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Show 11 K V H R 0 J I Amazing Recent Advances in Medicine and Surgery I ' : " "' ' I Robert Hannah's pr inting of V 1 1 v'y William Harvey clem- J ( covery that the mm I I "V blood passes Mmi I J S I through (' I body in a "hind 1 of circle" I VvEfiTRICtf? VEHTWCLE . r . m v. X ical literature, says f Dr. Honan must f S bo impressed with DIASTOLE SYSTOLE thc' preat numbt'r of cases whose hi;- HPS Diagram showing the operation of the tones continue for Valvei of the heart during the period of twenty-five or thirty , relaxation (diastole) and the period of years after grave contraction (systole) manifestations of W 10 BE told that anything was wrong with one's heart used to be regarded re-garded as a virtual sentence of i. Heart disease, even in its sim-t sim-t form, was thought to be incura-. incura-. There was nothing to do except try make the sufferer as comfortable as -ossible during the short time he or she had to live. But all this is a thing of the past. Medical science has found ways of patching patch-ing up weak or badly damaged hearts by medication, by carefully regulated habits of life and even by the use of the surgeon's knife, so that they will irn n doinc their work finite satisfactorilv I for many years. In fact, it is growing to be nothing uncommon un-common for persona to bo attacked by serious heart disease in early life and still live happily and usefully to a ripe old age. Medicine and surgery are enabling ena-bling thousands of hearts to keep right on the job which a few years ago would . have been regarded as hopeless wrecks likely to stop their work of pumping blood at any moment. Dr. J. H. Honan, one of America's distinguished dis-tinguished physicians! has written a very interesting book, entitled "Heart Disease: Dis-ease: Its Care, Cure and Prevention," and in his opening chapter he sums up the reasons why a much more favorable view can be taken of heart disease than formerly. In the first place, he says, there is no 'rgan in the body which has such recuperative re-cuperative power as the heart. Second There is no other organ which can do so much to remedy its own defects de-fects or to make compensation for them. As medical science has found out, thif powerful blood-pumping muscle will adjust and .'.dapt itself to new conditions in the most marvelous way. Third Science has found ways of relieving re-lieving many incurable heart troubles ways of correcting and counteracting them, of cojnterbalancing the functional or structural heart defects. Fourth Medical science knows more about the heart to-day than ever before. Not only are signs of weakness and defect de-fect more readily discovered and estimated, esti-mated, but the means of combating the progress of disease are better understood. under-stood. Fifth It is now known that the individual indi-vidual often holds his life in his own hands a fair assurance of restoration to health depending on his willingness to modify his mode of life for a fev. weeks or a few years, to take the r 3t and treatment advised, to be satisfied 'o walk the full course of life, if running involves in-volves danger. Last but not least, the individual who has heart trouble has good rea on for entertaining hope as long as there is life. Any one who reviews modern med- affections of the heart or arteries, and h where the records or re- A ports of many years are -.' interrupted only by the nat-uial nat-uial ending of the life of the pa- tient or the decease or retirement of the physician. Since the writings of conservative conserva-tive medical authorities abound with expressions ex-pressions regarding extreme cases, such as "All but miraculous recoveries," and since the personal experience of the physician phy-sician verities these statements, Dr. Honan thinks there can be only one conclusion con-clusion that there are no "hopeless more than in other ills it may well be said, "As long as there is life there is hope." A remarkable instance of the heart' ability to keep beating under the most adverse conditions was reported a few days ago from the Royal Infirmary in 1 Manchester, England. A young man twenty years old entered the hospital suffering from an abscess on the brain. At 4 o'clock in the morning, morn-ing, just as he was about to be operate I on, a deathlike pallor overspread his features fea-tures and his breathing suddenly stopped. The surgeons thought him dead until they noticed that his pulse vas beating strongly. Although every sort of arti ficial respiration was resorted to, the heartbeats gradually grew fainter and fninter. But it was not until 9 o'clock five