Omaha daily bee., 1881-07-14
Tho Presidents wound--wherc IL
the Hullet1

ANaH - -N|
Every day of satisfactory progress
adds to the confidence with which we
have regarded the hopefulncss of the
presidents prospects, and six days
have now gone by without a d%iscourag-
ing or alarming sign. AS suppuration
is now in progress we have reached
the period of possible secondary
hemorrhage, for it is the process of
suppuration and sloughing that opens
the blood vessels, if any lie hear to
the line of tissue bruised and killed
by the passage Of the bullet. We
shall soon know, therefore, the ex-
tent of this danger; but we do not be-
lieve it is very great, for we have no
faith whatever in the theory that the
bullet has gone in a direction where
it could give much trouble in that
way. We are astonished to hear IN
of the constant attendants at the
presidents bedside reported as saying
that che is most of the time under the
influence of opiates. What is that
forl We had supposed that the judi
cious advice of Drs. Hamilton and
Agnew had stopped this foolish dosing
with morphine, which has many a
time done more harm than a wound.
With infinite satisfaction the people
of this country have seen the presi.
dent pass through three stages of dan
ger with far less implication of the
great functions of life than was appre-
hended by everybody. The collapse
that threatens Immediately in all great
injuries was Of little moment with
him; there was no grave internal hem
orrhage, and no such diffused intlam-
nation Of the %peritoneum as was
looked for. Readers of The Herald
may have observed that we have in
terpreted all this as the evidence that
the man was less seriously hurt than
had been apprehended, for We were
more disposed to believe that a sur
geon was at fault in his diagnosis than
that the ordinary operations of nature
were set aside for this occasion. Yet
some surgeons persist in their gloomy
representations that though the pros
dent has passed through grave crises
graver ones are to come, and they
mention suppuration, s%epticaemia, ex-
haustion, secondary hemorrhagc, and
ven argue that the p%eritonitis may be
there, Though you cannot find it. All
this is possibly true; yet if our view
of the reasons why the symptoms have
been so slight hitherto is accurate
these are mere lugubrious forcbodings
without a basis in reason. If the ball
has not gone where it was 80 hastily
assumed it had gone, then there will
not be such septiciemia, exhaus-
ton, secondary hemorrhage and diff
fused inflammation as we are told to
expect, nor any but e natural and
healthy s%uppuration, and we may as
well contemplate the case from one
side as another.
Apparently the one fact which con
cluslvely determined the first judg-
ment that this ball was in the liver is
that the liver is opposite that point at
which the ball hit the body. 1t went
in here-the liver is there, therefore
the liver is hit. That was the ratio
cination; and a hasty, incompetent
examination satisfied men of the truth
of what they already believed. This
theory kept out of sight all the posi-
bilities of resistance and DETECTION. Ii
the ball had gone on in the direction
noted at the mouth of the wound it
might have hit the liver. But did it
so go on2 Some considerations of
the obstacles encountered will help us
to judge this, and considerations like
this are the only help we have. Am
brose Pare had a mans head brought
from a prison and drove a splinter in
to his eye, that he might t~hereupon
observe precisely what injuries had
been caused by the splinter tina.
was ut that moment in the eye of the
king of France. But an OK periment-
al study of that sort is perhaps be.
yond the u of our criminal
Jurisprudence, and we must content
ourselves with the logic of the case.
An enumeration of the obstacles to
a bullet which touches the body at the
point involved will indicate at least
the mere impiobabilities of penetra-
ton. First to be pierced were the
garments worn a coat, a waistcoat,
and perhaps the waistband of his pan
falcons and the thickness Of two
shirts. 1t may be even that a button
on the pantaloons had to be smashed.
Next comes the skin, which derives
the power of resistance due to e~lastici-
ty from the adipose tissue immediate.
ly beneath it. All these pierced the
bullet would come upon the wide
%aponeurotic expansion of the latis.
SINUS dorsi muscle. Ii must not be
supposed that the resistance ,nhere
was merely the resistance of ordinari
ly recognized muscular tissue. The
missile did not touch red meat, but
rather a material like what in popular
language would BIO called whiteleather
"a tough, dense, tendinous, fbrous
tissue, capable of great resistance.
Immediately beneath this lie the
sacro-lumbalis, longissimus dorsi and
around each of these at this we'll pro-
tected part of the human body is a
sheath of fascia far tougher than the
muscle itself. Next come the two in
tercostal muscles; and the resistance
here must be counted as much in
creased by contact WITH the eleventh
rib, the edge of which was Clipped.
Inside the rib the obstacles are the
q%uadratus lumborum muscle, the
psoas magnus muscle and the pillar Of
the diaphragm: these or the aponeuro,
tic attachments Of one or the other
as well as the very tough Jumbo costa
lis ligaments.
Now, the total thickness of the alb
dominal wall at this point is much
greater than it is at any other part o
the body. In an ordinary man tn,
thickness of the wall at this nnint In