Responses of patients with high spinal transection to high ambient temperatures.

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Abstract
Five patients with cervical and 2 with high thoracic spinal transections were exposed to progressively rising ambient temperatures while sweating, cutaneous volume pulses, deep and skin temperatures were recorded. In all patients, sparse but distinct sweating was observed on most of the body surfaces as environmental temperature increased, with disappearance of sweating upon return to control conditions. Simultaneously, skin volume pulses progressively increased in amplitude during warming and slowly returned during the recovery period. Marked vasomotor activity was regularly recorded on the palmar and plantar surfaces during preliminary exposure in a cool ambient temperature and this activity was also elicited for or intensified during muscular spasms. The amplitude of cutaneous pulses progressively increased as local and mean skin temperatures became elevated during heating and achieved dilatations of 400-500% above control as skin temperatures approached maximum levels. There invariably occurred a significant rise in rectal temperature. It is concluded from these studies that the spinal cord, isolated from hypo-thalamic and brain-stem influences, is capable of independent mediation of thermally induced sweating. It is also capable of initiating profound vasomotor activity in both palmar and plantar areas and of marked release in constrictor tone in forearm, chest, and thigh skin during heating. The latter may be supplemented by a direct action of elevated local temperatures upon the cutaneous blood vessels.