The Evening critic. [volume] (Washington, D.C.) 1881-1885, 1881-08-23
THE PRESIDENT
CONTINUED from First Page. /

the Presidents condition. The matter is
being watched with interest, for DR.. Boyn-
toms relation to the people at the White
House Is peculiar one, and the objections
Of the doctors in attendance arc not likely
to influence his behavior in this regard,
unless he shall accede to their wishes in the
interest Of peace and harmony, as the poll
ticians would say"
Views Of DR.. j. +. May.
Dr. J. f.. May, formerly q prominent
medical practitioner in this city and now a
resident of New Yerk, was interviewed in
that city yesterday lie was asked whether
he considered the swelling of the parotid
gland an unfavorable symptom.
have considered 1t n very grave symp-
tom, DR.. May replied from the moment
il was mentioned in the daily bulletin as /
thought II indicated poisoning"
The reporter reminded DIR. May that the
attending physicians had said that there
was no sign Of blood-poisoning, and that
such swellings of the gland were not UNI
common in wounds. One of the doctors
had stated that he had seen it occur in
hundreds of such cases as that of the Presi-
dent.
"Thc bulletins have never said so," said
the Doctor, and it is from them only that
we are authorized to form an opinion, and
not from the daily exaggerated and often
extreme statements in some of the news
papers. / can only speak from my own ex-
perience. think IL is u very uncommon
occurrence in gunshot wound or wound
of any kind unless it be connected with the
cause I have mentioned. When these swell
ings occur in glands or other parts, however
distant they may be from wound that is
suppurating, they are almost invariably
caused by the condition Of the blood and
usually terminate in abscesses."
Although it had been said that the swell
ing of the parotid gland could not be due to
pyemia, because it is IA secreting and not
an absorbing gland" DIR. May said the
gland "could take in the poison" Any
part of the system through which the blood
courses could do so. "The liver and the
kidneys" he continued, care nothing more
than large secreting glands, and numerous
assesses often form in them in pyemia,
more frequently on the liver, think, than
in any other internal organ except the
lungs, and they not unfrequently form in
the prostate, which isalso a secreting gland.
There are three pairs of glands whose
ducts open into the mouth and pour
out fluids and form the saliva, which
mostens and lubricatcs the food. OF these
the parotid is much the largest. Now, 1
recollect a case of a severe wound in which
soning was the formation of an abscess in the
smallest of these glands (the sublingual,
which lies, rs its name Indicates, just be-
meath the tongue" DIR. May said he very
much wished that occasional statements
might be made by the physicians attending
the President as to the state of the patients
urine because he thought that in most of
the cases of pyemia he had seen there had
been albumen in the urine, and he believed
it was almost always found in it in such
cases. fa
But is not pyemia always rapid in its
course, and soon fatal in its termination ?"
In the majority of the cases it is rapid
in its course, and fatal generally from the
fourth to the tenth or twelfth day. On the
other hand, 1t sometimes assumes slow,
and, as it may be called, chronic form,
characterized by great prostitution, shrink
ing and shriveling of the tissues, slow fever,
an apathetic state, with sweating, some-
times vomiting, and other symptoms not
necessary to enumcratc and terminates in
as many weeks rs have mentioned days
for the rapid or acute form of the disease.
1t is from this slow form that patients do
occasionally recover. In the case l men,
toned of an abscess forming under the sub
lingual gland, a number of other external
assesses formed beneath or among the
muscles, and after ten weeks of suffering the
man finally recovered. do not think that
the bullet not having been recovered is the
cause of the trouble in the Presidents case.
The physicians having charge Of it have
very prudently abstained from any effort
to extract it. 1t would in all probability
have been fatal to attempt it, Nature will,
or rather has, taken care of the ball by
encysting it, The much more serious com
plication was the fracture and splintering
of the rib, for nothing Is so Irritating to a
wound as pieces Of detached and dead bone,
and nothing is so apt to form unhealthy
and poisonous pus. In the slow cases of
pyemia l have mentioned no treatment
can arrest it. The only thing to be done
is to open the assesses when within
reach aud to sustain the vital
power by. proper. nourishment and by
tonics and stimulants, and thus support
nature in her struggle to throw off the
deleterious matter, which, by poisoning the
blood, is sapping the foundation of life. If
in this struggle the blood-posoning mani
tests itself slowly, owing, probably, to a
small quantity of vitiated pus circulating
in the veins, and especially if it is confined
t0.the:: formation of external assesses in the
effort of nature to eliminate the poison, the
patient may pull through even after many
weeks of trial. But If these abcesses form in
the internal and vital organs, the course
is rapid and the termination uniformly
fatal. In fact, l believe as general
rule (ceteris paribus) when the disease
assumes the rapid and acute form it is
owing to the larger and continued and more
vitiated quantity of pus which is intro
duced into the blood, thus causing the for
nation of assesses in internal and vital
organs and in the joints. When it takes
on the slower form there is a more limited
portion which gets into the veins, and
probably less noxious in its quality, which
expends itself more gradually in forming
Assesses nearer the surface and in parts not
so essential to life
tory.
The noon bulletin is good one under the
circumstances, and contains cheering intel
ligence of the Presidents stomach, his
wound, and the annoying parotid gland.
The bulletin was awaited Mt the White
House by a number of interested people,
including II number of newspaper, men and
the general opinion was that its contents
were favorable. There is scarcely any diff
ference in the pulse, Temperatures, and res
piration over yesterday, but the general
features of the case have improved. The
hope now becomes stronger that with the
utmost care and good nursing the presi-
dents stomach will be restored to its nat
ural character, and that by the use of good,
nutritious food he will be endowed with
sufficient strength to battle with the wound
and oil his nthar trnuhlac