Injuries of the Heart

Injuries of the heart are usually considered so little amenable to surgical interference that they receive but little attention in surgical literature.It is believed that a further advance may at some future time include this organ in the number of those subject to surgical ac¬ tion.In order to increase the amount of the available data bearing upon this subject, the following recent cases are presented without other remarks than may have been made by the operators.Case I. Perforating Stab Wound of the Heart; Recovery-A Caucasian Cosack, in a drunken fight with a comrade, was stabbed in his chest with a dagger, the accident taking place on the street, close to Dr. Kravkoff's lodgings.Having instantly arrived at the spot, the author found the man lying on the ground in a formidable pool of blood, deadly pale, in an insensible state, with stertorous breathing.He was still profusely bleeding from a clean-cut transverse wound, iJ/2 inch long, situated in the left 4th intercostal space, 1 cm.above the nipple, on the mammillary line.The haemorrhage was at once stopped by means of a compressing bandage.Under the influence of analeptics, the man soon recovered his senses, and could be, without delay, car¬ ried to a casualty station.■ On a closer examination on the next morn¬ ing the cardiac dulness proved to be considerably enlarged both verti¬ cally (reaching upward to the 4th and downward to the 7th rib) and hori¬ zontally (from the right parasternal line to a point i1/, finger's breadth outside of the mammillary line).When the patient lay on his back, the cardiac dulness became narrowed; when on his right side, the left border of the dulness receded toward the right, and when on his left 'Dr.