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Brought Back to LifeI -

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Brought Back to Life I 1 DARING SURGICAL OPERATIONS I Ðr. T. A. Green, F.R.C.S., surgeon to out- Patients at the Bristol Royal Hospital for Sick Children and Women, tells in "The liajicet" of a remarkable oaee at Bristol, in wtieh the action of the heart was restored by means of maesa-ge after apparent death. The patient was a boy of nine, who was Emitted suffering from a complaint whien Necessitated, operation. Chloroform was admbiistered, and the operation commenced, \vhen, after difficult breathing, respiration ^■ceased. No heart sounds could be heard. Hot towels were applied, and injections of strychnine; but without success. h Then, twenty-five minutes after the heart ad been stopped, Dr. Green decided to aPpiy direct compression to the organ. An IDDening was made sufficient to admit the tight hand, and the heart was felt to be Quite immobile and flaccid. The doctor com- fenced rhythmical compression of the ?rg--in, with his right hand pressing against It., lower surface, and his left hand outside; the rate of compression being about 70 a Minute. This method was continued for about two ftiiuutes without appreciable effect. Then <r. Green grasped The Apex of the Heart I tith,hiz, right hand, and in this manner con- tiiiued the intermittent compression. Soon slight fluttering of the organ was noticed. ■file pupils of the eyes ak-o contracted, and Within a few seconds the heart be.-an to "cat forcibly with more than normal vigour. Meanwhile, artificial reepi ration had been c°atinued all the time; and within a short t-riod of the reao-ration of the pulse sponta- neous ibreathing asserted itself, and gradu- became regular. In ten minutes the bcartand luvigs were performing their -tions normally, although the patient had DOL recovered consciousness. The subsequent history of the case was, b.llÍ() rtWl ,ÜeIy not so satisfactory. Sensi- bility never returned. The patient developed 6fiisms, and early next morning he was found to be obviously sinking, the heart-beat gettin .r feeble. Death took place twenty hours ftiter the heart-beat and respiration had been Established. Another Bristol case was that of a boy of 'hree, who was admitted to the same hospital Buffering1 from diphtheria. The difficulty of breathing passed off without an operation, out ,a.fter a sudden attack of syncope heart- hCièt and respiration ceased. Compression of the heart was commenead by Dr. Green, an in the former case, and after five minutes a elow wave of contraction was felt passing over the organ. At the end of another five iiiiil r. the heart was beating at the rate of 4,3 a minute, a tld the ears and lips, which had been livid, had resumed their Ruddy Appearance br. Green, however, was unable in this case Jo restore spontaneous breathing, and the heart itself stopped pulsating half an hour Further massage made it contract several tirnes. but after a few more attempts efforts Wtre reluctantly give-n up, one hour and a half after the mat-sage had been commenced, ^nd on3 hour and three-quartera qfter the eb:ld had died. Dr. Green was led to try these measures through having seen them adopted by Mr. C. 13, Kcetey in a case at the West London Hos- pital in the summer of 1903. That case, which has not before been Published, was that of a man in Middle life. Chloroform was employed fúr the operation, and before the patient "'as completely under it his breathing £ nd puls:) stopped. The usual methods for ^'vsioration were adoptad without avail, and tlio end of three-quarters of an hour Mr. "'■ctley made en opening and compressed the rt in 'the manner described by Dr. Green 111 bis first case. The iesults, however, were Negative. In giving Dr. Green permission to 'lke use of this case Mr. K-eetlerv wrote: — I have had another case like it since, in J* ii ich we endeavo jjed to restore circulation bv opening the abdomen and pressing the .'cart through the diaphram, but unsuccess- '"lb-

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