A few words on cardicentesis, or intentional heart-puncture, may here be appropriate. It has been suggested as a means for rapid abstraction of blood from the right heart in intense pulmonary and cardiac engorgement, and for the abstraction of air after air-embolism has occurred from wounds of the large venous trunks. It has been known for years that aspiration and similar punctures of the heart are comparatively harmless. Roger accidentally withdrew 200 grammes of blood from the right ventricle of a boy of five years without doing harm. Hulke seemed to benefit a case of pleuro-pneumonia by accidentally aspirating the right heart. Cloquet, Bouchut, Steiner, and Legros and Onimus have made similar observations on the absence of danger from such wounds. Westbrook of Brooklyn, Corwin,15 Dana,16 and apparently Janeway of New York, have performed intentional cardiac aspiration in moribund patients without causing any noticeable harm. The contributions of Westbrook,17 Roberts,18 and Leuf19 on this topic, as well as that of Senn20 on air-embolism and its treatment, will interest those who wish further information.
15 N.Y. Med. Record, March 10, 1883, p. 263.
16 Ibid., Feb. 3, 1883, p. 140.
17 Ibid., Dec. 23, 1882.
18 Philada. Med. News, Jan. 13, 1883.
19 Amer. Journ. Med. Sci., Jan., 1885, p. 79.
20 Trans. Amer. Surg. Ass., 1885, and Annals of Surgery, St. Louis, 1885.
The results of operations for pericardial aspiration or incision are exceedingly good when the frequent postponement of the operation till the patient is almost moribund is recollected. Elaborate statistical tables would be out of place in this volume; and, besides, it seems almost impossible to get a complete collection of the cases. Hindenlang, West, and I have published and analyzed long lists of cases collected from various sources, and I have now references to more, but this tabulation seems unnecessary, as the practical points to be derived from their study are well proved by the previous work done. In addition to the bibliographical notes already given, I add for the use of inquirers in this field two recent monographs—one by a German,21 the other by a French writer.22
21 Ueber Paracentese des Herzbeutels, Gerhard Beck, Würzb., 1882, p. 33 (Thesis).
22 Contribution à l'Étude de la Paracentèse du Péricarde, H. Ferraud, Bordeaux, 1883.