Abstract INTRODUCTION AND HISTORICAL REVIEW In 1908 B. Aschner1 first observed that pressure on the eyeball caused slowing of the pulse and decrease in the depth of respirations. He found that it would arouse stuporous, anesthetized and unconscious patients, and enable them to respond to questions. He also showed that in narcosis the oculocardiac reflex lasts longer than the corneal or pupillary reflexes. Grossmann and Miloslavich2 in 1912 made similar observations, and Fabre and Petzetakis,3 working six years later than Aschner, confirmed the observation that the oculocardiac reflex persists even under deep ether or chloroform anesthesia, and can be elicited after the corneal reflex has gone. It was demonstrated by Aschner that the afferent impulse of the reflex passes through the trigeminal nerve to its nucleus in the midbrain, and that the efferent passes by way of the pneumogastric nerve. By cutting the third, fourth, sixth, seventh or References 1. Aschner, B.: Ueber einen bisher noch nicht beschriebenen Reflex vom Auge auf Kreislauf und Atmung , Wien. klin. Wchnschr. , 1908, xliv, 1529. 2. Grossmann, J., and Miloslavich, E.: Ueber die Beeinflussung der Herztätigkeit durch Bulbusdruck , Wien. klin. Rundschau , 1912, xii, 177. 3. Fabre and Petzetakis : Persistance du réflex oculo-cardiaque pendant l'anesthésie générale , Compt. rend. Soc. de biol. , 1914, lxxvi, 343. 4. Milian: Du ralentissement du pouls radial au cours de la compression oculaire dans la maladie de Basedow , Bull. et mém. Soc. méd. d. hôp. de Paris , 1913, No. (14) , p. 878. 5. Loeper, M., and Mougeot, A.: Le réflexe oculo-cardiaque dans le diagnostic des nevroses gastriques , Bull. et mém. Soc. méd. d. hôp. de Paris , 1913 No. (14) , p. 865. 6. Gautrelet, J.: Le réflexe oculo-cardiaque , Paris méd. , (Nov. 29) , 1913, p. 583. 7. Lesieur, Ch.: Vernet, M., and Petzetakis : Sur un cas d'arrêt total du coeur par réflexe oculo-cardiaque chez un épileptique , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (9) , p. 394. 8. Lesuier, Ch., Vernet, M., and Petzetakis : Contribution à l'étude du réflexe oculo-cardiaque. Son exagération dans l'épilepsie, les variations sous l'influence d'actions médicamenteuses ou toxiques , Bull. et. mém. Soc. méd. d. hôp. de Paris , 1914, No. (9) , p. 440. 9. Lesieur, Ch., Vernet, M., and Petzetakis : Considerations sur les modifications des reflexes pendant la compression oculaire chez certains épileptiques , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (11) , p. 510. 10. Lesieur, Ch., Vernet, M., and Petzetakis: Glycosurie, albuminurie, polyurie provoquées par la compression oculaire , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (11) , p. 515. 11. Guillain, G.,, and Dubois, J.: Action inhibitrice de la compression oculaire sur les mouvements anormaux dans un cas d'athetose double , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (16) , p. 850. 12. Loeper, M., and Mlle. Weil : Action favorable de la compression oculaire sur certaines manifestations nerveuses et en particulier sur le hoquet , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (13) , p. 631. 13. Guillain, G., and Dubois, J.: L'abolition et l'inversion du réflex oculo-cardiaque dans les paralysies pseudo-bulbaires , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (12) , p. 584. 14. Lesieur, Ch.: Vernet, M., and Petzetakis : Le réflexe oculo-cardiaque chez les sujets atteints de divers tremblements , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (12) , p. 593 15. Réflexe oculo-cardiaque et maladie de Parkinson , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (14) , p. 599. 16. Miloslavich, E.: Ueber Trigeminus-vagus Reflex , Wien. med. Wchnschr. , 1910, lx, 3051. 17. Loeper, M., and Mougeot, A.: L'absence du réflexe oculo-cardiac dans le tabes , Progrès méd. , 1913, No. (52) , p. 675. 18. Loeper, M., and Mougeot, A.: Absence fréquente du réflexe oculo-cardiaque dans le tabes , Bull. et mém. Soc. méd. d. hôp. de Paris , 1913, No. (39) , p. 942. 19. Lesieur, Ch.: Vernet, M., and Petzetakis : Note sur l'abolition fréquente du réflexe oculo-cardiaque dans le tabes , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (9) , 446. 20. Loeper, M., Mougeot, A., and Vahram : Abolition fréquente du réflexe oculocardiaque chez les syphilitiques , Progrès méd. , 1914, No. (14) , p. 157. 21. The authors give no reason why the cases should be considered syphilis of the nervous system and not merely tertiary syphilis. They conclude, however, that the frequent absence of the oculocardiac reflex is evidence that the nervous system is early involved. 22. Sainton : Le réflexe oculo-cardiaque dans la syndrome de Basedow , Bull. méd. , 1913, No. (60) , p. 701. 