The paralysis of autonomic ganglia, with special reference to the therapeutic effects of ganglion-blocking drugs / by W.D.M. Paton.

  • William Paton
Date:
[1951?]
Catalogue details

Licence: In copyright

Credit: The paralysis of autonomic ganglia, with special reference to the therapeutic effects of ganglion-blocking drugs / by W.D.M. Paton. Source: Wellcome Collection.

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    Effects on Normal Blood Pressure and in Hypertension Arnold and Rosenheim (1949) and Arnold, Rosen¬ heim, and Goetz (1949) showed that pentamethonium lowers the blood pressure to a degree comparable to, and sometimes greater than, that by sedation or by tetraethylammonium; that with this is associated a warming of the skin of the lower limbs and an increase in digital blood flow ; and that adrenaline is still fully effective in the presence of pentamethonium. Burt and Graham (1950), in a quantitative analysis of these vascular actions, confirmed and extended these findings. They found that the effects of pentamethonium and hexamethonium were associated with an increase of limb blood flow, and that this increase was greater, more regular, and longer-lasting in the lower limbs than in the upper limbs, although vigorous reflex vasodilata¬ tion of the upper limb could be obtained. The paucity of the response of the upper limb is a curious observa¬ tion, about which one can only speculate. Sweating was also investigated, and was depressed by both drugs in those cases in which a rise in skin temperature was elicited. They have also observed paralysis of the bladder (by cystometrogram) and abolition of move¬ ments of the small intestine studied through an ileo¬ stomy. Lately, several more studies of the actions of hexa¬ methonium or pentamethonium have been initiated by Turner (1950, 1951), Saville (1950), Campbell and Robertson (1950), Mackey (1950, personal communica¬ tion), Smirk (1950, 1951), Frankel (1951), Locket (1951), and others, bearing more directly on its use in hyper¬ tension and toxaemia of pregnancy. This is all recent and current work, and it is perhaps still premature to do more than outline its character. There is no doubt, however, that regular oral doses of pentamethonium and hexamethonium can in many cases cause a substantial fall in blood pressure, which may be maintained for weeks or months. With this fall there is usually relief of such symptoms as headache, dizziness, ocular disturbance, and breathlessness on exertion. Further, there have already been indications that the physical signs of hypertension, particularly in its so-called “ malignant ” phase, may actually regress. There may be disappearance of papilloedema, diminu¬ tion of heart size, and improvement in renal function. There is tentative evidence that some of these benefits may persist after ceasing to give the drug, suggesting
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