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Moritz Schiff and the history of open-chest cardiac massage

      Open chest cardiac massage is still practiced in some instances of cardiac arrest. The historical development of this technique is frequently attributed to Moritz Schiff [
      • Pike F.H.
      • Guthrie C.C.
      • Stewart G.N.
      Studies in resuscitation: I. The general condition affecting resuscitation, and the resuscitation of the blood and of the heart.
      ], one of the most distinguished physiologists of the latter half of the 19th century [

      Obituary—Moritz Schiff. Lancet 1896;2:1198–9.

      ]. In 1874, Schiff was in charge of the physiology laboratory at the Institute of Advanced Studies in Florence in Italy. Doctor G. Hake joined him while he was investigating the comparative effects of ether and chloroform and in one of their articles published in The Practitioner in 1874, Hake described how Schiff practiced open-chest cardiac massage after cessation of heart function produced while using chloroform [
      • Hake T.G.
      Studies on ether and chloroform from Prof. Schiff's physiological laboratory.
      ] and Green addressed the matter again later in 1906[
      • Green T.A.
      Heart massage as a means of restoration in cases of apparent sudden death.
      ].“The heart is in a vital state favorable to its renewed action when paralyzed by the influence of chloroform on the vaso-motor nerves, is demonstrated by Professor Schiff's practice of artificial circulation. He lays open the thoracic cavity, and, compressing the passive heart with his fingers, imitates in it the periodic movements of the organ. The circulation is restored, the nerves of the heart recover their force, and the organ finally resumes its spontaneous action. Before long, signs of returning sensibility become apparent, the reflex action of the eyelid return and the animal is now capable of being brought back to the cerebral consciousness.” [
      • Hake T.G.
      Studies on ether and chloroform from Prof. Schiff's physiological laboratory.
      ].
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      References

        • Pike F.H.
        • Guthrie C.C.
        • Stewart G.N.
        Studies in resuscitation: I. The general condition affecting resuscitation, and the resuscitation of the blood and of the heart.
        J. Exp. Med. 1908; 10: 371-418
      1. Obituary—Moritz Schiff. Lancet 1896;2:1198–9.

        • Hake T.G.
        Studies on ether and chloroform from Prof. Schiff's physiological laboratory.
        The Practitioner. 1847; 12: 241-250
        • Green T.A.
        Heart massage as a means of restoration in cases of apparent sudden death.
        Lancet. 1906; 2: 1708-1713
        • Zesas D.G.
        Zur Frage der Hermassage beim Chloroformkollaps.
        Centralblatt fur Chirugie. 1903; 17: 588-589
        • Tuffier T.
        • Hallion M.
        De la compression rhythmic du Coeur dans la syncope cardiaque par embolic.
        Bull. Mem. Soc. Chir. 1898; 24: 937-939
        • Paradis N.
        • Martin G.
        • Rivers E.
        Use of open chest cardiopulmonary resuscitation after failure of standard closed chest CPR: illustrative cases.
        Resuscitation. 1992; 24: 61-71
        • Battelli F.
        Functions du Coeur et du systems Nerueux Central.
        J. Physiol. Pathol. Gen. 1900; 25: 443-456
        • Prus J.
        Veber die wiederbelebung un todesfallen in folge von erstickung, chloroform-vergiftung und electrishem schlage.
        Wien. Klin. Wochenschr. 1900; 21: 482-487
        • Keen W.W.
        Case of total laryngectomy and abdominal hysterectomy in both of which massage of the heart for chloroform collapse was employed with notes of 25 other cases of cardiac massage.
        Ther. Gaz. 1904; 28: 212-230
        • Gray H.M.W.
        Subdiaphragmatic transperitoneal massage of the heart as a means of resuscitation.
        Lancet. 1905; 2: 1708-1709
        • Lee W.E.
        • Downs T.M.
        Resuscitation by direct massage of the heart in the cardiac arrest.
        Ann. Surg. 1924; 80: 555-561
        • Bircher N.
        • Maryland B.
        • Safar P.
        Manual open-chest cardiopulmonary resuscitation.
        Ann. Emerg. Med. 1984; 13: 770-773
        • Beck C.S.
        • Mautz F.R.
        Ventricular fibrillation of long duration abolished by electric shock.
        J. Am. Med. Assoc. 1947; 135: 525-537
        • Stephenson H.E.
        • Reid C.
        • Hinton J.W.
        Some common denominators in 1200 cases of cardiac arrest.
        Ann. Surg. 1953; 137: 731-744
        • Kouwenhoven W.B.
        • Jude J.R.
        • Knickerbocker G.G.
        Closed-chest cardiac massage.
        J. Am. Med. Assoc. 1960; 173: 1064-1067
        • Arai T.
        • Dote K.
        • Tssukahora I.
        • Nitta K.
        • Nagaro T.
        Cerebral blood flow during conventional, new and open-chest cardio-pulmonary resuscitation in dogs.
        Resuscitation. 1984; 12: 147-154
        • Varon J.
        • Marik P.E.
        • Fromm R.E.
        Cardiopulmonary resuscitation a review for clinicians.
        Resuscitation. 1998; 36: 133-145
        • Hosler R.M.
        Advantages of open and closed chest resuscitation.
        J. Intern. Coll. Surg. 1966; 6: 687-692
        • Del Guerico R.M.
        Open chest cardiac massage: an overview.
        Resuscitation. 1987; 15: 9-11
        • Rubertsson S.
        • Grenvik A.
        • Wiklund L.
        Blood flow and perfusion pressure during open-chest versus closed-chest cardiopulmonary resuscitation in pigs.
        Crit. Care. Med. 1995; 23: 715-725
        • Boczar M.E.
        • Howard M.A.
        • Rivers E.P.
        • Martin G.B.
        • Horst H.M.
        • Lewandowski C.
        • et al.
        A technique revised: hemodynamic comparison of closed-and open chest-cardiac massage during human cardiopulmonary resuscitation.
        Crit. Care Med. 1995; 23: 498-503
      2. The American Heart Association in collaboration with the International Liason Committee on Resuscitation. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiac Care—An International Consensus on Science. Resuscitation 2000;46:291.

        • Safar P.
        • Bircher N.G.
        Cardiopulmonary Cerebral Resuscitation. Saunders, London1988: 212-219
        • Buckman R.F.
        • Badellino M.M.
        • Mauro L.H.
        • Aldridge S.C.
        • Milner R.N.
        • Malaspina P.J.
        • et al.
        Open chest cardiac massage without major thoracotomy: feasibility and systemic blood flow.
        Resuscitation. 1995; 29: 237-248
        • Pavia E.F.
        • Kern K.B.
        • Hilwig R.W.
        • Scalabrini A.
        • Ewy G.A.
        Minimally-invasive direct cardiac massage versus closed-chest cardiopulmonary resuscitation in a porcine model of prolonged ventricular fibrillation cardiac arrest.
        Resuscitation. 2000; 47: 287-299