Roedling, Herbert A.

Eight hundred fifty-seven determinations of the pH of venous blood with simultaneous blood pressure observations were carried out on 590 patients. The pH of venous blood of the patients who had been under medication for a long period before the tests did not vary significantly from that of patients who had had no medication. The most consistent result was the rise in the pH of venous blood 30 minutes after a dose of phentolamine hydrochloride (Regitine). The oral administration of 40 grains of sodium bicarbonate did not increase the response of the blood pressure during the histamine test, irrespective of the type of previous medication, even though the pH of the venous blood was low initially and rose to normal levels after the administration of the sodium bicarbonate. This may be due to the fact that none of the patients had pheochromocytomas with excessive release of pressor amines.

A group of 26 patients who had peripheral occlusive arterial disease of the lower extremity were studied before and after chemical or surgical unilateral lumbar sympathectomy. The temperatures of the gastrocnemius muscle and of the skin of the sural area were determined simultaneously preoperatively and postoperatively. Only patients who had undergone successful unilateral lumbar sympathetic denervation based on the postoperative area of anhidrosis were included. The data were obtained under basal conditions among the 26 patients, and the persons studied were divided into two groups. Group 1 was composed of 17 patients (65 per cent) who had a definite parallel increase of 1.2 C. in the temperature of the gastrocnemius muscle and the skin after unilateral sympathectomy. In group 2 (nine patients or 35 per cent) the temperature of the gastrocnemius muscle and the skin of the sural area was unchanged after unilateral sympathectomy. Since none of these patients were suitable for surgical bypass arterial-grafting procedures and all were in the older age group, not too much could be expected from the standpoint of an increase in temperature. However, when the temperature of the skin after operation increased, the temperature of the gastrocnemius muscle also increased.