The Osceola times., 1881-12-17
GARFIELD'S FATAL WOUND.
-Four Eminent surgeons Discuss the Case
Three Of Them Practically Agree That
Death was Inevitable The Fourth
Denies That IL was.
New York Times.

Death was IneSithbio- iho s""
Denies That IL was.
New York Times
-Four eminent surgeons-Dr. J. Marion
Sims and DR.. w. A. Hammond, OF New
York; DIR. John Ashhurst, Jr., ot Phila-
delpbia. and DR.. John T. Hodgen, OF St.
Louis. contribute papers to the December
number of the North american Retiew,
published to-day, ON THE Surgical Treat
ment of President Garfield" Three OF
the four practically agree that the Presi-
dents case was hopeless from the start.
The exception TO this accord IS iound IN
Dr. Hammond. DIR. Sims declares that
Gar6eld's ound was "as certainly NOR
tai" as Yves Lincoln's, which was IN
stantly fatal" and concludes his article
in these words: "View the Presidents
case IS we may, he had not the least
chance of recovery under any circum
stances or any treatment. Without the
wopnd of the vertebre it would have
been impossible for him to die. With 1t
it was impossible for him 10 live" Dr,
Sims prints diagram to show now
difficult, almost impossible, it was TO
probe such rectangular, zlgzag canal as
the ball made in this case" And how
could any one" he asks, find the course
of the ball fit were impossible to fol-
low its track with a probe" Even II
the course Of the ball could have been
ascertained, the result" he says, would
have been precisely the same. The sur
geons could only have kept the pls
pouch between the fractured ribs and
spine aud the one extending down INTO
the pelvis empty and clean This they
did all the time, rs the history OF the
case and the autopsy show. They could
have done nothing whatever for the
results of the compound, comminuted
fracture ofthe two vertebre. From the
very nature of this part of the wound,
death was sooner or later inevitable"
Again he SAYS "But for the injury to
the spine the President would have re-
covered. and / must here repeat that
with this injury it is marvel that he
lived so long" DIR, Sims adds that the
attending surgeons have been severely
and unjustly treated by some newspa-
pers and even some members OF the
medical profession, and then continues:
"a correct diagnosis is essential to sue
cessfull treatment. II is the basis Of all
treatment, But we may diagnose accu-
rately. and vet our patient dies when the
wound is mortal. We may fail to dag
nose correctly, and our patient dies for
| the same reason that the wound is NOR
tai. In a mortal wound the diagnosis,
true or false, is powerless to save life.
And so ii was with the President. His
wound was mortal whether diagnosed
correctly or not. And it is uncharitable
and ungracious to blame the surgeons in
the Presidents case for its fatal termin-
alton. They did all that men could do;
all that the present state of science would
permit and all that could .have been
done, even if they had at first ascertained
the course and direction of the ball
| Medical science is not yet an exact one
| II is in transition state. Although il Is
progressing with wonderful rapidity, the
| time will, fear, never arrive when such
cases as the Presidents may be treated
with any more success that at the present
day.
DR.. Ashhurst reviews the history ofthe
case from the day the wound was in
ficted. He does not think the attend
ing surgeons should have made an effort
TO remove the ball, either when frs
called in or at any subsequent time, and
| his conclusion, "looking at the whole
case from beginning to end" is this: 81
| do not see that the treatment could have
been altered in any way to the advan
tage of the illustrious patient; nothing
was done that should have been omit
| ted, and nothing was left undone that
could possibly have been of benefit
| On the question of necessarily fatal
ending, his answers somewhat qualified
| but "given a ease precisely like the Pres.
ident's and it must, no doubt, end In
DEATH" still, "the case might be different
while the wound was similar, by
which he means that, had the President
been youth of 90, entirely free from
care, and able to consume in his illness
an ample supply of food "the case might
possibly, though not probably, have ter
minated differently"
DIR. Hodgen "can find no reason foi
adverse criticism of any part of the man
agement," and does not see that any
thing was done, "either at the examina.
| ton or, in the treatment, tended to hast
en- death or IN any wav unfavorably in
| fuence the progress of the case" ANY
probing beyond the inner surface of the
ribs, he believes, would have been 20
no value" His conclusion is this: "HaC
the site of the ball been known, it coulc
not have been removed. Had the site
character and relation Of the aneurisn
been known, the vessel could not hav,
| igated. Had the presence of the pui
cavity been recognized, IT could not have
been evacuated without Fastening tn,
fatal termination. Finally, if the pui
cavity had disappeared harmlessly, fifth,
aneurism had been spontaneously cured
| If the bullet had remained encysted, tn,
injury to the spine, with the carious con
dilion of the bones and the ulceratin,
inter vertebral cartilages, must have lef
the President deformed invalid"
DR.. Hammond, among numerous othe
points that he raises against the treat
ment the President received, makes
these, which he calls alleged "circum
stances" believed by him to be true
"There never was any adequate reason
why athorough exIloration ofthe wount
with finger and probe, could not hav'
been made within "a hours after tn,
shooting. Had this been done the tracl
of the bullet would certainly have beer
discovered, as it had pursued perfectly
straight course, undefected by any tbs
sue through which it had passed. thu
injury TO the ribs and the first lumbar
vartabrun uoplJ buva beap aaaarfoi nod