Swelling and oedema is often observed in patients with Raynaud's disease or causalgia after acute interruption of post-ganglionic sympathetic fibres such as a wide-spread sympathectomy. Complete sympathetic
block dilates vein and capillary and increases peripheral pooling, which raises hydrostatic the shins and feet (fig 2), constipation and
abdominal distention, and dysuria were observed. Oedema was not noted in the
hands or face.
There were no signs or abnormal laboratory data suggesting heart failure, renal failure, liver dysfunction, thyroid dysfunction or local inflammation. Venography of the left leg did not show obstruction in the deep veins.
We showed that the preganglionic sympathetic tract in the spinal cord was often
disturbed in patients with multiple sclerosis with myelopathy.' Most patients with com-
plete transection of the spinal cord due to injury showed swelling of the lower limbs or
oedema, but they gradually subsided within several months even without restoration of
somatic function. Probably some compensatory mechanism improves the hydrostatic
condition in the chronic stage and explains why oedema is not noted in patients with
chronic autonomic failure syndrome.
