Relation of the Carotid Sinus to the Autonomic Nervous System and the Neuroses

Since the pioneer work of Hering¹in 1926 a mass of experimental data has accumulated concerning the function of the carotid sinus in animals. The significance of the carotid sinus mechanism in man, particularly as regards certain abnormal bodily states, has, however, not been duly appreciated in the United States until recently. One of us (S. W.) and Baker²reported the cases of a series of fifteen patients, all of whom complained of attacks of unconsciousness, with or without convulsions, which were caused by a hypersensitive carotid sinus reflex. In a recent publication we³reported studies of thirty-two additional patients suffering from syncopal attacks of carotid sinus origin. This syndrome is reflex in nature, and the reflex pathways are parts of the autonomic nervous system. In other reports⁴we presented evidence of the nature of other types of reflex syncope, such as vasovagal, vagovagal and oculocardiac