The Portland daily press., 1881-08-22


Not Healed but Temporarily Distracted
"A Catheter Introduced IL IL Inches
The Fate oflthe Patient Hanging on His
Stomach.
WASHINGTON, Aug. 2O-In an interview
with representative of the Associated Press
this afternoon DR.. Bliss gave in substance the
following account of the recent exploration of
the Presidents wound by means of flexible
rubber catheter, reference to which was made
for the first time in the noon bulletin today.
Since the operation of the Sth of August no
drainage tube has been used the wound. At
the morning and evening dressings however,
a small flexible tube about a quarter of an inch
in diameter was introduced and q weak solu-
ton of carbolic acid and water forced through
it to cleanse the wound and bring out accumu-
lating pus. Up to yesterday morning the sur
geons had been unable to pass the tube beyond
appoint distant three and half or four inches
from the mouth of the last incision. At that
point it always met with an obstruction which
could not be overcome without exercising
force, and force the surgeons did not think it
prudent to employ. The apparent permanence
of this obstruction finally led the surgeons to
believe the depths Of the wonnd had healed, or
at least the track of the ball had healed at a
point where the rubber catheter was stopped.
A few days since, however, it was noticed
that the quantity of pus discharged by the
wound at one of the regular blessings was
greater than the quantity of water which the
wound would hold after the pus had been re-
moved. This clearly indicated one of two
things viz, either that the pus. which was in
excess of the apparent capacity of the wound,
came from concealed or unsupported cavity,
or that the surgeons were mistaken in suspect
ing the depths of the wound to have healed.
1t also indicated that the obstruction which
prevented the passage of the catheter did not
interfere with the flow of pus outward from
the deeper and unhealed interior. The low
temperature of the patient negatived the theo-
ry of a pus cavity, and the surgeons therefore
came to the conclusion that the deeper parts of
the wound must still be open and that the ex-
cess of pus which could not be otherwise &C
withstanding the Obstruction encountered by
the catheter' On Thursday DR.. Bliss made a
long and careful examination of the wound,
but was still unable to get the tube in deeper
than about three and half inches. sOn Fri
day morning, however, during the dressing of
piece as large sas the end3 sof ones little
finger, sloughed off or became detached and
was washed out with the pus. This fragment
of tissue had apparently been half detached for
some time and had acted as sort of valve at
the point where the track of the ball seemed to
be INSTRUCTED, closing it against the catheter
and against water from the outside but OPEN
ing to pressure from the inside and allowing
the outflow of pus from the deeper parts of the
wound. Upon the removal of this fragment of
tissue DR.. Bliss again introduced the flexible
rubber tube and finding that it no longer en-
stated to distance of 12a inches. Almost the
entire track of the ball was then thoroughly
washed out and cleansed. The pus which
came from this deeper part Of the wound al
though not great in quantity, was unusually
white and was perfectly healthy in character.
1t was in fact better pus than that secret
ed by the more superficial parts OF
the wound. If auy septic faint has
passed into the patients blood it
originated not in this pus which has been en-
tirely protected from the air, but from that
secreted in the suppurating surface between
incision. Nothing new with regard to the
location of the ball had been learned.
In reply to question with regard to the bed
sores from which the President has been re-
ported to be suffering, DR.. Bliss said emphati-
cally that the President has not on his body a
single sore,i swelling or abrasion Of any kind
with the exception Of the swelling under the
ear caused by the Inflammation of the parotid
gland and wound in the back caused by the
bullet and knife The Inflammation of the
parotid gland has not, he said, diminished
much since yesterday. The swelling of the
surrounding parts has subsidized and that the
expression OF the face is again natural but the
gland itself is still troublesome. Scattering
applications of collodion aud iodine shave
been made to it, but it is impossible to say yet
whether suppufaIlon can De prevented. In
the meantime the patient suffers to some ex-
tent from stiffness of the jaw and from the &C.
emulation of phleghm in theithroat. Upon
being asked whether there were any symp-
toms yet in the Presidents case of malaria,
DIR. Bliss replied in the negative.
In conclusion DIR. Bliss said that the whole
question Of the future of the Presidents case
turns upon his stomach. If that organ can re-
ceive and assimilate food enough to make
good the present drain upon the system and
enable the patient to regain his strength he
will stand fair chance of recovery. If on the
contrary the stomach becomes intolerant OF
nourishment and entirely refuses for any
great length of time to receive food the con-
sequence may be fatal. At present all indica-
lions are that the stomach is recovering its
tone and upon this fact, he said, we base our
houeful authorizations