The relief of cardiac enlargement by surgical measures / by G. A. Gibson.

Date:
1910
Catalogue details

Licence: In copyright

Credit: The relief of cardiac enlargement by surgical measures / by G. A. Gibson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    showed chronic venous stasis, while the liver, spleen, and kidneys also showed venous congestion. The facts which have been described are of no value in attempting to form an estimate of the benefits to be derived from operation in more favourable cases; as has, however, been already remarked, every instance, whether satisfactory or other- wise, ought to be narrated in the case of new methods. Some further experiences of mine in this direction will shortly be published. An attempt to relieve a labouring heart by thoracostomy was originally suggested, as far as consists with my knowledge, by klorison^ in 1897. It was first carried out, however, for Brauer^ by Petersen and Simon. Since the date of the three operations described by Brauer, Wenckebach ^ has published details of a case performed by Koch, and this was followed by one carried out for ]\Iorison‘‘ by Stabb. It is too soon yet to discuss the results of these operations, but in some of the cases great relief followed the procedure adopted. From the point of view of diagnosis, it is interesting to observe that there may be absolute fixation of the heart with- out adherent pericardium in the ordinary sense of adhesions between the epicardium and pericardium. The extra-pericardial adhesions present in this case must certainly be somewhat un- common, except in association with pleural adhesions, and, as nothing of the kind was present, it is impossible to account for the origin of the strong fibrous connections. The indrawing during systole of the epigastrium, and of the region above and 1 around the apex, but not of the apex itself, was suspicious but I not pathogpomonic of adherent pericardium ; and the absence ' of any diastolie rebound, as well as of any diastolic collapse of the veins, prevented the positive diagnosis of such a condition. References.—* On Cardiac Failure and its Treatment, London, 1897, p. 89. Archiv. fur Min. Chir., 1903, Bd. Ixxl S. 258 ; Verhandl. dei' deutsch. Gesellsch. Jur Chir., 1903, Bd. x.x.xii. >S. 133 ; Verhajidl. des XXL Congresses fur innere -Medizin, 1904, S. 187. ^ Brit. Med. Journ., 1907, vol. i. p. 63. * Lancet, 1908, vol. ii. p. 7.