Bauhaus-Universität Weimar

Titel:
Handbook for the Physiological Laboratory. Text
Person:
Burdon-Sanderson, John Scott E. Klein Michael Foster T. Lauder Brunton
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit18583/288/
BY DR. BUR DON-SAND ERSON. 
279 
ligatures, the next step is to find the pneumogastric nerve 
at the upper part of the wound, and free it from the surrounding 
tissues. This done,’ a blunt aneurism needle is threaded and 
passed carefully, with its convexity backwards, along the course of 
the nerve, between it and the carotid artery. Its point is then 
made to penetrate the sheath and fascia immediately above the long, 
cord-like, sterno-clavicular ligament. The thread is then severed, 
and the ends having been drawn out to a sufficient length, the two 
ligatures are tightened, the one inside and the other outside of the 
aneurism needle, after which the whole of the tissues which are 
tied off between the ligatures, including the great veins, may be 
raised on the needle and divided. The needle, which has been 
carefully kept in its place, is now again threaded, and its point 
pushed downwards under the edge of the pectoral muscles, as far 
as the upper surface of the first rib. The point is then pushed 
outwards and forwards through the muscles, the thread is again 
severed, and the muscles are divided between the two ligatures in 
the manner already described. By this proceeding a deep hollow 
[see fig. 243) is exposed, in which, among other important parts, 
the ganglion inferius lies, covered by a layer of fascia. This 
hollow is bounded below by the crescentic upper border of the 
first rib, behind and to the outside by the scalenus anticus, and 
to the inside by the trachea and (on the right side) by the 
oesophagus. In the depth of the hollow, to the outside, lies the 
subclavian artery on its way to cross outwards over the first rib : 
the vertebral artery springs from it just as it is about to leave the 
hollow space. This vessel is the guide to the ganglion which lies 
on its inner side concealed in a good deal of cellular tissue. To 
find it, the most certain method is to seek for the trunk of the 
sympathetic in the upper part of the space where it lies con* 
cealed behind the carotid artery, and then to trace it down 
to the ganglion. All this having been accomplished without 
bleeding, there is no difficulty in passing a ligature round the 
ganglion, so that at any desired moment it may be extirpated. 
The same operation is then performed on the opposite side of the 
body. Both ganglia having been thus prepared with as little 
loss of time as possible, the sympathetic and vagus are divided 
(so as completely to sever the nervous connection between the heart 
and the central nervous system), and one of the carotids is con¬ 
nected with the kymograph. 
The medulla oblongata is then divided,and comparative observa¬ 
tions are made, in the manner already directed, as to the effect of exci¬ 
tation of the peripheral end of the spinal cord on the arterial pressure, 
and on the frequency of the pulse before and after extirpation of both 
ganglia. In the one case, the rise of pressure is attended with accele¬ 
ration ; in the other, the frequency of the contractions of the heart
        

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