THREE MINUTES DEAD

Dominion, Volume 11, Issue 292, 29 August 1918, Page 6

THREE MINUTES DEAD

THEN BROUGHT TO LIFE

HEART MASSAGE OPERATION

IN AUCKLAND

(By Dr. Carrick Robertson, in "The Medical Journal.") The current issue of the "New Zealand Medical Journal" includes an article by Dr. Carrick Robertson, of Auckland, illustrating the efficacy of heart massage in cases of apparent death under an annesthetic. The account is of extraordinary interest, in that the man in the case liad been dead at least three, and probably five, minutes. This is what Dr. Robertson says:—■

"A sailor came to the Auckland Hospital with a septic tlnimb. 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 bouse surgeon incised tbe abscess. As soon as he had done this he noticed that no bleeding took place from the incision; this was the first !*iimation he had that tbe man's heart had stopped. It tlien discovered that 'there was no radial puke and the respirations were dying away. Artificial respiration was immediately- started, and, as I happened to bo in the hospital at the time, I' was sent for. . On my arrival in the casualty room tho 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 seamed quite dead, so I quickly put iodine on the skin and made an incision in the upper right rectus region. Introducing m.v hand through this incision, I was able to grasp tho heart firmly in my hand, for the diaphragm was so flaccid that this was quite easy. 1 then waited for a few seconds to see if there was any muscular movement in the hoart, nut could feel none, so 1 squeezed the heart between the hand and tho ribs" several times, whereupon it gave a distinct But feeble kick, followed by slow and feeble contractions, 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, lie almost seemed to lift off the couch with each beat. We were afraid that there must be clots in "the smaller vessels (vliich required this excessive driving force to push them along. However, as events showed no embolism or thrombosis took place, the wound was sewn up and'the man put to'bed. On recovery he became maniacal and had to be put in a restraining-slieet. He remained in this excited state for twelve hours; after this he quietened down, but was quite childish for another day. In two days' time he was quite normal, but could not remember coming to the hospital or anything that had happened for two days afterwards.

"I havo had several cases of 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 at the lowest calculation this man must havo been dead for three minutes, probably live. 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 he was a comparatively'' young man (34 years) that he did not burst a cerebral blood vessel during the first five minutes after the heart started to beat _ 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 niassago which I tried was upon a man on whom I was operating for appendicitis. Ilis heart stopped after 1 had made tho appendix incision, and as 1 could not reach the heart from this incision another was made below the costal margin as related in the above case. This man did well, b.nt, of course, the result was not,so striking, for a very little time elapsed between his heart stojtping and the massage which restarted it. In a third case in which this manoeuvre was tried I am sorry to say it was 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 cases may be of interest to tho profession in New Zealand. It will be seen that heart massage adds another, efficient method of dealing with cases of sudden oollaps,o on the operating table. With the experiences recorded abovo I am firmly convinced that when the surgeon is sure that the heart has stopped there should be no excuse for not applying this procedure; but I should like to emphasise the fact thst this should only be done after failure to restore animation with the usual restoratives, and. judging from the first case, it wou|d seem that- there is no great, hurfy, for the heart will respond after a. comparatively long latent period."