Evening star. [volume] (Washington, D.C.) 1854-1972, 1905-05-30
PRESSURE ON THROAT.
High Collars and the Pneumoeastric
Nerve

From the Literary Digest
That a stiff high collar may press
against the pneumogastric or vagus.
nerve to such degree as to cause serious
symptoms, such as loss of strength. neu-
ralSfc pains, nausea and even anesthesia
Is the belief of DR.. f. B. Brubaker. as
stated in the Medical Mirror (St Louis).
People who habitually wear high collars
without experiencing any of these i'll eff
fects may be surprised to learn the harm
that this seemingly innocent article of
haberdashery can wreak Says Dr. Bru-
baker:
1T is a noteworthy fact that all the
more important vital structures of the
body are safeguarded from injury, en-
caSed within bony walls or hidden deep
under layers of muscles.
The important functions of the pneu-
mogastrtc nerve render 1t necessary that
In its passage through the neck it should
be protected from injury. We therefore
find 1t inclosed within the same sheath
as the carotid artery and placed between
the artery and internal jugular vein, ly-
ing posteriorly to both. By this provision
the nerve Is placed between fluid on
either side. this arrangement providing a
degree of elasticity uncommon in nerve
protection.
The effect Of compression on struc-
lures in this locality was known to the
ancient writer's on medicine, but the phe-
nomena observed were ascribed to the
artery rather than the nerve. For in
stance, 1t was noticed then, as now that
pressure on this part of the neck was fol-
lowed by a sensation of want of air. by
deep and laborious breathing, rapid heart
primarily. to be afterward retarded with
sometimes q sense of sinking over the
precardial region. Continuing the press
ure occasions a deep-seated benumbing
sensation in the head. as If one were
about to lose consciousness. Gastric
symptoms. amounting to nausea, &c,
even vomiting, may arise, with lassitude,
languor. lowness of spirits and want of re-
pose, remaining for an hour or two then
gradually wearing away. 1t will thus be
seen that pressure over the carotid artery
in the neck is followed by various symp-
toms"
After describing several cases in which
these and similar symptoms seem to have
been caused by wearing high, close-fit-
ting collars, DR.. Brubaker reminds his
readers that they also accompany many
diseases such as those of the lungs, In
which disintegration of the pneumogas-
trio nerve Is a feature, and he asserts
that we are warranted in believing that
irritation due to prolonged pressure may
act in a similar way. He goes on to say:
Believing that collars extremely high
and tight might become an exciting cause
of irritation to this important nerve in
certain cases. and being stimulated to
further research along this line by the
experience Of my patient, whose difficulty
was undoubtedly caused by continuous
pressure upon this nerve by his collar l
believe IL 10 De the cause OF at least
transitory symptoms in such people as
bookkeepers. writers, professional men
and others whose various callings require
constant and interrupted STOPPING and
bending Of the neck. 1t Is not necessary
to suppose In support of our argument
that irritation or pressure must be d.
rect and immediate upon the pneumo
gastric the nerves supplying the integu-
ment of the neck and the everything skin
being al least simply supplied by nervous
energy which communicates with the
pneumogastric. All irritation and all
pressure, therefore. when of sufficient de-
gree, must become reflected thereon to
the detriment of the sufferer"