The Wheeling daily intelligencer. [volume] (Wheeling, W. Va.) 1865-1903, 1881-11-16
THE SHOT OF JULY 2.
HAMMOND oNTHEwoRN OF euITEAu
Aa Expert Opinion on the Wound Of the late PrsSi'
dsat Garfield, and the Management Of 1t
BY the SurgsOu In Chargs-YIsWT Of
Other Emlasnt Surgeons

IIeslutut buIHtlll WHICH 10 W upPcuI ~
the December number OF the North Imcri
can RspisG. The other contributors arC
DR., John Ashurst, Jr., Of Philadelphia; DR.
]. Marion Sims, OF New York, and DR.
John 7, Hodgen, of st, Louis.
1t is believed that these papers will close
the controversy on this subject, and it i.
further believed that the contents OF tht
four articles having been made known tC
Guiteaus counsel destroyed their intention
OF pleading malpractice for the defense
The following Is the paper OF DR.. Ham
mond:
1t has been asserted that the unfortunate
termination OF the Presidents illness was
due to one Of the following causes;
First-The necessarily mortal character
Of the wound,
sccond-Thc imperfect development OF
the science Of surgery.
Third-.The disregard by the attending
and consulting surgeons OF well recognized
principles OF surgery, which, II acted upon,
would have diminished or abolished the
tendency to death. The short space in this
journal at my disposal will only admit OF Il
very CursOry examination OF these points,
while many others Of great Importance
must be passed over altogether
First-Was the wound necessarily NOR.
taP 1t appears that the ball, after fractur.
ing the eleventh and twelfth ribs, the
former in two places, continued on its
course without marked DETECTION, and,
striking tho spine obiQuely, passed
through the inter.vertebral substance be-
tween the twelfth dorsal and first lumbar
VertcbraG, cutting groove in the latter,
and lodging on the left side OF the spine,
below the panCreas and outside tho peritO-
neal cavity. The spinal cord received no
injury beyond a slight conclusion, which
WINS recovered from in II couple OF days.
No important vessel was injured, and all
the abnormal organs escaped. Now,
where ARE the elements OF inevitable death
as the result Of such wound?
DR.. Hammond then quotes authorities
that although the ball may have trayersed
the body Of the verebrp in its interior part,
and although it may have caused paralysis,
We should still trust in the infinite resources
OF nature. Fractures OF the vertebra col
umn with compression Of the spinal cord
have recovered to an extent greater than
would be supposed. Surgeon General
LongmorC, OF the British army, says
"Balls have been known to pass through
the base OF the yertebnr, and an apparent
cure fOllowed.' I.iddell states that out OF
ten cases Of gunshot fracture Of the verte-
bre without injury to the cord, four recoy-
cred.
DR.. Hammond quotes the followingcase
reported by DR.. Frank II. Hamilton, one
Of Gardeld's consulting physicians But
one OF the most instructive eases on record
is that reported by DR.. +. II. Hamilton. A
soldier was wounded March 10, 1885. The
ball perfoNtng, or possibly growing the
anterior surface OF the body OF the second
lumbar vertGbrE, In September, 1865, a
small fragment Of bone escaped. In Sep
tember, 1867, DR.. Hamilton found him suf.
fering only with slight paralysis of the
bladder. The ball was found lying In the
muscles on the other side OF the spine, and
Dr. Hamilton cut it out. Since then il
is stated recovery Is complete. DR.. Hamil.
ton took the man before the New
York Pathological Society, and he says
"The members present cOnourred with me
in my opinion that the ball had struck the
body of the yertcbrae" Many other au.
thorties to the like effect might be cited,
but they are probably unnecessary. As to
the injury TO the ribs no civil or military
surgeon will venture to affirm that gun.
shot fractures OF the ribs, unGompliCated
with lesions Of the abdominal or thon,ic
yiscera, are necessarily fatal. Itappears 10
me, therefore, and | think the great ma,
jority Of civil and military surgeons will
agree with the, that while the Presidents
wound was serious one, there was not n
single feature or combination Of features
about it which rendered death inevitable
Second-Was death due to the nCOhate
condition OF the science OF SURGERY In
gunshot wounds the science OF surgery re.
quires certain things to be done. In the
first place the relative positions of the as
sailant and the patient should, II possible,
be asCertained. A thorough examination
OF the wound should be made for the pur.
pose OF determining the course OF the ball
and its situation, IA the case requires
There is no possible condition which can
be had in opposition 10 this precept, though
there may be such an existing state Of the
patient as to cause the exacrination to be
deferred for few hours. Such cases are
however, exceedingly rare. Then all foreign
bodies, such as pieces Of clothing, specula
Of bone, etc, should be removed a.
soon rs discovered, and the bullet itsel
should be extracted, II Its removal can bt
effected without the inIliction Of serious
additional injury. All fractured bone.
should be adjusted, and II necessary theil
rough ends removed All these things
should be done under antiseptic condi
tions, and antlseptic dressing should be ap
piled. There il more necessity for suCl
precautions during the first forty-eigh
hours than during all the rest Of the perioC
Of treatment II, after thorough examin
alton, 1t should be found that the bail ha.
entered the brain, or heart, or liver, oi
other vital organ, or is lodged in one o
the great cavities Of the body, further in
reference is in general unjnstihable; bu
such facts can in many instances only bt
asCertained by an exploration, conducted
by a skillful surgeon, and witt
every preCnutiOn to guard agains
being deceived. II Is In no case tc
be deducted from Il hurried and superficial
insertion Of finger or probe into what may
AT first sight be deemed the track Of the
bullet, Then Hammond quotes authoritic,
OH these points aud proceeds: And in re
gard to the treatment Of the hemOrrhagl
from which the President suffered for The
first few hours after the inhiCtlon OF thu
wound and the management OF the fraC
tured rib. will only make one quotation
and that will be from the excellent work o
Or. i. H. Hamilton ut is seldom, ever
in gnnshot fractures that The lntercosta
artery bleeds sufficiently to require {
liputnre, but this source is alarming, ant
the artery cannot be tied in the usual way
or It's bleeding be arrested by digitnl com
preston, 1t will be proper to cast n lgaturt
around the entire rib on the side Of thu
fracture nearest the spine, or even in somt
cases 10 cxseCt portion Of the rib In ordei
to reach and secure the bleeding vessel
Or. Hammond continues, "Nothing more
is required, so far as can see, 10 demon
strate what the science Of surgery require,
Of its followers. It's precepts are Of no un
certain tone. Certainly the President diL