PAGE 4
The Permanent Stiletto
by
“That will do,” said Arnold. He beckoned me to bend closer. “You must watch this man; he is too sharp; he is dangerous.”
“Then,” resumed Entrefort, “I shall tell you what I intend to do. There will undoubtedly be inflammation of the aorta, which, if it persist, will cause a fatal aneurism by a breaking down of the aortal walls; but we hope, with the help of your youth and health, to check it.
“Another serious difficulty is this: With every inhalation, the entire thorax (or bony structure of the chest) considerably expands. The aorta remains stationary. You will see, therefore, that as your aorta and your breast are now held in rigid relation to each other by the stiletto, the chest, with every inhalation, pulls the aorta forward out of place about half an inch. I am certain that it is doing this, because there is no indication of an escape of arterial blood into the thoracic cavity; in other words, the mouths of the two aortal wounds have seized upon the blade with a firm hold and thus prevent it from slipping in and out. This is a very fortunate occurrence, but one which will cause pain for some time. The aorta, you may understand, being made by the stiletto to move with the breathing, pulls the heart backward and forward with every breath you take; but that organ, though now undoubtedly much surprised, will accustom itself to its new condition.
“What I fear most, however, is the formation of a clot around the blade. You see, the presence of the blade in the aorta has already reduced the blood-carrying capacity of that vessel; a clot, therefore, need not be very large to stop up the aorta, and, of course, if that should occur death would ensue. But the clot, if one form, may be dislodged and driven forward, in which event it may lodge in any one of the numerous branches from the aorta and produce results more or less serious, possibly fatal. If, for instance, it should choke either the right or the left carotid, there would ensue atrophy of one side of the brain, and consequently paralysis of half the entire body; but it is possible that in time there would come about a secondary circulation from the other side of the brain, and thus restore a healthy condition. Or the clot (which, in passing always from larger arteries to smaller, must unavoidably find one not sufficiently large to carry it, and must lodge somewhere) may either necessitate amputation of one of the four limbs or lodge itself so deep within the body that it cannot be reached with the knife. You are beginning to realize some of the dangers which await you.”
Arnold smiled faintly.
“But we shall do our best to prevent the formation of a clot,” continued Entrefort; “there are drugs which may be used with effect.”
“Are there more dangers?”
“Many more; some of the more serious have not been mentioned. One of these is the probability of the aortal tissues pressing upon the weapon relaxing their hold and allowing the blade to slip. That would let out the blood and cause death. I am uncertain whether the hold is now maintained by the pressure of the tissues or the adhesive quality of the serum which was set free by the puncture. I am convinced, though, that in either event the hold is easily broken and that it may give way at any moment, for it is under several kinds of strains. Every time the heart contracts and crowds the blood into the aorta, the latter expands a little, and then contracts when the pressure is removed. Any unusual exercise or excitement produces stronger and quicker heart-beats, and increases the strain on the adhesion of the aorta to the weapon. A fright, fall, a jump, a blow on the chest–any of these might so jar the heart and aorta as to break the hold.”