Recent surgical progress : a result chiefly of experimental research / by W.W. Keen.

  • William Williams Keen
Date:
1911
Catalogue details

Licence: In copyright

Credit: Recent surgical progress : a result chiefly of experimental research / by W.W. Keen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    by Rehn’s famous paper recording the first successful case. How quickly surgeons followed this happy lead is seen by the statistics given me by Dr. Francis T. Stewart (who himself has had a successful case), that up to June, 1908, 141 cases of wound of the heart had been operated on, and sixty-four of them had recovered. When one considers the difficulties of such an operation, the speed with which the heart must be exposed by making a trap-door through the chest wall, and divid- ing two or three ribs, without, if possible, injuring the left lung by opening the sac in which the heart lies (the pericardium), clearing it of blood, seizing the heart, tiiid while it is actively pulsating, with a jet of blood from the wound at every pulsation obscuring the field of operation—when one considers these difficulties, and yet DOtes that over 45 per cent, have recovered, and that this percentage of recoveries is steadily increasing, it is a matter of both surprise and gratification. In a good many operations, when chloroform and even sometimes when ether is given, the patient sud- denly passes into collapse, the heart ceases to beat, the respiration stops a few minutes afterward, and death quickly follows. Whether the pulsation of the heart could be re-established was first investigated by Schiff m 1874, and in animals, by means of rhythmical compres- sion of the heart by the hand, he succeeded in start- ing the heart beating. It is impossible for me to state in detail the experiments of Pruss in 1889 and Battelli in 1900, both of whom were able in a considerable number'of animals and by various methods to re- establish cardiac pulsation. The most extraordinary experiments, however, were made by Kuliabko in 1902- on hearts which had been removed from the body; all prior experiments having been made on hearts remaining in the body of the animal. Kuliabko showed