Surgery of the Sympathetic

was amputated at the site of election on the 1st November. The pain and other symptoms were becoming worse day by day and she had to be given morphia. She was kept in the infirmary as an invalid. I was asked to see her in September 1933: I found her to be extremely emaciated and unable to leave her bed. She had gangrene of the left foot and had already lost four toes; there were deep ulcerations on the dorsum of the foot and black patches of necrosis on the leg up to the knee. The ulcers were very painful and she could not tolerate the weight of a blanket on the foot. The pulse in the dorsalis pedis artery could be felt only at intervals. The radial pulse on the right side could not be felt. The hands were cold. I diagnosed the condition as Raynaud's disease and decided to perform the operation of lumbar sympathectomy