Evening star., 1901-04-22

Patient Survived the Operation anti
May Wholly Recover.

A dispatch to the New York Herald from
st. Louis Mo. Sunday. SAYS:
Though his heart. according to A phySi-
clan. was wounded by a dagger. and three
stitches Were sewn in the most delicate
vital organ of the body. Philip Gum,
twenty-five years old. is still alive, and
there is hope for his recovery.
The wound was stitched last night by
Dr. II. l.. Nietert, superintendent of the
City Hospital. remarkable thing in con-
nection with the operation was the fact
that Gum recovered from the anaesthetic
wnile has heart was exposed to the air, and
talked to the doctor while he was stitching
away.
DR.. Nieterts today gave this explanation
of the case: Philip Gum was brought to
the City Hospital in a semi-conscious con-
dition about O'Clock last night. He be-
came unconscious subsequently. 1t was
found that a stab wound three-quarterS OF
an inch in length. situated to the right of
the breast bone and on a level with the
fifth rib had been inflicted. Examination
of the heart showed that it pulsated very
feebly
The radical artery and carotid We're
pulseless. The patient was very pale and
there was every indication of an internal
hemorrhage. Further examination showed
that the dagger passed directly into the
heart. and its bleeding occurred from that
organ. / immediately concluded to oper-
ate.
"Incisions were made and the heart was
exposed for the operation. The patient
ceased to breathe several times. SO that it
was necessary to resort to artificial respi-
ration and stimulation. This irregular
breathing continued until the pericardium
was opened and the restriction of the heart
relieved by the removal of the clot of blood
from the pericardium.
The heart then began to act very pow
erfully and the pulses from the various
arteries could easily be dscerned. The
hearts action was free and it was noticed
that the right ventrce had been pierced.
penetrating iucised wound about one
third of an inch in length was found
Bleeding from the heart at this time was
quite rapid. and the patient lost consid-
erable blood
a part of saline solution was introduced in
the veins to replace the lost blood. The
sutures We're applied, three being neces-
sary to secure the wound The pericar-
dunn and the external wounds were then
closed. The operation was performed in
about twenty-five minutes.
In the ma ajority of the cases death re-
suits before the surgeon has time to oper-
ate. Ny theory for death not resulting
Immediately in this is on account of
the obliquity of the incison into the right
ventricle of the heart. The blood. as is
we'll known. is forced from the right Nen-
tricle into the lungs.
Il noticed that the blood flowed from the
wound when the ventricle was diStended to
receive the blood from the auricle more
than when contracted to force the blood
into the lungs | therefore believe that the
wound was made when the ventriCe was
distended. and for that reason partially
closed when it contracted.
Had the wound been made when the
ventricle was contracted ii would not have
closed at any time during the heart beat,
and the blood would have beeu forced out
instead of into the lungs, and death would
have been instantaneous. | can recall but
three or four cases of a similar kind in
medical history