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These nerves assist in controlling respiration and are called the phrenic nerves. Find other nerves going to different parts of the thorax. Remove the heart and lungs. Find in the back part of the thoracic cavity, on each side of the spinal column, a number of small "knots" of nervous matter joined together by a single nerve. These are sympathetic ganglia.
Care must be taken not to injure the important nerves, particularly the accessory, the vagus, and the phrenic. The inframaxillary branches of the facial, the hypoglossal and its descending branches, and the motor branches of the deep cervical plexus, are also liable to be injured.
Congestion and œdema of the arm, with pain, numbness, and muscular weakness, may result from pressure on the veins and nerves as they pass under the clavicle; and pressure on the phrenic nerve may induce hiccough. The aneurysm is of slow growth, and occasionally undergoes spontaneous cure.
In severe cases the application of hot cloths over the heart, or of the faradic current over the line of the phrenic nerve, just above the clavicle, may be called for. #Surgical Shock.# The condition known as surgical shock may be looked upon as a state of profound exhaustion of the mechanism that exists in the body for the transformation of energy.
The left recurrent nerve may be stretched or pressed upon as it hooks round the arch of the aorta, and hoarseness of the voice and a characteristic "brassy" cough may result from paralysis of the muscles of the larynx which it supplies. The vagus, the phrenic, and the spinal nerves may also be pressed upon.
The stomach, small intestines, and part of the large omentum lay in the left pleural cavity; both the phrenic nerves were normal. Many similar cases of diaphragmatic hernia have been observed.
As a principal branch of the fourth cervical nerve of the left side, after having joined a branch of the third and of the second cervical nerves, descending between the subclavian vein and artery, is received in a groove formed for it in the pericardium, and is obliged to make a considerable turn outwards to go over the prominent part of it, where the point of the heart is lodged, in its course to the diaphragm; and as the other phrenic nerve of the right side has a straight course to the diaphragm; and as many other considerable branches of this fourth pair of cervical nerves are spread on the arms; does not a pain in the left arm distinguish a disease of the pericardium, as in the angina pectoris, or in the dropsy of the pericardium? and does not a pain or weakness in both arms distinguish the dropsy of the thorax?
"Am I to be paid always thus? Did I not stand two hours upon a glass insulator while you poured electricity into my body? Have you not stimulated my phrenic nerves, besides ruining my digestion with a galvanic current round my stomach? Four-and-thirty times you have mesmerised me, and what have I got from all this? Nothing.
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