The Results of Celiac Ganglionectomy in Cases of Essential Hypertension
The criteria on which rests the evidence of the presence of essential hypertension are reliable. These are an increase in the diastolic blood pressure, a change in the eye grounds and often in the kidneys, and the patient's own story of disability and distress. Equally evidential are the postoperative findings, among which most significant of all is the patient's own story—whether or not he is able to go back to his usual occupation; whether or not the symptoms which were present before operation have disappeared. The important fact is that a fall in blood pressure is not the only criterion upon which to base the effects of any procedure for the treatment of essential hypertension. The eye grounds, the kidney function, the state of the heart and, most important of all, the subjective effects must be considered. The presence of sclerosis is not a criterion. Sclerosis may be present in any disease; it is not uncommon in the sixth and seventh decades of life. If the hypertension was initiated in younger years, sclerosis may have become established as a result of the disease by the time the patient comes to operation. This sclerosis will not disappear even though the hypertension is completely arrested. It should be noted, as our follow-up studies have shown, that when a certain advanced degree of sclerosis has been reached, the blood pressure cannot return to the normal level, an observation which is analogous to that of the sclerosis of old age. In old age. . .