New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1881-10-02
PRESIDENT G ARFIELD'S CASE.

PROCEEDING FROM RENT IN TIE Mo-" go,
OF THE sPENIC ARTERY-TuE cfsi Nv
THE BALL WAS FOUND THREE AM
INCHES TO THE LEFT or TIE coE,iAO go, Sc
n,,,, Oct The October issue OF
Ia''.n,J n, the Medical Sciences contains
.o toIov,g official report of the autopsy OF FRESH
AT corfelJ prepared by the surgeons III ch'is0'
pooor, of the post-mortem examination o, h tnp
BODY of President J.; a. a ~ M eighteen hours
after death at FaNcklyn cot see pls SURGEON
Present and assisting; Dr. y: W. bliss scoon ! J,
Genera, .; n n = amy. DR.. Robert Reyburn, Dr.
Frank Fl. Hamilt'n DR. D. Hayes A SgofW and
amare" ~. surgeon D. s. Lamb, OF the Army
Medical Museum, Washington. d. Z: u,,,o
Before commencing the txamina,i ION room ad;oin
;nc That m which the body lay, and ~ was UTAH.
,onsIv agreed that the dissection should DE ha noS
Dr. Lamb and tn Surgeon o1dwaia nanmonsly
the observations made. 1t was iurlheI u.i'' ad Snr
aIrreed that the Uranium should not he 0peneu 80
gcon Woodward then proposed that tne That the
finn shonld he conducted as ioiIo"s aorh;d
i1o H IiId I've Waved externally, and any m9rolu
on'Sargnccs existing recorded; Ihat d oa done
should then be passed IN e nmrnose of assisting
70 t;r5 the nosition of the bullet that long
sbonld next be made from the superior ea ny "
the srernIrn TO the pubs and TINS crossou ny
WIG So ~ one inst below the umbilcum that the
abdominal flaps thus made shouiu tueH Va W" that
back aud tne abdominal vlscera ad th no ition
after me Snnd he nscSrtained if possible be ore
making any further inclson ana ,ha IN nr3or Of
fhoracIc yiscera should be examined. ihiS o' "
nrocrdure was unanimously agreed 10; 81, a .bo
The examinati IN wa tn proceeded with ana Inc fhe
folov1np external appearances were oos9r Neu ~
LII & considcrably emaciated, but the face was
mnch less wasted than the hhnS. PHinar
alive fluid had been injected py u no o~inrV
Jew mou used for The purpose were still in posi-
ton The anterior surface Of the Dody p dcsSve
NC Abnormal appearances and there wasn0 ecchyn''r
On
the abdomen Just below the night ear anu d nc.io
behind it there was an oval nlceIated JpV ln
ahnut half an inch in diameter from Whch eoino
s.ncons nus was escaping but no tumeiactlon
could be observed in the par0td region oVnSlu
era lie number OF purpura-hka sp4's th f"rar
as far as the axia. They ranged from
one-eighth to one-fOurth OF an men IN
diameter were slightly elevated ana InfIu dceous
on The surface and many of them were comment II
groups of two to four or more. similar put iu'i
less abundant eruption was observer epi S9 ,"nt
tered over the corresponding region Oh tn1 ilsh'
side An oval eXcavated ulcer about an ihcIl lois'
the result of a small carbuncle was seated over the
snineous process of the tenth dorsal vertebra oVe
~ socrhm there were four small bed sores, the
largest about half an inch In diameter. rev acne
pustules and a number OF irregular Spots % po ',
mortem bvpostatlc congestion were scattered over
the shoulders back and butockS. The inferior part
of the sCrotum was much dlscolored Oy hyPOslduc
congestion. group of hemorrhOldal juniors rather
Larger than walnut prot uded from tne arms ,
Ihe depressed cicatrix OF the wound made by the
pistol bullet was recognized over the tehtn inter
the yertebral splnes. deep linear lIclslon tIiaue
in mart Nv the O,eration of July "A ana EXTENDED
by that of August 81 occupied position CLOSELY
c9rresnonding to the upper border OF the rlght
twelfth rib. 1t commenced posterlorlv about TWO
inches from the vertebra spmes and extended lor-
ward a little more than three inches Az the an
tenor extremity of tins incision there was deep,
nearly square, abraded surface about an men
arross < well-oiIed flexible catheter fourteen
inches long was then passed into this wound
az had been done to wash 1t out during LIE, More
