HYPERTENSION

Abstract

Restriction of activity, extension of periods of rest and natural sleep, and generous use of sedatives are commonly employed in the medical treatment of hypertension. Splanchnicectomy (Peet,¹ Craig and Adson,² Smithwick³ and others) or subtotal to total paravertebral sympathectomy, splanchnicectomy and celiac ganglionectomy (Grimson⁴) have been of value as occasional supplements to medical management. Selection of patients for surgery has proved difficult. The effect of rest and sodium amytal on hypertension determined by hourly blood pressure readings during twenty-four hours or more has been emphasized by many physicians as one of several important factors indicating the advisability of surgery. Vasomotor instability evidenced by abnormal elevations of blood pressure during reflex or emotional stimulation has long been recognized in many patients and associated with the term "neurogenic hypertension." The function of the sympathetic nervous system in mediating such elevations of blood pressure and the important role of