DONALD KENNERLY, M.D., PH.D.
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To the editor: The recent paper by Jobe and associates, (1) provides not only a simple treatment for mild Raynaud's symptoms but perhaps more importantly raises an interesting scientific issue. Although the data reported are compatible with classic Pavlovian conditioning because the symptoms in the patient's legs did not respond to the "conditioning" of the arms with warm water, another interpretation is possible. The treatment may directly alter local vascular responsiveness to cold stimuli without involving a central nervous system pathway. A long-term change in a locally active "factor" or in the intrinsic cellular responsiveness may be induced by these
KENNERLY D. Raynaud's Disease and Prostacyclin. Ann Intern Med. ;98:258. doi: 10.7326/0003-4819-98-2-258_3
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Published: Ann Intern Med. 1983;98(2):258.
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