His Heart Sewn Up, Patient Recovers.
A remarkable operation, involving the sewing up of a wound in a man’s heart, was performed successfully recently at the Beth Israel Hospital, Monroe and Jefferson Streets, New York City. The injured man, Israel Ziff, of 238 East 105th Street, is well on the way to recovery, and probably will be out of the hospital in a few days.
Ziff operates a pushcart in Monroe Street, near the hospital, selling slices of coconut to passers-by. He is in the habit of slicing the coconut himself with a knife, more than a foot long, whose wide blade tapers down to a sharp point.
Several months ago Ziff cut himself badly while cutting up his wares, and his wife and children begged him to give up his occupation and find some other method of earning a living. He tried to do it, but he could find nothing else. His pushcart was well known in the neighborhood, and his business was good; so he was compelled to keep at it.
Business was brisk one night, and the coconuts were going fast. Ziff had to cut up new ones from time to time, and every few minutes found him bending over with his knife at work. Presently the thing he had always feared happened; his knife slipped and cut through the left breast, a deep wound.
Ziff knew he was badly hurt. So he straightened up, laid down his knife, and started for the Beth Israel Hospital, about a block and a half away. How he got there continues to be a mystery to the surgeons, but he did get there. He walked into the office in Jefferson Street,[{61}] near Cherry Street, looking as if nothing much matter.
Doctor George Levy, who received him, saw that his injuries were serious, and notified Doctor Alfred A. Schwartz, the house surgeon. Doctor Schwartz’s examination disclosed a wound at least an inch and a half long at the outer surface and going far down in.
Doctor Schwartz called up Doctor Charles Goodman, of 969 Madison Avenue, the attending surgeon, and told him that he was badly needed at once. Doctor Simon D. Ehrlich, the hospital’s anæsthetist, also was notified, and Ziff was carried to the operating room. Here Doctor Schwartz packed the wound with gauze and stopped the flow of blood, and everything was made ready to start work when Doctor Goodman arrived.
The operating surgeon arrived in record time, and then began some quick work. The flow of blood had to be stopped in the first place, and the patient anæsthetized for the operation. But if the chest where cut open to check the hemorrhage, the lungs would have collapsed from the air pressure on the outside, so air had to be pumped in until the inflation was sufficient to resist the pressure from without.
This process was combined with the application of the anæsthetic by the method known as intertracheal anæsthesia. By means of an apparatus operated by electricity, ether was mixed in a jar with air in the proportion considered advisable, and the resultant mixture forced through a tube far down into the patient’s throat. By this means anæsthesia was produced and the air within the lungs was raised to double the normal pressure.
With the patient anæsthetized and the lungs secured against danger of collapse, Doctor Goodman cut away three ribs and a piece of the breastbone. He found the chest full of blood, and this had to be drawn off before anything more could be done. When the blood was cleared away, Doctor Goodman found that the knife had made a big cut in the pericardium and that the point had gone flown nearly three-eighths of an inch into the heart.
The most ticklish part of the operation followed—sewing up the heart while it was palpitating. One stitch was sufficient to close the wound in the heart itself, three more did the work with the pericardium. Doctor Goodman sewed the skin together over the wound, and Ziff was put away to recover. He came out of the operation as rapidly as could have been expected, and except that the protection of the ribs over the heart will be missing, he is likely to be in no way the worse for his experience.
Had the point of the knife gone a millimeter or so farther in, Ziff never would have lived to get to the hospital, as the consequent hemorrhage would have been almost instantly fatal. The hospital authorities at first supposed from the nature and depth of the wound that he had been stabbed in a fight, and it was not until a day or two ago that Ziff recovered sufficiently to tell them how he had been injured.