hours after the breathing had stopped that they ceased altogether. In a London hospital the other day a man expired on the operating table while being treated for an obstruction of the throat. At first the physicians tried to revive him by the aid of artificial respiration, respira-tion, and when these efforts failed they decided to massage the heart itself. By this treatment they actually succeeded suc-ceeded in re-establishing the circulation of the blood for half an hour. At the end of this time, however, the heart again stopped, and this time nothing could set it beating again. "It is quite possible," says Dr. Pierre Bazy, of the French Academy of Medicine, Medi-cine, "that some day heart massage will really call back life. Science has surprised sur-prised us so many times that anything may be expected of her. "But before we can hope tq accomplish this miracle we must know how long thr nerve cells which are, as it were, the spark of life of the human machine can exist when deprived of the blood's circulation." Since a wrong diet plays an important impor-tant part in causing heart disease and a right one is very U3eful in relieving it, valuable results are expected from the investigations which Dr. M. Heitler, a German physician, has been arrying on to determine the effect of various foods Which Enable Sufferers From Even the Worst Forms of Chronic Heart Disease i to Live Happily and Usefully to a Ripe Old Age nST jdjdflHHBMMHRBHRL. A new VtiNGS :VV J operating w i Cable cspe- . i for use in the j J the cardicscop A&h LA) H r . j j Uiagram If Vs showing how RV L Vn the heart, LI x A S T beating y normally V III seventy-two I k V y times a . minute, I TlcrcnP P"mps the SHr blood ali o ' through the BODY body with K" " every beat as well a of cooking, chewing and digestion, diges-tion, upon the heart's activity. He found that all foods ami spices, with the exception of very acid substances, sub-stances, and coffee, tea and cocoa have a stimulating effect on the heart. All foods arc more stimulating when eaten raw than when cooked. Cold and heat are both depressing and moderate heat has the mot stimulating effect. Dr. Heitler's investigations established the fact that the mixture of several foods has a cumulatively stimulating effect. ef-fect. The act of chewing causes depression depres-sion of the pulse. It diminishes the ef-fect ef-fect of stimulating foods on the heart and increases the effect of depressive ones. "There has never been a time in the history of the world," says Dr. J. H Honan, "when physicians were in such position to know the condition of the heart as they are to-day. The modern scientific instruments of precision, the iphymograph, polygraph, prphygmotono-graph, prphygmotono-graph, orthodiograph, electrocardiograph and others have given an understanding of heart functions entirely unknown a few years ago. "With these instruments we are able to measure the exact amount of resistance resist-ance the heart is pumpinc against, to detect de-tect the slightest irregularity in the pulse beat and measure the pulse wave, to observe the slightc-t enlargement and detect the slightest weakness in the operations which surgeons expect e to make possib!e on the heart heart muscle, to measure with a fair degree of accuracy the amount of reserve force in the heart muscle in other words, to get a fairly accurate ac-curate estimate of the amount of work a heart is capable of doing. "We are further enabled by these instruments to study much more accurately ac-curately the mechanism by which symptoms are produced and to interpret in-terpret their significance. It will be readily seen that these studies and interpretations are invaluable in guiding us in our treatment of heart trouble." The strides BUrgery has taken in the last few years make it possible to penetrate the heart muscle with the knife when that seems to be the only way of repairing some defect or alleviating allevi-ating some diseased condition. But until very recently it has not been possible for the surgeon to look inside the heart and guide with his own eye the progress of his knife's sharp steel. Now this miracle of surgery is being attempted with the aid of an ingenious little device known as the cardioscope. This is a metcal tube, one end of which is closed by a planoconvex lens. The plane surface of th- lens is within the tube and the convex surface without. The convex surface is curved in such a way that it can be applied snugly to the walls of the heart cavity. A small olectric light bulb, fitted on a carrier, is placed against the plane surface of the lens. This illuminate? that portion of the heart's lining