Skip to Main Content

++

The development of major surgery was retarded for centuries by a lack of knowledge and technology. Significantly, the general anesthetics ether and chloroform were not developed until the middle of the nineteenth century. These agents made major surgical operations possible, which created an interest in repairing wounds to the heart, leading some investigators in Europe to conduct studies in the animal laboratory on the repair of heart wounds. The first simple operations in humans for heart wounds soon were reported in the medical literature.

++

On July 10, 1893, Dr. Daniel Hale Williams (Fig. 1-1), a surgeon from Chicago, successfully operated on a 24-year-old man who had been stabbed in the heart during a fight. The stab wound was slightly to the left of the sternum and dead center over the heart. Initially, the wound was thought to be superficial, but during the night the patient experienced persistent bleeding, pain, and pronounced symptoms of shock. Williams opened the patient's chest and tied off an artery and vein that had been injured inside the chest wall, likely causing the blood loss. Then he noticed a tear in the pericardium and a puncture wound to the heart "about one-tenth of an inch in length."1

++
Figure 1-1
Graphic Jump Location

Daniel Hale Williams, a surgeon from Chicago, who successfully operated on a patient with a wound to the chest involving the pericardium and the heart. (Reproduced with permission from Organ CH Jr, Kosiba MM: The Century of the Black Surgeons: A USA Experience. Norman, OK: Transcript Press, 1937; p 312)

++

The wound in the right ventricle was not bleeding, so Williams did not place a stitch through the heart wound. He did, however, stitch closed the hole in the pericardium. Williams reported this case 4 years later.1 This operation, which is referred to frequently, is probably the first successful surgery involving a documented stab wound to the heart. At the time Williams' surgery was considered bold and daring, and although he did not actually place a stitch through the wound in the heart, his treatment seems to have been appropriate. Under the circumstances, he most likely saved the patient's life.

++

A few years after Williams' case, a couple of other surgeons actually sutured heart wounds, but the patients did not survive. Dr. Ludwig Rehn (Fig. 1-2), a surgeon in Frankfurt, Germany, performed what many consider the first successful heart operation.2 On September 7, 1896, a 22-year-old man was stabbed in the heart and collapsed. The police found him pale, covered with cold sweat, and extremely short of breath. His pulse was irregular and his clothes were soaked with blood. By September 9, his condition was worsening, as shown in Dr. Rehn's case notes:

++

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.