New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1881-07-26


of the discharge is carefully ascertained by micro
scopic and other tests Every discharge of pus thus
far has been perfectly healthy except that which
was released from the cavity at first. That not
perfectly laudable-hcalthy-bu it showed no symp-
toms of blood poisoning"
"llave any of the recent examinations changed
your opinion respecting the of the bullet or
enabled YOU to fix definitely its place of lodgment ~
No. we are still of the same opinion, and we can
not positively tell where the bullet is"
"Supposc that your patient not President of
the United States, Doctor; what would you be will
ING to say regarding the prospects of his recovery
"Well, | should say that while he had been very
seriously wounded and was not yet out of danger,
he stood fair chance of recovery"
The hour of 6 o'clock arrived, and the courteous
surgeon excused himself to attend the evening con-
sultation of physicians.
After the evening consultation and the dressing of
Rcyburn again, and asked
DO you feel as hopeful ROW a. you did two hours
agos"
eyes, was the reply, the symptoms are not dis
cOuragng. There is some fever. but it has been un-
accompanied by any symptoms of chill, and the
patient is doing well. The situation is still en-
cOuraging"
THE OPINIONS OF DIR. BLISS.
"You say nothing, Doctor, in your bulletin of this
charge continucdw asked TRIBUNE correspondent
of DIR. Bliss this evening.
"lcS; il has been in every way satisfactory" was
the reply. "When we came to dress the wounl to-
night found that it had been discharging nicely
all day"
"Then the curved tube works well p
"Ies, very wcll.'
Some alarm has been created by the rise in tenn
perature and pulse rs given i'll this evenings bullc
tins are there reasons for alarm p
"No, there need be no alarm. The symptoms
noted are due entirely to the fcbrlc rise which has
occurred almost every afternoon since the wound
was made. These symptoms were expected and
have not alarmed u.s."
doctor, what would be the first symptoms of
the formation of a new pus cavity?'
:" A chill would probably be the first decided
symptom"
"Then in the absence of that symptom, You feel
assured that no new cavity has begun -
There might be formation of the kind so small
in its beginnings not to create a chill manifest
itself III any very definite way but there would be
disturbances of the system recognizable by all
physicians before the development could reach
alarming proportions. We feel confident that moth
ing of the kind is in progress yet. For instance
on Friday night noticed symptoms which nd-
Gated that some obstruction had occurred, and that
the Presidents condition was not as favorable
where the pus had accumulated and from
the wound there issued pus which felt certain did
come directly from the place of ITS origin. The
symptoms continued to be such as to indicate that
some barrier to the free exit of the pus had been
formed, and on Saturday morning. when we began
TO dress the wound and again pressed the spot where
pus seemed to have been gathered the sac was SEN
sibly felt That fact once ascertained there was
never any doubt as to what should be done but il
fnouQlt in of fhp viety of la. lie
that the consulting surgeons ought TO be present
and we were ourselves very glad To have their aid
and counsel; so they were sent for Before they
arrived the pus had been so far relieved by pres
sure of he hand that the consulting surgeons did
not think il necessary to the patient on the night
of their arrival.
THE OPERATION UPON THE PRESIDENT
"It was agreed by all, however, that an incsion
into the pocket should be made on the following
morning. The operation was a simple one but there
have been some misstatcmcnts in regard To it, 1t
was only about thrcc-quartcrs of an inch in dcpth
1t was snolc incision made with n knife The
sac at once relieved, and IA connection was cs-
tabshed with the lower line of the wound This
operation having been performed ana the pIIs hay-
ing been released felt sure that the President
would mend. He has done so In fact
he has been helped by the operation.
because the pus can now discharge more freely
When we had completed the incision and connected
it with the channel leading from the lower line of
the wound to the pus sac, able to connect
the two openings by passing through the upper n
curved tube which came out at the lower Before
doing tins, with a fountain, not Il syringe we
thoroughly clcansed the wound with carbolilcd
water This removed all the pus matter lying in
the channel between the upper and lower openings
Now through the tube drain the woundr
"Through the lower opcning?"
Yes, that Is more convenient than the upper
Thus we tap the lower line of the wound and drain
its inner end-wc think. OF course we do NOT
know whether tap The lower end of the wound
or not. We know that drain thoroughly the
outer end. We can look in for distance a, long as
your forchngcr, and with my finger while we were
making the operation touched the fractured RIB.
We know all about the wound as far as one can See
and feel. Beyond that we can only surmise"
at has been said that delay ought not TO have oc-
CURED from Saturday morning until Sunday morn
ing; that the incsion ought to have been made ot
Once."
:" If it ought to have been made we would have
madelt."
1T has been said that pus cavities may have
formed elsewhere while the flow of pus was
coggcdg"
That was not the case. We relieved the only
pus cavity or rather pocket; it was "a sac between
the SKIN and the bend in the wound into which the
pus ran"
" But other pus cavities may form ~
Certainly. If the pus becomes clogecd and q
| stoppage occurs pus cavity may he formed II i,
possible, but we do not look for it, As long IA IN,
channel is kept open, and the pus discharges freely
through 1t, there need be no expectation of the for
| nation OF II pus cavity"
" If such pus cavity should form-Y
IA ..11 1t,A,