"The effect of a diminished supply of blood to the brain and nervous
centres quickly became apparent in threatened syncope. Our only hope
lay in closing the wound so completely that no more air could enter,
and then removing from the heart and capillaries of the lungs the
air already received, and now hindering the flow of blood to the
brain. One mode of treatment recommended by French surgeons consists
in introducing the pipe of a catheter through the wound, if in the
right jugular vein--or if not, through an opening made for the
purpose in that vein--and the withdrawal of the air from the right
auricle of the heart by suction.
"Doctor Kline favored this treatment, but I knew that it would be
fatal. Any reopening of the wound now partially closed in order to
introduce a tube, even if my instrument case had contained one of
suitable size and length, must necessarily have admitted a large
additional quantity of air, and so made death certain.
"Indecision in a case like this is fatal. Nothing but the right
thing done with an instant promptness can save the imperiled life.
But what was the right thing? No more air must be permitted to
enter, and the blood must be unloaded as quickly as possible of the
air now obstructing its way to the lungs, so, that the brain might
get a fresh supply before it was too late. We succeeded in the
first, but not in the last. Too much air had entered, and my patient
was beyond the reach of professional aid.
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