Thoracolumbar Sympathectomies Examined with the Electrical Skin Resistance Method

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Abstract
48 such operations, most of them including T9 to L1 levels, were done on 24 patients. Areas of high electrical skin resistance (ESR) were then outlined and compared with results of the starch-iodine-sweating test of Minor, with which there was close agreement. High-ESR areas were of extremely variable pattern, no two being alike. Several cases exhibited gaps on either dorsal or ventral body surfaces. One patient had an intraspinal section of spinal nerves T9 and Tio; high-ESR areas thereafter had regular outlines, unlike all other cases. Perhaps sympathetic neurones leave the spinal nerves in a more regular segmental distribution than when they leave the sympathetic ganglia. Since only a narrow strip of skin is denervated, the pronounced fall in blood-pressure following sympathectomies must stem from denervation of internal organs, not skin. The ESR method yields nerve distribution data not discoverable by dissection (e.g., the irregular asymmetrical distribution of posterior and''anterior primary rami of intercostal nerves).