PAR VAGUM. 
appearance of this swelling depends upon fat 
globules placed in the intervals of the plexus. 
At the lower part of this gangliform enlarge- 
ment the nerve becomes smaller, rounder, 
firmer, and of a whiter colour.* This inferior 
or second ganglion of the vagus has been long 
known. Fallopius+ speaks of an oblong olivary 
swelling on the vagus soon after its exit from 
the cranium. Willis t has described it in the 
following words : “nervi truncus, ibidem major 
factus, in tumorem quemdam corpori calloso, 
seu ganglio similem, attolli atque excrescere 
videtur,” and in fig. ix. he has delineated it 
under the name of “ plexus gangliformis paris 
vagi.” Vieussens§ also describes and figures 
it, and terms it “ plexus gangliformis cervica- 
lis nervi octavi paris.” Winslow]|| describes it 
as “une espece de ganglion.” “It has also 
been described by Prochaska, {| Wutzer, Scarpa, 
Bellingeri, &c. Some have considered it to be a 
true ganglion, others only a plexus. Some re- 
strict the term of inferior ganglion to that por- 
tion of the enlargement of the nerve immediately 
below the origin of the superior laryngeal nerve, 
and have described it as being placed upon the 
internal fibres only, so that, according to this 
view, some of the external fibres of the vagus 
and the strengthening fibres of the spinal ac- 
cessory do not pass through it. 
The vagus in its passage down the neck gives 
off pharyngeal, laryngeal, esophageal, cardiac, 
and vascular branches. 
Superior pharyngeal branch (ramus pharyn- 
eus seu primus n. v.)—This is by much the 
argest and most important pharyngeal branch 
of the vagus, and is frequently designated, par 
excellence, the pharyngeal branch of the vagus. 
It arises from the anterior surface of the vagus 
shortly after its exit from the foramen lacerum, 
and opposite the upper part of the atlas, and 
is evidently formed by fibres, partly from the 
internal branch of the accessory, and partly 
from the vagus. Generally the greater part of its 
filaments, occasionally nearly the whole, appear 
to come from the accessory. It passes inwards 
and a little downwards across the anterior sur- 
face of the internal carotid artery, to which it 
is generally pretty closely connected by cellular 
tissue, and lies a little inferior to the glosso- 
pharyngea Inerve.** Immediately after crossing 
the internal carotid, it passes over the ascend- 
ing pharyngeal artery, and after a short course 
* Oper. cit. S. 484. 
+ Opera omnia, p. 407. Francof. 1600. 
¢ Cerebri Anatome, p. 226. 1666. 
§ Neurographia Universalis, P 118, and pl. xxiii. 
Edit. Novissima. Lugduni, 1716 
{| Exposition Anatomique de la Structure du 
Corps Humain, tom. iii. p.237. Paris, 1732. 
¥ De Structura Nervorum, 1779. 
_ ** Cruveilhier (Anatomie Descriptive, tom. iv. 
p- 958, 1836,) describes the pharyngeal branch as 
passing behind (derriére) and not in front of the 
internal carotid. Cloquet (Traité d’Anatomie De- 
scriptive, 2de partie, p. 620,) also described it as 
passing behind the internal carotid. No doubt this 
nerve may occasionally pass behind the artery, and 
similar varieties are to be found in the course of 
all nerves ; but it is equally certain that its usual 
course is in front of the artery, and this inaccuracy 
must have occurred through some inadvertency. 
885 
it reaches the surface of the middle constrictor 
muscle of the pharynx. As it is crossing the 
carotid it is-generally joined by one, two, or 
three small branches descending from the glosso- 
pharyngeal, and at the point of their junction 
a small plexus or ganglion is formed on the 
pharyngeal. (Vide article Giosso-Puaryn- 
GEAL Nerve.) At this point the pharyngeal 
generally divides into several branches.* ‘Two 
of these are considerably larger than the others, 
and one of them passes inwards and upwards, 
and the other inwards and downwards over the 
lateral surface of the pharynx; while the smaller 
branches, two or more in number, pass upon 
the surface of the internal carotid and neigh- 
bouring bloodvessels, especially the arteria 
pharyngea ascendens, to assist in forming the 
nervous plexuses surrounding them. The two 
larger branches which pass upon the surface of 
the pharynx are soon joined by branches from 
the superior ganglion of the sympathetic. The 
upper branch passes over the superior pharyn- 
geal constrictor to its upper edge, sending 
filaments to that muscle, to the elevator palati, » 
the palato-pharyngeus, the azygos uvule, and 
also to the stylo-pharyngeus, and anasto- 
moses freely with the pharyngeal and tonsillitic 
branches of the glosso-pharyngeal nerve and 
twigs of the sympathetic coming from its 
superior cervical ganglion. The lower runs 
downwards over the surface of the middle and 
inferior constrictors, distributes twigs to these 
muscles, and anastomoses with the inferior 
pharyngeal branch of the vagus, the pharyngeal 
branches of the superior laryngeal, and with 
some filaments of the sympathetic. 
Inferior pharyngeal branch (ramus pharyn- 
geus inferior ).—This branch arises a very little 
below the last, and runs parallel to it and across 
the anterior surface of the internal carotid. It 
is joined by a considerable branch from the 
superior ganglion of the sympathetic, which 
generally forms an arch with it around the 
ascending pharyngeal artery. It soon divides 
itself into different branches, which are distri- 
buted upon the lower part of the middle con- 
strictor muscle, and over the whole of the 
inferior constrictor, and anastomoses with the 
twigs of the other nerves found on the surface 
of these muscles. 
Valentin describes under the name of middle 
pharyngeal nerves (rami pharyngei medii seu 
tenwores n.v.) some small filaments arising 
from the anterior surface of the vagus imme- 
diately below the superior pharyngeal, and 
which pass forwards to join the pharyngeal 
branches of the glosso-pharyngeal. The free 
anastomosis of the nerves we have mentioned, 
viz. the glosso-pharyngeal and sympathetic, with 
the numerous subdivisions of the pharyngeal 
branches of the vagus, intermixed with a few 
twigs from the superior laryngeal, and also ° 
with some small filaments from the upper part 
of the cervical plexus of nerves, and an occa- 
sional twig from the hypo-glossal, form an 
elongated and intricate plexus (plexus pharyn- 
* Wrisberg (De Nervis Pharyngis, Ludwig’s 
Script. Min. Nerv. Sel. tom. iii. p. 58) describes five 
branches radiating from the ganglion pharyngeum. 
