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Galen · The Anatomy of the Nerves §10

The Sixth Cranial Pair and Recurrent Nerves to the Larynx

Passage 4 of 7 · Greek

Summary

Galen discusses the course and laryngeal distribution of the sixth pairing of cranial nerves (including the vagus), emphasizing his discovery of the recurrent laryngeal nerve, while pointing out the errors of previous anatomists.

§10Οἵ γε μὴν κοινοὶ πρὸς ἄλλα μόρια τοῦ λάρυγγος μύες οὐ διὰ παντὸς ἀπὸ τῆς ς΄ συζυγίας λαμβάνουσι νεῦρα, καθάπερ οὐδὲ οἱ τὸ λαμβδοειδές τε καὶ ὑοειδὲς ὀστοῦν ὀνομαζόμενον τῷ στέρνῳ συνάπτοντες·
However, the muscles common to other parts of the larynx do not always receive nerves from the sixth pairing, just as those connecting the bone called lambdoid and hyoid to the sternum do not either.
ὑπὲρ ὧν ἀκριβοῦται μὲν ἐν ταῖς ἀνατομικαῖς ἐγχειρήσεσιν, ἐν αἷς καὶ περὶ τῶν τριῶν λέγεται νεύρων τῆς νομῆς, τῶν διὰ τοῦ τρήματος, ὃ κατὰ τὸ τέλος ἐστὶ τῆς λαμβδοειδοῦς ῥαφῆς, εἰρημένων ἐκφύεσθαι, καίτοι γε ἑκάτερον ὀλίγου δεῖν ἅπαντες ἓν εἶναι νομίζουσιν, ὃ παραπεφυκὸς ταῖς καρωτίσιν ἀρτηρίαις εἰ βρόχῳ διαλαμβάνομεν, τὸ ζῶον αὐτίκα ἄφωνον γίνεται.
Concerning these, details are precisely given in *Anatomical Procedures*, in which there is also talk about the distribution of the three nerves said to arise through the foramen which is at the end of the lambdoid suture, although almost everyone considers each of them to be one, which, growing alongside the carotid arteries, if we constrict it with a ligature, the animal immediately becomes voiceless.
παρὰ τούτων μὲν οὖν καὶ οἱ τοῦ λάρυγγος μύες ἀποβλαστήματα λαμβάνουσιν.
From these, then, the muscles of the larynx also receive offshoots.
τῶν δὲ ἄλλων δυοῖν τὸ μὲν εἰς ἑκατέρους τοῦ φάρυγγος μῦς καὶ τῆς γλώττης τὴν ῥίζαν ἀφικνεῖται, τὸ δὲ ἐπί τε τὸν τῆς ὠμοπλάτης μῦν καὶ τὸν πλατὺν καί τινας ἄλλους τῶν τῇδε.
Of the other two, one arrives at each of the muscles of the pharynx and the root of the tongue, and the other at the muscle of the shoulder blade, the flat one, and some others of those in this region.
λελήθασι δ’ αὐτοὺς καὶ τῶν παραφυομένων ταῖς ἀρτηρίαις οὐκ ὀλίγαι τῶν ἀποφύσεων, ἃς διά τε τοῦ τραχήλου καὶ τοῦ θώρακος φερόμενα ποιεῖται, πρὶν ἐμπίπτειν τῷ σώματι τῆς γαστρὸς, εἰς ὅπερ ἡ πλείστη μοῖρα καταφύεταί τε καὶ διασπείρεται τῶν νεύρων τούτων.
And they have also overlooked not a few of the offshoots of those growing alongside the arteries, which they make while being carried through the neck and the thorax, before falling into the body of the stomach, into which indeed the greatest part of these nerves descends and is dispersed.
ἀλλ’ ἐκεῖνο θαυμαστὸν, ὅτι ταῖς μὲν φρεσὶν ἐξ αὐτῶν τινα λέγουσιν ἀπονέμεσθαι μόρια, μηδ’ ὅλως λαμβανουσῶν τῶν φρενῶν ἐκ ταύτης τῆς συζυγίας μηδὲ τὸ σμικρότατον· ὅτι δ’ ἐκ μέσου τοῦ θώρακος ἀνάπαλιν ἥκει τινὰ μόρια ἐκ τούτων τῶν νεύρων ἐπί τινας τοῦ λάρυγγος μῦς, οὐκ ἔτι λέγουσιν, οὐδ’ ἥντινα δύναμιν ἔχουσιν ταῦτα.
But that is marvelous, that they say certain parts from them are distributed to the diaphragm, although the diaphragm receives not even the slightest part at all from this pairing; but that from the middle of the thorax certain parts from these nerves come back to some muscles of the larynx, they no longer say, nor what power these have.
καί τοι τοιαῦτα τῆς ἀφωνίας ἐστὶν αἴτια τοῖς ζώοις βλαβέντα, καὶ ἡ μεγάλη συζυγία τῶν παρὰ τῆς ἀρτηρίας νεύρων, ὅτι ταῦτά ἐστιν αὐτῶν μόρια, τὴν φωνὴν ἀναιρεῖν πέφυκεν, εἰ βλαβείη.
