Occasionally there is a case of hiccoughs that has been continuous for
hours or even days and that all efforts have failed to stop. They are
caused by an irritation to the peripheral distribution of the phrenic
nerve from some gastric disturbance or a local irritant acting upon the
center in the medulla. It may follow fright or great emotion and be
associated in persistent form in rheumatism, typhoid fever and other
febrile diseases. It follows abdominal operations at times and is very
distressing. When occurring in elderly people with pneumonia and in
peritonitis with distention it usually marks the end. The same may be
said in case of carcinoma of the stomach and bowels.
=Treatment.=—Go first to the origin of the phrenic nerve at the third,
fourth and fifth cervical and, if there is a lesion as there will
probably be, adjust it and note results. This will be sufficient in
many cases. Failing, bring direct pressure on the nerve just above
the clavicle and anterior to the sternomastoid muscle and release
the scaleni muscles. After this examine and treat at the fifth and
twelfth dorsals. Correct any lesions but best results will be had from
inhibition at these points. Another method is to stand beside the
patient and insert the fingers of both hands under the costal end of
the ribs and lightly pull. Firm pressure over the solar plexus with
flat of the hand is sometimes beneficial. In hysterical cases, drawing
out the tongue will often be effective and it has been suggested
that standing the patient on the head will stop them in short order.
Tickling the nose to produce violent sneezing is an ancient remedy.
Some one of these will cure the case, as osteopathy has never failed so
far as recorded.
The stomach should be emptied of all irritating matter to prevent
recurrence.