The Thorax 131 



Vecchio succeeded in saving a dog which had sustained two ex- 

 perimental perforating wounds of the left ventricle and subsequent 

 suturing of the same, and since then, Salomoni, Philippov, and the 

 other experimenters previously mentioned have determined the feasi- 

 bility and usefulness of suture of the heart and pericardium with vari- 

 ous results. More recently Tuffier and Hallion have made a very in- 

 teresting demonstration. They ane^thetised a dog until respiration 

 and cardiac pulsation had ceased. After a minute's waiting, with 

 no sign of return of life, they incised the sixth intercostal space 

 and forced the ribs apart. The heart was seen to be perfectly still. 

 It was then seized between the fingers in such a manner that the 

 apex lay in the palm of the hand, while the ventricles were encircled 

 by the fingers. The next step was massage of the organ by com- 

 pression. For a period of one minute it remained motionless; 

 then very feeble intermittent contractions were apparent. It pro- 

 pressively recovered its functions and respiratory efforts recom- 

 menced. The thorax was closed, and the animal eventually re- 

 covered. 



As has been pointed out under Traumatic Lesions of the Lungs, 

 it is impossible to open the pleural cavity to any extent without re- 

 sorting to artificial respiration, and for the same reason provision 

 cannot be made for drainage, and since it is rare to accomplish 

 surgical interference with this part of the organism without the 

 introduction of pathogenic microorganisms, in spite of the utmost 

 care, the usual termination is a lethal one from septic infection. 

 However, there have been several recoveries from experimental 

 wounding and opening of the pleura and pericardium, and a clinic 

 case has been recorded by Delafond in which the pericardium 

 having been perforated by a wild-boar, the wound in the thorax 

 was closed with sutures, and in eight days the animal recovered, 



SUTURE OF THE HEART. 



The technic of this extremely delicate operation is as follows: 

 Every aseptic precaution being observed and the animal being 

 secured and anesthetised, the first step is to perform tracheotomy, 

 insert a tube in the trachea and connect the same with bellows, 

 which must be entrusted to the hands of a capable assistant, whose 

 whole attention must be bestowed on this important part of the 

 operation. A free longitudinal incision is made on the left side 



