It might be added that the shock to the cardiac
action might be sufficient to check it, and at present we would
have no sure means of starting pulsation if once stopped. In
heart-injuries, paracentesis, followed, if necessary, by incision
of the pericardium, is advised by some surgeons.
Realizing the fatality of injuries of the heart, in consequence
of which almost any chance by operation should be quickly seized
by surgeons rather than trust the lives of patients to the
infinitesimal chance of recovery, it would seem that the
profession should carefully consider and discuss the feasibility
of any procedure in this direction, no matter how hypothetic.
Hall states that his experience in the study of cardiac wounds,
chiefly on game-animals, would lead him to the conclusion that
transverse wounds the lower portions of the heart, giving rise to
punctures rather than extensive lacerations, do not commonly
cause cessation of life for a time varying from some considerable
fraction of a minute to many minutes or even hours, and
especially if the puncture be valvular in character, so as to
prevent the loss of much blood. However, if the wound involve the
base of the organ, with extensive laceration of the surrounding
parts, death is practically instantaneous.
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