THREE MINUTES DEAD.

Western Star, 10 September 1918, Page 4

THREE MINUTES DEAD.

' THEN BROUGHT TO LIFE. HEART MASSAGE OPERATION IN AUCKLAND. The current issue of the “ New Zealand Medical Journal” includes an article by Dr Garrick Robertson, of Auckland, illustrating the efficicacy of heart massage in oases, of apparent death under an anaesthetic. The account iiS of extraordinary interest, in that the man in the case had been dead at least three, and probably five, minutes. This is what Dr Robertson says:— “ A sailor came to the Auckland Hospital with ai septic thumb. He was seen in the casualty department, when' it was decided that the thumb should be opened under a general .anaesthetic. The man was apparently in good'health. The anaesthetic was proceeded with, and when the man was ‘ under ’ the house surgeon incised the abscess. As soon asi he had done tins he noticed that no bleeding took place from the incision; this was the first intimation he had) that the man’si heart had stopped. It was then discovered that there was no radial pulse- and the respirations were dying ; away. Artificial respiration was immediately started, and, as -I happened to he in the hospital at the time, I was sent ‘for. On my arrival in the casualty room the man was quite white and there were no heart sounds. Artificial respiration was going on, but there was no attempt at voluntary respiration. The man seemed quite dead, so 1 quickly put iodine on the skin and unjade an incision in the upper right rectus region. Introducing my hand through this incision, I was able to l grasp the heart firmly in my hand, for the diaphragm! was sc flaccid that this wais quit© easy. I then waited for a few seconds to see if there was any muscular movement in the heart, but could feel none, so 1 squeezed the heart between the hand and the ribs several times, whereupon it gave a, distinct hut feeble kick, followed by slow and feeble con tractions, which soon became bounding and rapid. At this time the'appearance of the man was quite alarming, for owing to the excessive pulsations in all the arteries of the body ho almost seemed to lift off the couch with each beat. We were afraid that there must he clots in the smaller vessels which required this excessive driving force to push, them along. However, as events showed no embolism or thrombosis took place, the wound waisi sewn up, and the man put to bed. On recovery he became maniacal, and had to be put in the restraining sheet. He remained in this excited state for 12 hours; after this he became quietenedl down, hut was quite childish for another day. In two days time he was quite normal, hub could not remember coming to the hospital or anything that had happened for two days afterwards. “ I have had several cases erf heart massage during the last year or two, but I have never seen so- striking an example of its saving powers! The ' interest of this case lies particularly in the fact that ait the lowest calculation this man must have been dead for three minutes, probably five. His mental symptoms I put down to an oedema of the brain supervening on the stasis of the circulation. I think it was only because 1 lie was a comparatively young man (34 years) that I he did ’ not burst a. cerebral bloodvessel during the first five niinutes after the heart started to heat again, for I feel sure that no arteries at all senile in type could have withstood such excessive heart action. “ The first case of heart massage

which I tried was upon a man on whom I was operating for appendicitis. His heart stopped after I had made the 'appendix incision, and 'as I could not reach the heart from ■ this incision another was mode, below the costal margin as related in• the above case. This man did, well, but, of, course, the result wins not so striking, for a. very little time elapsed, between Jus heart stopping and the mussa.gei-which restarted it. In a third case, in which this manoeuvre was tried I am sorry to s'ay it wins unsuccessful. “Although heart massage- is fairly well known as a possible procedure, I have not heard any personal reports of such cases, so I venture to think the record of these oaises may be of interest to the profession in Now Zealand. It will be seen that heart massage adds another efficient method of dealing with cases of sudden collapse on the operating Ruble. With the experiences recorded above, I am firmly convinced that when the surgeon is sure that the heart lias stopped Ihere should be no excuse for not applying, this procedure;,- but I should like, to emphasise the fact that this should only be done after the. failure to restore animation with the usual restoratives, and, judging from; the first case, it would seem -that there is no great hurry, for the heart will respond after a- comparatively long latent period.”