The Portland daily press. [volume] (Portland, Me.) 1862-1921, 1881-09-23

r. rib.
l, intestine.
LK, left kidney.
RK. right kidney.
L, liver.
P, poncreas.
LV, first lumbar ysftsbra,
S, spleen.
A, aorta,
", vena cava,
M, loin muscles
G, lowest part OF stomach.
\. point beneath which tbs bnIiAt was found.
AS one kidney Is Situated naturally higher
than the other, they are not severed by the
knife in corresponding portions which accounts
for their different appearance. The iHtsstfnes
are normally coiled and twisted. SO that thesec-
ton shows them in irregular and fantastic
shapes. But small portionof the liver iseutof
with this half OF the body, land only minute slice
of the lowest part Of the stomach and the low
ar end OF the spleen. The broad black line
running from r to x represents the track OF
the ball, as described In the official report 1t
entered at a point a httle above e, that is, at
level above any portion Of this section,
broke the eleventh rib. ploughed through the
great loin muscles shaded dark, as are all
the other muscular strnctures), just missing
liver and right kidney, both of which ii was at
first feared were wounded, then crashed
through the body of the first lumbar vertehra,
breaking off spiinters of bone and driving
them into the soft parts around, passed close to
the aorta, and finally stopped just below the
panersas, at point beneath x in the picture.
The report does not state that the track was
straight; but straight line drawn irom the
right eleventh rib 10 the left, forwards and a
-
route above described. In the drawing it Is
impossible to show this downward defection,
as the cut surface Is horizontal. but, by re-
garding e as little above, and & as little be-
low the level OF this surface, 1t VIII be easily
understood.
The great muscles accumulated around the
backbone all have general vertical direction
running up and down alongside of the spinal
column, of which column the vertebra in
question is one piece. These muscles were
torn through by the bullet, and when matter
wound, it burrowed Its way down between
these muscles and made channel which of
itself gave forth more pus. Thus. the matter,
on pus, kept working further and fnrther
down, conveying the impression that the bull
Let was at the end Oh this channel between the
muscles, and misleading the surgeons as to its
true location. The assesses IN the back,
which had to be opened several times, were
collections Of this pus which had gathered in
pockets at the side Of the main channel.
Tho bullet was found encysted, that is to
say, enclosed in firm sac of dense material.
This is natures method of disposing of many
foreign bodies in the soft parts. It never en-
tered the cavity Of the peritoneum, for this
lies in front of the pancreas.
The question has often been asked, why did
not the surgeons find the ball before the Presi-
dent died? But it will not be asked by those
who appreciate the extreme danger to which
the patient is subjected by the introduction of
any exploring instrument deeply among these
structures. 1t 10 we'll honored rule in surgery
not to drive probes through resisting parts
when searching for a ball. The surgeons re-
peatedly inserted probes into the wound, and
finding them go downwards almost Of their
own accord, and knowing that normally no
channel exists in that direction, they very
naturally thought that the bullet had made
this channel, and their attention was diverted
from its actual track by the fact that the
greater part Of it gave.no obvious symptoms
indeed, no symptoms at all which were not as
easily referabIe to the channel between the
loin muscles.
But, even II they had known exactly where
the bullet lay. they could not have extracted 1t
by any iustifable means. II they had follow
ed the line which it took In entering, they