to abnormal behavior of this vascular area. Various forms of evidence have been brought forward to support this possibility. In the first place, pathological studies show that the arterial lesions in hypertension are most intense in the splanchnic region, especially in the kidneys, adrenals, and pancreas. It appears, however, that no constant relationship exists between the severity of arteriosclerosis in the splanchnic area and high blood pressure. Longcope and McClintock (7) obtained transitory elevation of blood pressure by sudden occlusion of the splanchnic vessels in dogs. They attribute this effect to the increase in peripheral resistance, but find no evidence for regarding the splanchnic area as specifically important in the production of hypertension. Jansen, Tams and Achelis (8) found in animals that obstruction of the circulation to a limb caused a greater rise in blood pressure if the splanchnic vessels were first occluded. In subjects with hypertension they state that binding an extremity produced a higher and more sustained elevation of blood pressure than in normal individuals, and conclude from these results that hypertension is due to vasoconstriction in the splanchnic area. Splanchnic section has been performed (9, 10) in patients with hypertension on the basis of the same assumption, and lowering of the...

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Section: Literaturementioning

confidence: 99%

The Nature of the Peripheral Resistance in Arterial Hypertension With Special Reference to the Vasomotor System

Prinzmetal¹,

Wilson²

1936

J. Clin. Invest.

160

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Section: Literaturementioning

confidence: 99%

The nature of the peripheral resistance in arterial hypertension with special reference to the vasomotor system

1936

American Heart Journal

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“…The surgical approach to the treatment of hypertension was also received with too much unwarranted enthusiasm but, in retrospect, extensive sympathectomies have added comfort and years to the lives of some hypertensive persons (4, 5).…”

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confidence: 99%