And indeed, such things are causes of loss of voice for animals when damaged, and the great pairing of nerves alongside the artery, because these are parts of them, is of a nature to destroy the voice if damaged.
ποικίλη δὲ καὶ ἡ μετὰ τὰς φρένας νομὴ τῶν νεύρων τούτων.
Diverse also is the distribution of these nerves after the diaphragm.
καὶ γὰρ παρὰ τοῦ κατὰ τοῦτο τὸ μέρος νωτιαίου λαμβάνει τινὰ μόρια, καὶ διασπείρει πρὸς τὰ ταύτης σπλάγχνα, καὶ τοῖς εἰρημένοις ἔμπροσθεν ἀπὸ τῆς τρίτης συζυγίας καταφέρεσθαι διά τε τοῦ τραχήλου καὶ τοῦ θώρακος ἀναμίγνυται.
For indeed it receives certain parts from the spinal cord at this region, and disperses them to the viscera of this part, and mixes with those mentioned before as being carried down from the third pairing through the neck and the thorax.
καίτοι γε ἅπαντες αὐτὰ πάλιν ταῦτα τὰ παρὰ τὰς ῥίζας τῶν πλευρῶν καταφερόμενα τῆς ἕκτης συζυγίας ἀποβλαστήματα εἶναι δοκοῦσιν.
And yet, everyone again thinks these very things carried down alongside the roots of the ribs are offshoots of the sixth pairing.
ποικίλη δὲ καὶ ἡ τούτων ἐπιμιξία πρός τε τὰ τῶν μεσοπλευρίων νεῦρα καὶ τὰ κατ’ ὀσφὺν σχεδὸν ἅπαντα τὰ σμικρὰ καὶ τὸ λείψανον τῶν ἐπὶ τὸ στόμα τῆς κοιλίας ἐλθόντων.
Diverse also is their mixture both with the intercostal nerves and almost all the small ones at the loins, and the remnant of those that went to the mouth of the stomach.
ποικίλη δὲ νομὴ καὶ κατὰ τὴν ἐκτὸς τοῦ περιτοναίου χώραν, ἣν οὐ πρόκειται νῦν εἰς ἐσχάτην ἀκρίβειαν ἐξηγήσασθαι.
Diverse also is the distribution in the region outside the peritoneum, which it is not the present purpose to explain to the utmost accuracy.
ἀλλὰ μὴν ἱκανῶς ἐστιν οὐκ ἀγνοεῖν, ὅτι εἰς τὸ ἧπάρ τε καὶ τὸν σπλῆνα καὶ τοὺς νεφροὺς, ἔτι δὲ πρὸ τούτων εἰς ὅλην τὴν γαστέρα καὶ πάντα τὰ σπλάγχνα τὰ ἐξ ἐγκεφάλου νεῦρα ταύτῃ μὲν ἀπὸ τῆς τρίτης, ὡς εἴρηται, συζυγίας, ταύτῃ δὲ τῆς ἕκτης ἀφικνούμενα φαίνεται.
But indeed, it is sufficient not to be ignorant that to the liver, the spleen, and the kidneys, and even before these to the whole stomach and all the viscera, the nerves from the brain appear arriving, here from the third pairing, as was said, and there from the sixth.
ὅτι δὲ καὶ ὁ πνεύμων τε καὶ ἡ καρδία ἀπὸ τῆς ἕκτης συζυγίας τινὰ τῶν νεύρων μοῖραν ἐν τῷ τραχήλῳ λαμβάνουσιν, ἅπαντες μὲν δὴ ἐγνώρισαν.
And that both the lung and the heart receive some portion of the nerves from the sixth pairing in the neck, everyone indeed has recognized.
ἀλλὰ μὴν περὶ νεύρων τῶν ἀπ’ ἐγκεφάλου ἐπιφυομένων ταῦτα τοῖς εἰσαγομένοις ἐξαρκεῖ.
But indeed, concerning the nerves arising from the brain, these things are sufficient for those being introduced.
περὶ δὲ τῶν ἀπὸ τοῦ νωτιαίου ἀφικνουμένων ἐφεξῆς λεκτέον, ἐν οἷς οἱ πάντες ἀνατομικοὶ ἥμαρτον.
Next, we must speak about those arriving from the spinal cord, in which all anatomists have erred.
τὰς δὲ τῶν σφαλμάτων αἰτίας νῦν μὴ καιρός ἐστι διεξέρχεσθαι, ἐπειδὴ αὐτὰς ἤδη ἐν ταῖς ἀνατομικαῖς ἐγχειρήσεσιν ἐξηγησάμην.
The causes of the errors it is not now the time to go through, since I have already explained them in *Anatomical Procedures*.
ἀλλ’ ὅμως τῶν παλαιῶν μεμνῆσθαι διὰ τοῦτο ἀναγκάζομαι, ὅτι γ’ ἐκείνοις τοῖς αὐτῶν βιβλία μὲν ἀναγιγνώσκουσιν, ἀλλὰ μὴ μετ’ ἐμοῦ τὰ διὰ τῶν ἀνατομῶν φαινόμενα εἰσορῶσιν ἄδηλον εἶναι δόξει, πότερον ἅπαντες ἐκεῖνοι ἢ μόνος ἐγὼ ἥμαρτον.
But nevertheless, I am forced to mention the ancients for this reason, that indeed to those who read their books, but do not look with me at the phenomena shown through dissections, it will seem unclear whether all of those or I alone have erred.