23. Mougeot, A.: Tachycardie paradoxale des hypertendus et réflexe oculo-cardiaque , Progrès méd. , 1913, No. (51) , p. 663 24. Le réflexe oculo-cardiaque dans les tachycardies permanentes sans arythmie , Compt. rend. Soc. de Biol. , 1914, No. (5) , p. 205. 25. Loeper, M., and Mougeot, A.: Le réflexe oculo-cardiaque dans le diagnostic de la nature des bradycardies , Compt. rend. Soc. de biol. , 1914, No. (3) , p. 104. 26. Fabre and Petzetakis: De la bradycardie et automatisme ventriculaire provoqué dans les suites de couches par la compression oculaire , Réunion Obstétrical et Gynecologique de Lyon , (January 19) , 1914, p. 37. 27. Dufour and Legras : Réflexe oculo-cardiaque provoquant l'arrêt du coeur, l'automatisme ventriculaire et la dissociation auriculo-ventriculaire , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (14) , p. 686. 28. Petzetakis: L'épreuve de l'atropine, du nitrite d'amyl et de la compression oculaire dans les bradycardies totales , Compt. ren. Soc. de biol. , 1913, lxxv, p. 677 29. De l'automatisme ventriculaire provoqué par la compression oculaire et l'atropine dans les bradycardies totales , Compt. rend. Soc. de Biol. , 1914, No. (1) , p. 15 30. L'épreuve de la compression oculaire du nitrite d'amyl et de l'atropine dans le diagnostic des bradycardies totales d'origin nerveuse , Presse méd. , 1914, No. (17) , p. 161 31. Abolition du réflexe oculo-cardiaque par l'atropine; son exagération par la pilocarpine; sa persistance pendant l'épreuve du nitrite d'amyl , Compt. rend. Soc. de biol. , 1914, No. (6) , p. 247 32. Le réflexe oculo-cardiaque chez les sujets normaux non bradycardiques , Bull. et mém. Soc. d. hôp. de Paris , 1914, No. (12) , p. 562. 33. Mougeot, A.: Supression constante par l'atropine de réflexe oculo-cardiaque , Compt. rend. Soc. de biol. , 1914, No. (4) , p. 162. 34. This seems to be a small dose. 35. Mougeot, A.: Le réflexe oculo-cardiaque dans l'alternance ventriculaire , Compt. rend. Soc. de biol. , 1914, No. (12) , p. 541. 36. Petzetakis: Réflexe oculo-cardiaque et dissociation auriculo-ventriculaire , Compt. rend. Soc. de biol. , 1914, No. (10) , p. 409 37. Automatisme ventriculaire intermittent provoqué à l'état normal , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (14) , p. 727. 38. Gallavardin, Dufour and Petzetakis: Automatisme ventriculaire intermittent, spontané ou provoqué par la compression oculaire et l'injection d'atropine dans les bradycardies totales , Arch. de mal. du coeur , 1914, vii, 1. 39. Petzetakis : Block auriculo-ventriculaire provoqué par la compression oculaire , Bull. et mém. Soc. méd. d. hôp. de Paris , 1914, No. (14) , p. 739. 40. Petzetakis: L'épreuve paradoxale de l'atropine. Son action ralentissante sur le rhythme cardiaque , Bull. et mém. Soc. méd. hôp. de Paris , 1914, No. (12) , 567. 41. Robinson, G. C., and Draper, G.: Action of Vagus Nerve on Human Heart , Jour. Exper. Med. , 1911, xiv, 217Crossref 42. Studies with the Electrocardiogram on the Action of the Vagus Nerve on the Human Heart , Jour. Exper. Med. , 1912, xv, 14. 43. The protocols have been compiled to report the sex, age, occupation, previous diseases having a possible influence on the cardiovascular system, the state of the pupils at the time of examination, and the clinical diagnosis. 44. Case 14 has been omitted because he began to show signs of early tabes, although the oculocardiac reflex was present. 45. The term non-tabetic is used throughout to include all the cases in the series except those of tabes dorsalis. 46. Case 14, originally included here, has been omitted because he began to show signs which may be those of early tabes, although the oculocardiac reflex was present. 47. Wenckebach, K. F.: Die Unregelmässige Herztátigkeit und ihre klinische Bedeutung , W. Engelmann, Leipzig and Berlin, 1914, p. 172. 48. Von Hoesslin, H.: Beobachtungen über den Einfluss des Vagus auf das menschliche Herz , Deutsch. Arch. f. klin. Med. , 1914, cxiii, 537. 49. Since these observations were made, three cases of diabetes in the medical wards of the Peter Bent Brigham Hospital were investigated. In one case the oculocardiac reflex was absent on two different occasions. In the other two there was a moderate slowing on right ocular pressure, but none on the left. 50. I have included under tabetics Case 7, which is probably a case of early tabo-paresis. 51. The greater slowing seen in the charts of pressures on the left side is only apparent and not real; it depends on the blocking of auricular beats which were slowed less by left than by right sided pressures. Rates, however, are counted from ventricular contractions. 52. Cohn, A. E.: On the Differences in the Effects of Stimulation of the Two Vagus Nerves on Rate and Conduction of the Dog's Heart , Jour. Exper. Med. , 1912, xvi, 732.Crossref
Archives of Internal Medicine – American Medical Association
Published: May 1, 1915
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