which is in contact with the lens. This portion por-tion of the endocardium can be plainly seen through the tube. Direct vision of the interior of the heart is thus made possible in spite of the presence of blood. A knife to cut the valves as is often necessary in relieving certain kinds of heart troubh is ci.rrted alongside the tube of the cardios ; ope. The fiat steel handle is held close to the tube by two collars. The blade of the knife is placed at right angles to the handle. The cut- 9HHb9L Diagrammatic view drawn from f surgeon's description of a ly iccent successful operation per- tsjHK formed on the heart of a living P I dog with tho aid of the cardio- .ojjj', thr i n n i o u -. Ot which enables the surgeon to fl t ire right inside thr he.irt I ii'isclu end guide hi' Itmlo in MJftji cutting the valves or doing (i 3 ' 'BPKkS whatever else may be ncces-IfU&B&BRl ncces-IfU&B&BRl sary. A, the lung; B, thr xUBBeBbU phrenic nerve; C, the heart's I l I t auricular appendage, Ixol :igh which the cardioscope jjj !. inserted; D, tlv pe r ir .-. rd i u.n . lining the heart, in which the incision to admit the enrdio- J cope is made J A B " I J I 1 1 I '11 How the record of the heart's beats left on one of the delicate instruments science has devised for measuring them, varies in health and different conditions of disease. A, normal heart action; B, sinus arrhythmia; ar-rhythmia; C, premature contraction; D, auricular auricu-lar fibrillation; E, heart block; F, in infectious infec-tious disease tniK' edge faces the lens. The whole of the knife can be concealed in a groove ut across the center of the lens. Thus the knife is held ready for immediate use. The cardioscope is the invention of Dr. Duff S. Allen and Dr. Evarts A. Graham, two well known St. Louis physicians. physi-cians. In a recent issue of "The Journal Jour-nal of the American Medical Association" Associa-tion" they describe a number of successful success-ful operations performed with its aid on the hearts of dogs. "Heretofore," they say, "no method has been described by which it is possil ble to go into the cavities of the heart without haste, to examine its chambers carefully and to operate with deliberation delibera-tion on the interior of the heart under guidance of the eye. Wc have been able to do this while the normal flow, or nearly near-ly normal flow, of blood was taking place through the chambers of the heart. "The blood supply to the body and to the heart itself was maintained throughout through-out the operation. Great speed of execution execu-tion therefore was not imperative. Wc have repeatedly looked into the cavities of normal hearts of etherized dogs for a long as twenty minutes with impunity. impu-nity. "This new surgical procedure for operations op-erations on the heart has these desira- From left to right, the carrier car-rier with its tiny electric light bulb, the metaJ tube with a lens on the lower end and the knife with a flat steel which make up the cardioscope ble features: Hem-orrhasrc Hem-orrhasrc does not occur; oc-cur; the circulation is not interrupted; haste is not imperative; impera-tive; the operation is carried out under the guidance of the eye, and the normal heart of the dog tolerates tol-erates the procedure. "During the last year wo have been able to cut any de-aired de-aired leaflet of the tricuspid, tiie pulmonary or the aortic valves. This has been done with deliberation delib-eration and under guidance of the eye. "By the use of the cardioscope the lary muscle, the muscle bundles and the valves, the chordae tendineae, the papil-openings papil-openings of the large and small arterii and veins into the cavities of the heart can be clearly seen and definitely identified. identi-fied. "With the proper attachments for the cardioscope it is possible, therefore, to do accurate experiments and operations on in the functioning heart." There seems every reason to believe that the instrument which Drs. Allen and Graham have invented will soon bo perfected, so that it may be used in operations op-erations on human hearts When that day comes heart disease will be robbed of still more of its terrors. The cardioscope is designed especially for use in the relief of thr- condition known as mitral stenosis. The possibility possi-bility of treating this through a surgical surgi-cal operation was first suggested twenty years ago. But until now all the methods meth-ods proposed have seemed impracticable impractica-ble of application to the human heart, since they necessitate cither the cutting of the valve without the guidance of vision or the arrest of the circulation and a speedy operation. |