The Portland daily press. [volume] (Portland, Me.) 1862-1921, 1881-07-25
The Presidents Progress to
Recovery interrupted.
A CHILL FOLLOWED BY
A HIGH FEVER.
An Obstruction in the
Wound the Cause.
AN OPERATION PERFORMED
AND PATIENT RELIEVED.
The Symptoms Now Much More
Favorable.

1t will be remembered that the, official bu!-
letin Of Friday night announced a
considerable increase in the Presidents fever,
his temperature having risen to 101. The sur
geons looked upon this simply as one of the
ordinary fluctuations which are liable to occur
In such cases and attached no particular sig
niicance to it. In the light of subsequent de-
velopments, however. it is pparent that the
increased fever was much more serious
symptom than was supposed. The President,
during the night, was restless, and though the
fever abated he did not wake in the morning
as much refreshed as usual. At a. m. Sat-
urday, while the surgeons were preparing to
dress the wound, his temperature was found to
be normal. with pulse at 80 and respiration 49,.
At 7.30 he had slight chill, in consequence
Of which tho dressing Of the wound was post
poned. A reaction soon followed and at 10
o'clock the dressing OF the wound was COM
pleted, but his pulse had risen meanwhile to
ITO, temperature to 101, and respiration to "a.
At 11.3O another chill set in and his tempera-
ture began to 90 up still higher, till at 1890 p.
m. it had reached 1O4. His pulse at the same
hour was 10S and respiration %. These were
dangerous figures and the surgeons became
considerably alarmed, and the public much
more so. At 100 the consulting surgeons Drs
Hamilton and Agnew, were telegraphed to
come Immediately to Washington for consul
tstion. There were rumors that there
were signs Of the formation of an abscess and
of pyemia or blood poisoning, but both of
these reports were denied by the surgeons who
said that there was not the slightest symptom
of either. During the afternoon the Pres-
dent impr owed little but not enough to allay
the anxiety. The explanation of the unfavor-
able symptoms given by tho physicians is as
follows:
Sometime during Friday night or early Sat
urday morning, the patients wound, which
had for several days been discharging freely
became 0bstructed at or near the inner end of
tho drainage tube, while the process of sup
puration in the deeper parts Of the wound con-
thus formed, and the discharge from the
mouth of tho wound nearly ceased. The nat
ural result Of this state of things was chill,
followed by higher fever, the patients pulse
rising TO maximum of about 1870 and his tenn
perature to 1O4. As rigor, followed by in
creased fever, is q symptom of pyemia, of the
formation of abscess and Of other unfavorabe
complications, it caused at first great deal of
anxiety
A careful examination, however of the pus
discharged by tho wound showed that it's
character was perfectly normal and healthy,
eral condition all indications of pyemia were
absent. These facts relieved at once the fear
Of blood-poisoning. An external examination
was then made of the abdominal and hepatic
regions, with view to ascertain whether
there were any signs Of an abscess at the sup
M n ot M m mol fap
derness was found in that part of the body or
any other indications of a changed condition.
From these facts, taken in connection with the
scanty outflow OF pus, the conclusion was
drawn that an obstruction existed near the in
ner end of the drainage tubes, which pre-
vented free discharge. This Imprisonment
Of pus, technically known as formation of pus
cavity, is entirely adequate to explain the
chill and increased fever, since they are its
natural and almost inevitable consequence.
It was at first thought the distractions
might be the result OF process OF healing
which had wholly or in part closed the wound
between the end of the drainage tube and
deeper suppurating surface.
Early in the afternoon, however, the OBJ
struction wholly or partially gave way, the
which the patient had suffered subsidized, and
he obtained relief. This proved that the OBJ
struction had not been of q permanent charac-
ter.
Drs. Hamilton and Agnew arrived during
the ev ening and held consultation with the
surgeons, but did not think it advisable at
that time to make an examination of the pa
tient.
During the night the patient was restless
and had another slight chill, but in the morn
ing his temperature was about normal. On
consultation the surgeons decided to make a
new outlet for the pus and accordingly an in
cision was made through the integument of
the back to the track Of the bullet aud drain
pipe inserted. A flow of pus followed and the
Presidents symptoms soon began to grow bet
ter and continued to improve throughout the
day and night. The history of the case since
Saturday afternoon is fully set forth in the
sabioined bulletins: