Interrupted Impulses

A hiccup is an involuntary contraction of the diaphragm that causes an abrupt intake of breath. An instant later, and also involuntarily, the opening in the larnyx (the glottis) closes and cuts off the flow of air, thus creating the audible hic. To most persons, it is merely annoying. But if it continues for days, it can be seriously weakening, as it was in 1954 for Pope Pius XII. More common and at least as worrisome is the effect on patients undergoing surgery, especially on the torso. The spasms complicate the surgeon's delicate maneuvers; during postoperative recovery, they may well rip open the wound.

Dr. Mohamad Ramez Salem, an assistant professor of anesthesiology at the University of Chicago, has just reported what he considers a near-sure hiccup cure. Standard remedies, which range from breathing into a paper bag to injection of muscle-calming atropine, can be effective, but not for all victims. Moreover, some have bad side effects. The new method has so far proved almost universally successful.

99%. The reflex arc of mechanism usually involved in hiccups is not entirely understood. The phrenic and vagus nerves are known to be part of it; Dr. Salem thought that it might often include irritation of the trachea, or windpipe. Using a catheter introduced through the nose, he and his colleagues tried spraying the back of the throat with a local anesthetic. They soon noticed, however, that the mere introduction of the catheter stopped the hiccups without drugs.

They concluded that the catheter was stimulating the pharynx, the upper segment of the throat. The resulting impulses given out by the complex nerves in and around the pharynx somehow interrupted the impulses driving the hiccups. The pharynx-stimulating technique has been tried on 100 patients, both conscious and unconscious. The catheter was introduced through either nose or mouth and was used to tickle or vibrate the middle section of the pharynx. The result in all but one case was immediate cessation of hiccups. It is hardly convenient for use at home. But if it works as well as Dr. Salem thinks it will, a patient headed for the operating table need not fear that his unconscious, uncontrolled hiccups will lead to a slip of the scalpel.

This file is automatically generated by a robot program, so reader's discretion is required.