心脏外科
“心脏外科”与“器官移植”被公认为20世纪外科学领域内进步最快的两大分支学科。以下辑录的这一组关于“心脏外科”发展各个阶段的格言与引语，尽管其中的大多数已是十足的老皇历，但却像一部高度浓缩的“心脏外科”编年史展现在我们面前，了解“心脏外科”这段筚路蓝缕的发展历程，除了增加我们茶余饭后的谈资以外，或许还能带给我们某些方面的感悟。
1.When a perforation penetrated in one of the cardiac ventricles, they died on the spot, mainly by blood loss, and even faster if the left ventricle was injured.When the penetrating object did not pass through the cardiac cavity but stopped at the cardiac muscle, some of the wounded gladiators lived through the very day ...as well the following night; they eventually died later because of an inflammation of the heart.
—— Galen, 129——199
【译文】一旦有一个心室遭到贯通伤那么患者会当场死亡，主要因为大量失血，如果受伤的是左心室，死得会更快。但如果穿透物没有穿透心腔，而是止于心肌，则一些受伤的角斗士可活过当天……甚至熬到晚上，但最终会死于心脏的炎症。
【点评】用现在的观点看，可能是死于心室壁的迟发性破裂或室壁瘤的迟发性破裂，而不是死于心脏的炎症。
2.The heart is the chief mansion of the soul, the organ of vital capacity, the beginning of life, the foundation of the vital spirits ...the first to live the last to die.
—— Ambroise Paré, 1510——1590
【译文】心脏是灵魂的家园，命脉器官，生命之始，元气之基……最早出现而最后消亡。
【点评】早年，“心脏”除了富有生物学上的科学实体意义外还赋予其更为丰富的艺术、风俗、宗教、文学和哲学上的精神寓意。
3.Often times an abundance of moisture there in (the pericardium), which causes suffocation and overwhelms the heart.
—— Jean Riolan, 1580——1657
【译文】通常心包积液过多，会压迫心脏并最后完全束缚住心脏。
4.A few years ago it was considered as a fact placed beyond any doubt that wounds of the heart were necessarily mortal ...even at present, in spite of the number of facts and observations collected at the Hotel Dieu ...the contrary opinion is far from being generally admitted.
—— Guillaume Dupuytren, 1777——1835
【译文】前几年，人们认为心脏外伤必定致命，这好像是一个不存争议的事实……即使现在，尽管从迪厄医院那也收集到不少事实和观察结果，但相反的观点还远没能得到广泛的承认。
5.To hear a murmur is a very different matter from feeling the blood itself pouring back over one's finger.
—— Henry Sessions Souttar, ?——1875
【译文】听到杂音和感觉血液倒灌到了手指是完全不同的两码事。
【点评】此处“感觉血液倒灌到了手指”指的应该是主动脉关闭不全时出现的“水冲脉”。
6.The suggestion to suture a wound to the heart, although made in all seriousness, scarcely deserves mention.
—— F.Riedinger, 1845——1918
【译文】缝合心脏伤口的建议,尽管说得很严肃认真，但绝不要轻易提及。(https://www.daowen.com)
【点评】尽管1902年 Luther Hill（1862——1946）首次成功完成了被穿透的心腔的修补术，但真正安全的、常规的开胸手术是直到第二次世界大战期间才普及开来的。
7.Surgery of the heart has probably reached the limits set by nature to all surgery: no new method and no new discovery can overcome the natural difficulties that attend a wound of the heart.
—— James Paget, 1814——1899
【译文】心脏手术可能已经达到了一种造物主所设定的极限，除非有新的方法和新的发现可以克服处理心脏伤口所遇到的困难。
8.First repair of cardiac wound: "It was very disquieting to see the heart pause in diastole with each pass of the needle ...the heart gave a laboured beat, and then resumed with forceful contractions as we breathed a sigh of relief".
—— Ludwig Rehn, ?——1896
【译文】看到首例心脏修补那场面实在令人局促不安：“每穿过一针，心脏就在舒张期暂停一会……心脏再费力地跳一下，然后恢复了有力的收缩，这才让我们轻松喘一口气。”
9.Let me speak once more my conviction that by means of the cardiorrhapy,many lives can be saved that were previously counted as lost.
—— Ludwig Rehn, ?——1896
【译文】我再次重申我的信念，通过心脏修补术，以前被认为可以放弃的生命是可以挽救回来的。
10.A car mechanic said argumentatively to his client, a cardiac surgeon: "So Doc, look at this work.I also take valves out, grind'em, put in new parts, and when I finish this baby will purr like a kitten.So how come you get the big bucks, when you and me are doing basically the same work?" The surgeon replied: "try doing your work with the engine running."
—— Legend has it that the Doctor was Michael DeBakey
【译文】一位汽车修理工当着他的一位心脏外科医生客户不容争辩地说道：“医生，你看看我，可以把（机器的）阀门取出来，对其进行研磨，然后装回新部件，一切完事后这宝贝就像小猫一样咕噜咕噜地欢叫了起来，我就不明白为什么你和我做着基本相同的工作，而只有你可以赚大钱？外科医生回答说：“你在发动机不熄火情况下工作试试看。”据传这位医生就是现代心脏外科之父——迈克尔·德巴基（1908——2008）。
【点评】可不是吗？1953年首次借助于“体外转流心-肺机”成功进行心脏直视手术之前，心外科医生都是在“没熄火”、不停跳动着的心脏上完成手术的。体外循环技术开启了心脏外科新的时代。
11.Any operation which reduces the mortality of a given injury from 90 to about 63 per cent is entitled to a permanent place in surgery, and ...every wound of the heart should be operated upon immediately.
—— Luther Leonidas Hill Ir., 1862——1946
【译文】任何手术只要能将某一创伤的死亡率从90%降低到63%左右，就有资格在外科获得永久承认的位置，所以……每一个受伤的心脏都应立即接受手术。
【点评】说这话的就是那位于1902年成功完成世界首例心脏修补术的牛人！
12.(About the first human heart transplant): It was a natural progression of open heart surgery.We did not think it was a great event and was no special feeling.I was happy when I saw the heart beating again.We did not stand up or cheer or something like that.I didn't even inform the hospital authorities that I was going to do the operation.
—— Christian Barnard, 1922——2001
【译文】（关于第一次人体心脏移植）：这是心脏直视手术的必然进步。我们不认为这是一件多么伟大的事，也没有什么特别的感觉。当我看到心脏再次跳动起来时，我很高兴，但我们没有雀跃欢呼或其他什么类似的反应。我甚至没有通知医院官方我打算要做这个手术。
【点评】如此淡定的这位伟人就是心脏移植的先行者——南非医生Christian Barnard。