Revised concepts of the treatment of Raynaud's syndrome and thromboangiitis obliterans (Buerger's disease)

Abstract

Consideration of Raynaud's syndrome and Buerger's disease as diseases of adaptation offers a more rational type of therapy. The hypersensitive sympathetic nervous system from a deranged anterior pituitary and hypothalmus has lead to depletion of the suprarenal cortex. Symptoms and signs in both diseases then develop. Previous therapy of sympathectomy for the vasospastic elements which are the end result of endocrine derangement has not been brilliant. Thromboangiitis obliterans or Buerger's disease is similar pathologically to periarteritis nodosa, in which necrotic or hypoplastic pituitary and/or adrenal glands are found. Relief of symptoms and signs in six cases of Raynaud's disease and apparent arrest of three cases of Buerger's disease during the past three years has been obtained by nutritional supplements and desiccated endocrine tablets of the anterior pituitary and the suprarenal cortex. Recently the use of the Rauwolfia root or its alkaloid, reserpine, for suppression of the sympathetic predominance at the hypothalmic level has stopped the profuse sweating, especially in cases of Buerger's disease.