File:Text-book of operative surgery (1911) (14740574826).jpg

Identifier: textbookofoperat01koch (find matches)
Title: Text-book of operative surgery
Year: 1911 (1910s)
Authors: Kocher, Theodor, 1841-1917
Subjects: Surgical Procedures, Operative Surgery, Operative
Publisher: New York : Macmillan Company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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(hgemothorax). If these complications are present the pulse is almost insensible, thecardiac region is dull, and when there is an associated injury to the lung the heartfiaction makes a gurgling noise which naturally renders the diagnosis much easier. Watson, Senn, Begouin, Brühl, and others have proved the efficiency ofcardiocentesis in animals in cases of entrance of air into the veins, and thence into theright side of the heart, and in cases where the right side of the heart was over-distended with blood. The procedure has also been employed in the human subject. 6ö OPERATIVE SURGERY 5. Finally, it must be borne in mind by tlie resident physicians who generally seetbese cases first, that in rupture of the beart secondary to diseases of the arteries, tbepatient does not die inimecliately, but may live for twenty-four hours or more. Evenin these cases, tberefore, it is justifiable to attempt to relieve the pressure on theheart (herztamponade), and even to suture the ruptured organ.
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Fig. 27.—Conibination of figiires froin Spalteliolz and Merkels Anatomy, showüig the outlines of the-heart (red line), luugs (thiek dotted red liues), aud the plturte (thin dotted red lines).The diaphragra is outlined in black. In addition to the treatment of pericarditis, cardiac injuries and foreign bodies inthe heart, cardiac surgery has developed in three other directions, namely—cardiacmassage, cardiocentesis, and cardiolysis. In considering the treatment of collapse under Chloroform, exposure and massageof the heart have been recomniended as important measures. Tuffier has exposedand massaged the heart in animals in which cardiac paralysis had been produced by SURGERY OF THE HE ART AND PERICARDIUM 89 means of an anaesthetic, and also in a case of syncope from embolus while Rotterrefers to Kiüiabkos and Maags experiments on animals. Sick succeeded in resuscitat-ing a case by means of cardiac massage when there had been complete coUapse for theSpace of an hour (Helfreichs cl

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