Daily globe. [volume] (St. Paul, Minn.) 1878-1884, 1881-08-09
Necessity for the Operation.
HOW 1T WAS DONE.

WASHINGTON, Aug. s.-The Presidents
surgeons this morning performed another
operation to facilitate the discharge of pus
The decrease of pus each evening for some
days has convinced the doctors that il was
due to an obstruction in the flow. Yesterday
they determined on another operation, and
this morning between and 10 o'clock it was
performed The President was put under the
influence of ether, as it was decided be WAS
strong enough to stand it. The first inclsion
made by DIR. Agnew was SO made that the
drainage tube had TO be inserted over the
twelfth rib. This necessitated an up
ward flow of pus, near the mouth of the
incision, and retarded it SO that instead of
flowing out promptly a sac was formed and
The pus remained in it, and was the cause of
impeding circulation. The surgeons this
morning drained the sac. Then Agnew made
an incision between the twelfth rib, reaching
into the former incsion. A drainage tube was
inserted into this new incision, and thus af-
fords straight channel for the flow Of pus
Besides putting the President under the inhu-
ence of ether, rigardne was used TO deaden the
spot where the knife was inserted. The
President early recovered from the effects of
the ether, and the surgeons speak hopefully
OF the g0OQ erect OF Lne operation.
NECESSITY FOR THE OPERATION.
The necessity for the operation which was
performed on the President this morn
ing became apparent to the physicians yes
terday when they found the drainage tube of
the size hitherto used could no longer pass
along the track of the ball between the ribs.
The process of granulaton at that point had
fo,-o To oil oil nri-
flee, and the ribs prevented the pushing aside
of the flesh which Was healing between them,
enough so that the tube could not be intro
duced. The result of this state of things was
that The pus formed in the deeper parts of the
wound rather faster than it could escape
through the half obstructed way between
the ribs, and its gradual accumulation be-
gan to cause a disturbance. 1t was decided
to
MAKE A NEW OPENING
in the track of the ball below the last rib so
that the ribs should no lSnger prevent keeping
the opening of the wound by the solid back
ing which afforded the granulating flesh be-
tween them. The operation was performed
at the reqnest of the other surgeons, by Ag-
new. AS soon as the patient had passed under
the influence of ether, long and slightly
curved instrument was introduced into the
wound, pushed between the ribs and carried
downward along the track of the bullet, until
its end below the last rib could be felt from
the outside. Holding this instrument in the
wound as a guide, DR.. Agnew made a counter
iucision below the twelfth rib,
CUTTING DIRECTLY THROUGH
the integument until his knife met the eud of
the first mentioned instrument, at the point
where he wished to iHtersect the back of the
ball. The operation was not a difficult one
nor dangerous one, and the patient bore
both it and the etherization extremely VII.
There is now an opening to the deeper parts
of the wound which does not pass between
the ribs, and which can always be kept free
and unobstructed. No further trouble from
accumulation of pus is anticipated. Since