Last Resort

Hiccups are no joke when you have been hiccuping for two months--as Anna Mayer had. Shrunk to a starved 82 pounds, she lay convulsed with racking spasms, 60 to the minute. Desperate measures were called for. The surgeon cut into her neck above the collarbone, snipped off an inch and a half of the right phrenic nerve. Like a disconnected electric vibrator, her convulsions slowed, stopped. "When do I eat?" she asked feebly.

Dr. Lester Samuels, chief surgeon of a Veterans Administration hospital in Louisiana, had flown to New York City (by special permission of President Truman, to whom the patient had appealed) to perform this emergency operation. (He had halted an attack, three years ago, by cutting her left phrenic nerve.) The cutting stops uncontrollable hiccups by disconnecting the diaphragm from nervous impulses that cause its convulsions.*

Nerve cutting is a drastic operation, and doctors know they cannot predict all its effects. Like the vagus nerve operation for ulcers, and pre-frontal lobotomy for insanity (TIME, Dec. 23), cutting the phrenic nerves impairs some internal functions, but doctors have observed no serious effects. Their conclusion: nerve cutting is justified as a last resort.

*Hiccups are spasms of the diaphragm resulting from irritation of the phrenic nerves. Causes: swallowing something hot, or any one of a wide variety of diseases. In minor cases, holding the breath, breathing in a paper bag (to get carbon dioxide), sneezing, salt and lemon juice or a teaspoon of whiskey may be effective.

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