A loud bellows-sound could be heard, which the man said
had been audible since the time of reception of the injury. This
was a double bruit accompanying systole, and entirely obscuring
the physical signs. From this time the man speedily failed, and
after his death there were cicatricial signs found, particularly
on the wall of the left ventricle, together with patency of the
interventricular septum, with signs of cicatrization about this
rent. At the side of the left ventricle the rent was twice as
large and lined with cicutricial tissue.
Stelzner mentions a young student who attempted suicide by
thrusting a darning-needle into his heart. He complained of pain
and dyspnea; in twenty-four hours his symptoms increased to such
an extent that operation was deemed advisable on account of
collapse. The 5th rib was resected and the pleural cavity opened.
When the pericardial sac was incised, a teaspoonful of turbid
fluid oozed out, and the needle was felt in an oblique position
in the right ventricle. By pressure of a finger passed under the
heart, the eye of the needle was pressed through the anterior
wall and fixed on the operator's finger-nail. An attempt to
remove by the forceps failed, as the violent movements of the
heart drew the needle back into the cavity.
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