Notes

  1. 245ἑκάτερον — 'ἑκάτερον' (each of the two sides) refers to the bundle on each side consisting of what Galen classified as the sixth pairing (including the vagus, accessory, and glossopharyngeal nerves). Galen criticizes earlier anatomists who, failing to distinguish these components, regarded the bundle on each side as a single nerve.
  2. p.842ἀνάπαλιν ἥκει — The phrase 'ἀνάπαλιν ἥκει' (comes back in reverse) explicitly describes the path of the recurrent laryngeal nerve, which was discovered and detailed by Galen. It refers to the anatomical characteristic where the nerve branches off from the vagus nerve in the thorax, loops back (recurs), and ascends to innervate the muscles of the larynx.
  3. p.843ἱκανῶς ἐστιν οὐκ ἀγνοεῖν — The impersonal construction 'ἱκανῶς ἐστιν' (it is sufficient) is followed by the negated infinitive 'οὐκ ἀγνοεῖν' (not to be ignorant, i.e., to know well), forming a double negation that serves as an emphatic expression meaning 'it is highly necessary to know well' or 'it is sufficient to be fully aware of.'

Cite this passage

Galen, The Anatomy of the Nerves §10. Humanitext Reader, https://reader.humanitext.ai/en/text/urn:cts:greekLit:tlg0057.tlg014.humanitext-grc1:10

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