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. About this stage of the
operation an unfortunate accident happened--the iodoform tampon, which
protected the exposed pleural cavity, was drawn into this cavity during
a deep inspiration, and could not be found. Notwithstanding subsequent
pneumothorax and extensive pleuritic effusion, the patient made a good
recovery at the end of the fourth week and at the time of report it was
still uncertain whether the needle remained in the heart or had
wandered into the mediastinum. During the discussion which followed the
report of this case, Hahn showed a portion of a knitting-needle which
had been removed from the heart of a girl during life. The extraction
was very slow in order to allow of coagulation along the course of the
wound in the heart, and to guard against hemorrhage into the
pericardial sac, which is so often the cause of death in punctured
wounds of this organ. Hahn remarked that the pulse, which before the
removal had been very rapid, sank to 90.

Marks reports the case of a stab-wound penetrating the left 9th
intercostal space, the diaphragm, pleura, pericardium, and apex of the
heart. It was necessary to enlarge the wound, and, under an anesthetic,
after removing one and one-half inches of the 9th and 10th ribs, the
wound was thoroughly packed with iodoform gauze and in twenty-one days
the patient recovered. Lavender mentions an incised wound of the heart
penetrating the right ventricle, from which the patient recovered.
Purple gives, an account of a recovery from a wound penetrating both
ventricles. The diagnosis was confirmed by a necropsy nine years
thereafter. Stoll records a nonfatal injury to the heart.

Mastin reports the case of a man of thirty-two who was shot by a
38-caliber Winchester, from an ambush, at a distance of 110 yards. The
ball entered near the chest posteriorly on the left side just below and
to the outer angle of the scapula, passed between the 7th and 8th ribs,
and made its exit from the intercostal space of the 4th and 5t