The use of ganglion blocking agents in relation to neurogenic factors in hypertension / by W.D.M. Paton.
- William Paton
- Date:
- [1954]
Licence: In copyright
Credit: The use of ganglion blocking agents in relation to neurogenic factors in hypertension / by W.D.M. Paton. Source: Wellcome Collection.
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![ill beyond half a shock per second. These results have two implications: first that the more active a ganglion is the more sensitive it will become. This may explain the considerable response one sometimes sees with very small doses of ganglion blocking agents in a hypertensive patient. Second, the only reactions to a substantial block which are likely to show themselves are either non-ganglionicones, or else the activation of new ganglionic pathways at a slower rate, which might only produce a transient effect. Prom this it seems probable that the tolerance developed to hexamethonium is largely humoral. If the superior cervical ganglion, which is quite a resistant ganglion, can be paralysed more or less completely even to so slow a rate as half shock per second, it is unlikely that any ganglion in the body will fail to be paralysed by the large doses of hexamethonium used in the tolerant patient. ’ests for the Neurogenic Component in Hypertension. Having armed oneself with a specific ganglion how to use it c ( 1 ] 1 blocking agent ,the question arises of assess the neurogenic component. Obviously any tests bust be done on a supine patient, so that one studies the Hypertensive processes (rather than postural reflexes). i)ince hexamethonium has only a slight or no effect in normal subjects lying down, one could then attribute the ■’all seen in hypertensives to removal of abnormal |utonornic tone. But clearly one would like to make this quantitative, hree types of test suggest themselves a) To determine the threshold dose, in which one would ssess the Intensity of the autonomic drive by finding ut how far it had sensitised the ganglia. This is attractive ecause it is very safe and would not be complicated by eactions to a big fall in pressure; but it would be liable o individual variations in sensitivity. t - _ c v (b) To determine the maximal fall in blood pressure llbtainable by ganglionic block, increasing the dose of locking agent until no further effect was obtained. This ijs attractive, theoretically,because with a big dose, llowed to act for a sufficient time , it is unlikely at any significantly active ganglia would be spared, ariations in sensitivity between subjects mught thus be inimised, but of course the method would have its dangers articularly in elderly people. t](https://iiif.wellcomecollection.org/image/b30633862_0005.jp2/full/800%2C/0/default.jpg)
