Morning journal and courier., 1881-11-02

it was about $S2, GOO, 600 annually. The pen
 sion list will be fully a1z. .0Q0, 900 less this
 year than last. ssProvided the tax on whis-
 key and tobacco remains the same and with
 out material change in the tariff we will not
 owe one cent ten years hence." said proml-
 nent Treasury official to-day
 President Garfeld's Mortal Wound-A
 Medical Criticism of Dr. Bliss. WASHINGTON, Nov. 1.-The current num-
 Der of Dr. Walshs Retrospect of Medicine and
 Surgery, published this evening, will contain
 a long editorial comment on the case of the
 late President Garfield, or as the journal
 terms 1t, 'sThe result of our investigation in
 the case for the purpose of giving truthful
 and fearless account. Dr. Walsh first quotes
 from the official account by Dr. D. W. Bliss,
 in which he recites how he probed the Presi-
 dents wound with his finger at the depot and
 how he afterwards used small flexible silver
 probe, also how he expressed his opinion that
 stimulants should not be given the wounded
 man at that time because of his constant suf
 fering from nausea. pr. Walsh says he had
 an opinion that it was Surgeon General Wales
 who made the first digital examination of the
 wound and that the stimulants were given
 after Dr. Bliss arrived. In substantiation of this opinion the article includes letters to the editor from Dr. Smith Townshend, health of fcer of the District, and Dr. c. B. Purvis | The former says he himself gave the Presi- dent a stimulant before Dr. Bliss arrived, that pr. Bliss brought long probe which was not, however used that after the President was remoFed to the White House Drs. Wales and Woodward were selected by Dr. Bliss to make an examination, that Dr. Wales did so and made the first report to the other physicians as to the course of the ball. Dr. Purvis says brandy was given the Presi. dent both before and after Dr. Bliss arrived, that Dr. Bliss undertook to probe the wound first with small silver probe and then with a Wealton probe At the White House Wales wanted to know just the nature of the | wound and announce it, but Df. Bliss who l gave the impression that he had been special | ly summoned. said wait Afterwards how | ever, Drs; Bliss, Wales and Woodward made | an examination, and Wales said he had | passed his little finger in the wound and | found the eleventh rib fractured and the | liver perforated. Dr. N. s. Lincoln also | writes to the editor that when he arrived at | the depot Dr. Bliss said to have made l hurried examination of the wound and had | expressed the opinion that further examina- l tion then would be dangerous, also that Dr. | Bliss examination obtained no definite in | formation and that Dr. Wales first ascertained | the fracture of the rib. Dr. Wales himself | writes to the editor that on reaching the de- pot he learned that Dr. Bliss had assumed | charge of the case and heard Dr. Bliss telling | the crowd that he had passed the | probe three and a half inches in the | wound, but not telling it's nature or the | exact location. Dr. Wales also says that | he made two examinations of the wound. | personally and found the fractured rib and | so reported. He says too that he did not share in the general opinion that the wound was fatal either at first or when he received | 8 polite note that his services were no | longer required. The editor then quotes from the official reports Dr. Bliss statement that Doctors Hamilton and Agnew individu- ally examined the wound at the first joint | also Dr. Hamilton's statement | of finding the track of the wound com pletely closed up by a blood clot." Dr. Walsh is at loss what to think of 8 paper so at variance with the statements of reliable gentlemen. He asserts that the failure to en- large the wound and remove the spicula of bone soon after the reaction was established was great mistake, and expresses the belief that if that mistake had not been made the pus cavity would not have formed, quoting from Dr. Hamiltons own work on military 1 surgery, page 265, s'One of the most fre- 4uent causes of death and of delay from re- 1 covery is found to be small spicula of bone toosened or completely detached from the rib" Had not a false channel formed, says the editor, false diagnosis would not have | been made, and the danger of py- emia would have been greatly lessened There IS quoted eminent authority to show that 8 thorough cleansing and drainage from the right side of the vertebrae need not have been fatal. The further assertion is made that traumatic aneurism was not proven by the autopsy, making this point chiefly on the fact that there was nothing to show that the splenic artery was in the track of the ball. Taking up Dr. Bliss points for the consider ation of the profession Dr. Walsh expresses he opinion that if Dr. Bliss made an exam nation with the probe at the depot, as he says he did, it was more thorough and the patients condition justified 1t, three inches 1 and a half downward and forward and down. ward and backward out. The course of the oall might lacerate health tissue. To Dr. Bliss inquiries as to whether the Presidents transfer to the White House was timely and appropriate, and whether the most judicious means were used to secure prompt reaction, he editor is glad to answer ives" As to whether the mistaken diagnosis was a natural result of the conditions Dr. Walsh replies that it was natural result of the conditions In reply to another query of Dr. Bliss he states that had the wound been properly enlarged the ball could have been traced as far as necessary with the finger. In contra | fiction of Dr. Bliss statement that President Garfield personally placed himself under his Dr. Bliss') care Dr. Walsh says that it is of proof that Garfield stated, af- ,er Dr. Bliss had assumed control of the case md refused admission to Dr. Baxter, that Dr. Baxter had been for many years and was still considered by him his physician and that le had never expressed desire for Bliss to
 ake charge of the case The assertion is slso made that Mrs Garfield was at no time aware that the Pr sident had selected Dr. Bliss as his medical attendant. The article
 LI~ I-r kl- condition from the public was a mistake resulting in a loss of confidence in the physiciani statements and public re-
 ance upon the profession and the Cabinet officers dispatches. Another error was the failure to call in eminent pathologists not previously connected with the case to assist in the autopsy, particularly as that might have ensured protection against unfavorable criticism The article further admits that there can be no censure of the medical treat ment of the case and concludes as follows: Briefly summarizing we say that the failure to enlarge the wound and remove the spicula, l the treatment of false sinus for the track of the ball, the issuing of bulletins creating pub-
 lie distrust, the performance of the autopsy without the presence of eminent disinterest- ed pathologists, the arrival at uncertain de- auctions from said autopsy and the false made have done more to cast dis trust on American surgery than any other case known to our medical history"
 NEW ENGLAND. !