resistance at first encounte;e. thah had usually
been the case, but after several rlals the caeter
entered without any violence, 10 It's luL length III
was then lett in position, aud the body disposed SUI
plnely for the examination OF ihe NisceIa. ne
Uranium was not Upeneu long lnclsl0n was made
from the superior extremity Of the sternun to the
pubs followed by transverse inclson crossing
the abdomen just below the umDlllcus Inc lOur
fans thus formed were turned back and the alb
doIninal vlscera exposed. Inc subcutaheous
adipose tissue DIVIDED by the incislons was
tnlck over the thOrax, but was thicker
over the abdomen, being about quarter ol
an inch thick along the inca alba ana as much us
half an inch thick toward the outer eX-
trem tyOf the transverse Inclslon On lnspec-
ton of the abdominal yisccra ia STU the transverse
coIon was Observer lie little above the line OF
tne umbilicus 1t was firmly adhereut to The
terror cage OF the liver. The greater onentum COW
cred the mtestlncs pretty thoroughly from the
transverse coon almost TO the pubs. IL was sui
quite tat and was very much blackened by yeuous
congestion. On III sides its lateral margins were
adherent 10 the abdominal particles opp site the
eleventh and twelfth nbs On tn left size the adj
hosons were numerous. firm. well organized and
pIO ABLY ODD On the nght SIDE there
"a lew similar adhesious and number OF more deli
cate and PROBABLY recent ones.
mass of black, coagulated blood covered and
concealed the spleen and the left margin of tho
greater mentum. On raising the Omentum it
found that this blood mass extended through the
lett lumpar and lilac regions and dipped down mo
the pelvis, ia winch there clOtued blood
and "a her more than pint of bloody mud N The
blood cOagua having been turned out and .llectod
measured very nearly pint 1t was now evident
that secondary hemOrThage had been the immediate
cause OF DEATH but the point from which the blood
had escaped was not at once apparent.
The OInentum not adheTent TO the inteStlncs
which were moderately dlStended with gas. No
Intestinal adheslOns were found other than those
between the transverse colon and tho liver already
mentioned.
The abdominal cavity being now washed out az
thoroughly as possible, frultless attempt was made
to obtain some indication of the position of the
bullet before making any further lncisOn. Bv
pushing the intestines aside the extremity of the
catheteT, which had been passed into the wound
could be felt between the peritOneum and the right
lilac fascia, but ii hal evidently doubled upon it
SET and although prolonged search was made
nothing could be felt Ia ndi tbe preseuce
OF the bullet, either III that region or elsewhere
The abdominal viscera were then carefully re-
moved from the body, placed iii suitable vessels
aud examined seriatim with the following result
The ADMISSIONS between tho liver and the trans
colon proved to bound an abscess cavity be
tween the under surface OF the liver the transverse
colon. and the transverse meS0 Colon which in
VOWED the gall bladder and extended to about the
distance on each side Of it, measuring six
inches tansyersely, and four inches from before
backward. Tins cavity was lined by a thick
pyogenic membrane, winch complet, ly replaced the
capsule OF that part Of the under surface liver
ounces OF greenish-yellow fuid-a mixIure of ms
and hillary matter, This abscess did not involve
any portion OF the substance of the liver except the
surface with which it was in contact and no conmu
DlcanOn could be detected between it and any part
OF the wound.
Some recent peritoneal adhesions existed be-
tween the upper surface of the right lobe of the
liver and the diaphragm. The liver was larger than
normal, weighing elghty-four ounces its sub
stance was rm but OF pale yellOwish color on its
surface and throughout the interior of the organ
from fatty deOpneration M