The Dallas daily herald. [volume] (Dallas, Tex.) 1873-1887, 1881-10-01

covering on the convex edge of the right
kidney, sch about the size of vertical
section Ga lsrgqA,ea The abscess found
between the trsnt Srse column and the liver
was evidently not metastNtic, but probably
WAS eau cd by she original injury. There
was no clestrix nor wound Of the liver nor
anything TO indicate that it had suffered in.
jury in ne slightest degree. Since it has
0eon the ught by some that il was the duty
OF the surgeons TO have ascertained positively
the cot tse and location Of the ball, it is
proper H. consider whe her either the one or
the other we're practicable. AS TO determine
ing the course OF the ball by probe, every
anatomisi will see that II was impossible, if
no will consider the very tortuous course
which the ball must have taken TO reach its
final destination. 1t passed through the solid
structure ofthe vertebra, and no metallic in-
strument sufficiently firm to give indications
of the courso and direction which il took
within the body could even have reached the
ball, nor would any surgeon of
experience familiar with gun shot
wounds of the belly, in the absence of any
satisfactory or conclusive evidence a. to what
course the bail had taken, venture 10 intro
duce probe into the abdominal cavity for
the purpose Of exploring the track, or indeed,
If he had evidence ss to course and situation
Of the bsll, could he have been justified in
such an explanation. No point is better
settled in surgery than that interference of
this sort in gun-shet wounds of the belly is
meddlesome, useless and dangerous, and had
il been done and fatal peritonitis in conse'
quence been SGT up, the surgeon doing it
wO'' lave been Justly held responsible for
the q. result. AS to the possibility of the
ext It On of the ball safely, ii would have
req j a large documentary and muscular
inC,s.on as n means of approach to the spinal
column, and the actual removal of the whole
of the twelfth lumbar vertebra in order to
furnish sufficient channel through which
THE BOLD SURGEON
should advance with his instrument for ex-
traction, and after emerging from the cavity
thus made in the spinal column no would
have TO penetrate or grope his way eau
tiOusly between the glangllonc system of
nerves and arteries, veins and lymphatics,
including the thoracic, all of which are vital
structures almost inextricably Joined to each
other on the front and sides OF the spinal
column, and the lesion Of any one OF which
must have proved inevitably fatal. Through,
out the whole course OF the treatment, con-
trary to what has been publicly said repeat
eddy. SO far as it WAS possible to apply the
system of antiseptic surgery advocated by
Mr. Lister to wound of this character, it
was vigorously employed. | am reminded
now to say in reply TO some suggestions
made from time 10 time that we ought to
have made counter opening in
the lower portion of the long sinus
which terminated in the right lilac
losss, that there was no period OF time dur
ing the PROCESS of the case in which VIC felt
absolutely certain that what we recognized
10 the iosea as point OF induratlon was tho
bali, nor were We entirely certain as
any time wnore the lower end of the sinus
was actually situated, Nothing but = very
flexible instrument could ever be introduced.
lls presence in tho track could not be recoe-
nizsd by the sense OF touch, We were efs
without any means of determining, with h
sufficient degree of accuracy 20 justify an OPP
Grafton, where the lower end OF the channel
was. Indeed, il is probable that the flexible
chatheter employed never reached the lower
end of the channel, but doubled upon itself
near the crest of the ileum. To have cut
through or between the great mass of mus
cles in the lower lumbar region for the pur.
pose of making II counter inclsion into q
small channel, the course of which wa did
not and could not know even approximately,
would have been, under any circumstances,
an uniustaable proceeding, especially SO in
the case of the president, whose hold upon
life during all this period seemed TO depend
upon thread