Account of a remarkable case of suicide, with observations on the fatal issue of the rapid introduction of air in large quantity into the circulation during surgical operations / [Peter David Handside].

  • Handyside, P. D. (Peter David), 1808-1881
Date:
[1838]
Catalogue details

Licence: Public Domain Mark

Credit: Account of a remarkable case of suicide, with observations on the fatal issue of the rapid introduction of air in large quantity into the circulation during surgical operations / [Peter David Handside]. Source: Wellcome Collection.

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    How of blood to the head are apparent, and that too in less than a minute1 s time. The individual experiences faintness, and other symptoms of uneasiness; his face becomes pale, and his eyes are fixed ; next, he cannot distinguish objects, his head falls back, and he loses sensibility; his breathing becomes heavy and difficult, and the movements of the chest are feeble; and he is seized with ge¬ neral trembling, and his whole body is covered with a cold sweat. The contractions of the heart are at first hurried; the organ beats violently and irregularly; its action next becomes feeble and flut¬ tering, and the pulse extremely small and weak, very quick, hard, and irregular. At this crisis the unassisted powers of nature may prevail, the heart regaining strength to propel the volume of air; / or by the aid of stimulants and restoratives, by bleeding and arti¬ ficial respiration, employed at the proper juncture, the functions of the system may, as in ordinary syncope, be restored. In the second place, when restorative measures are of no avail, and the heart does not recover its action, or the air is admitted into that organ in large quantity, and has entered it with rapidity and force, then, after the appearance of some or all of the symp¬ toms of oppression now mentioned, the respiration becomes la¬ boured and stertorous ; some violent efforts at inspiration are made ; the body and limbs are strongly convulsed ; in a few se¬ conds more these violent convulsions are observed to recur; and, without the loss of more blood, often attended with the loss of less, than is drawn at an ordinary venesection, death closes the scene. Theory. In tracing the modus operandi of the presence of air in the veins producing the foregoing train of symptoms and ef¬ fects, although I may premise that we know with certainty but little, yet wre are justified in assenting to the well-founded general belief, strongly maintained by Nysten * and Magen- die, f and supported by the late Sir John Leslie, that when the cavities of the heart become suddenly and violently distended with air, this organ cannot freely exercise its functions, but en¬ counters much difficulty in contracting on such a powerful and elastic resistance. It cannot, however, be granted, that death is produced by the heart being prevented from propelling the blood which it contains, into the lungs, as Nysten argues; for both the blood and the air, we have seen, are propelled, and in cases where, from the quantity of air that has entered, a fatal result has ensued, not only has the heart been found empty, but the pulmonary ves¬ sels and the arteries of the system have at all parts contained air. * Op. cit. p. 27 ■f Ibid. cit. p. 101.