The Surgical Treatment of Hypertension

Surgical intervention as a means of attack in the treatment of both the benign and malignant forms of so-called essential hypertension has received active consideration in this country for the past several years. The experiences of the various workers are available in the literature and the types of operative procedures employed are more or less familiar to all. This work is now in its sixth year at the University of Michigan. All patients have been operated upon with resection of the splanchnic nerves and the lower dorsal ganglionated chain by the supra-diaphragmatic approach. The criteria of operability have been set forth in a previous communication by Dr. Peet. The time interval varies from six months to five years in the cases studied. It is obviously impossible adequately to discuss a subject of such proportions and with as many variants in a short paper. It is the purpose of this presentation to state the method of study and to record some of the information now available in an attempt to show that in a significant proportion of the cases -studied improvement has occurred and has been maintained. All of the patients included in this study were operated upon by Dr. Max M. Peet. The literature today is replete with dinical and statistical studies of many kinds and on a variety of subjects. As complete and convincing as some of them seem to be they unfortunately make some of us wonder just what methods were pursued and exactly what criteria were used from which deductions were made and conclusions drawn. To state these facts fully, then, becomes most important. In our cases funds were available which enabled us to request the patients upon whom we had operated to return to the hospital entirely at our expense for complete check-up examinations. Accordingly, contact was made with each patient and his referring physician with this end in view. At the same time, the referring physician was asked to forward any available information from his observa-