New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1881-09-27
THE LATE PRESIDENTS CASE.
AREvIEW BY DIR. F. H. HAMILTON.

OBSERVATION-DISCLOSURES NEUTRALITY-SUSPICIOUS.
TO LONG BRANCH-DEATH
The following is article by DR.. Hamilton on
President Gar6eld's case, to be published in The
MEDICAL Gazette October 1
Tn answer to inquiries, Dr. Hamilton dictated as
follows:
far rs am Informed, the testimony is conflicting as
20 the relative positions OF the President the assassin
when tn pistol was fred 1t is now rendered probable
ha rar OF the President The ball entered about four
inches to the right OF the spine penetrating and comm
stance the last dorsal aud first lumbar
me centre Of first lumbar vertebra front and was
found distance to the left OF the verebra at the
nostrior than anterior surfacewholly without the
donre of the ball after penetrating the rib was not de.
teunined until after death saw the patient on the
formed of the manner of the accident and that the
receipt Of the injury the President had fallen to the door
h. complained of pain in his right ankle, and subse-
n his LETT ankle which pains had been promptly
relieved by the hypodermic injection of morphine.
Of the injury, aud in the course Of the day urine
when first by myself nor has there been at any
time subsequently, any apparent loss of power in his
bity at any point: The pains in his ankles, however
we're accompanied with hyRer;eshesa of the integu-
was hyperuethesa of the integumeut of right side
tbe acknowledgement wholly in the course OF
The first week or two; and never returned. On the
morning of the 4th of July the patient being partially
under the influence of the morphine, not suffering
he bowels was
feeble Al the first eonsutation the question having
asen the probable course of the ball. il stated
Say Of the receipt OF the injury introduced his finger to
its fun extent, and that he had declared that pene
oed the liver the structure of which lie recognized bv
its granular feel; and Dr. Bliss stated that he had intro
auee ~ me same direction THIS test1ony \" Yc
crdcd sufficient to determine that the bali ut least
non, Dr. Woodward mad introduced his finger sum
GENTLY deep into the wound to determine that the rib
was broken. Finding upon personal examination and
inspection that the track OF the wound completely
closed by firm cot, refused to make any further cx
UNCERTAINTY ABOUT THE BALL
From this time forward great uncertainty existed in
the minds of the medical attendants as to the
actual and presence of the ball.
On the cath Of July, and after the COM
plete subsdence Of the tympanites, circumscribcd
point of nduraton discovered in the right lilac
fssa which at once led to a suspicion that the bah had
been detected coursng along the anterior surface of
the lumbar muscles and that this indurauon indicated
its present This suspicion was sustained by the
hyperRsthesa of the ri ght side scrotum which,
Professor Weisse had already shown in his anatomical
observations would he the natural result OF injury
the eO-nguna or 1eo-hypogasric nerves, which lie
the of the then supposed track of the ball St
further confirmation added when on the 27th of
July found that flexible catheter could he carried
downward in the direction of the supposed situation
the ball distance seven inches The point of IN
duration in the right lilac foSsa gradually moved down
ward and became hard and defined. conveying the
impression that II the ball and that ii encysed
was the ball further examination Of the channel
In this direction was not prosecuted Indeed this indu
presumed that II only indicated the lower end of the long
About this period small pouch of pus was formed in
connection with the main channel extending under
were at once relieved by free incsion; and little
liter rigors followed in consequence of the temporary
obstruction OF the channel caused by the floating of
small fragment Of the rib INTO the orifice which
On the sh of August great difficulty having been ex
perenced in the introduction the drainage tube
this long suppurating canal, incsiou made he
low the twelfth rib, the patient being under the infu
ence OF ether About week later the stomach the
exceedingly
found necessary to suspend Authorization by the mouth
enemata. On the fourth day after the suspension Of
s am by the mouth the rght par3td gland be
ed and incised the first incisiOn giving exit only
mouth and meatus suditorus externus, and three or
Jour incis9ns were made at dhere points on the snI
the suppuraton and swelling of the parotd gland had
almost entirely disappeared
DEVELOPMENT OF BRONCHITIS.
Following thelarottis there gradual development
Of bronchitis In the right lung; and finally broncho
pneumonia of the lower portion of the right lung, nd
Gated by well defined dulncss aud absence
respiratory rDurinur In that region From I'M
til the period OF his from Washington there are
events of striking worthy being related
In this brief summary except the alarming weakness
and great somnocucy Of the patient which occurred
the GATH 25th and Goth August which to an
apprehension that fatal issue hand The patient
was evidently suffering from atmospheric Influences, the
heat being intense and oppressive and OF the time
the air being mouonless, that leaf could be
There evidence, however. at time, that the
patient suffered from malaria having its source the
house drainage the marshes in the vicinity and which
latter at later time in the had always been
garded as pestferous HIS removal to Long Branch oc
CURED ON the 9th OF september and effected without
injury or discomfort to the patient. with only slight
amount Ot fatigue manifestcd after his arrival aud from
which on the following morning he had completely
recovered There day while he lay in the
a. Long Branch that he did not express himself as
pleased and even delighted with the change nor he
ever oppressed by the heat although of the days
The first after his arrival the hottest day of the
son At O'Clock in the afternoon of this day when the
heat was greatest III reply To- my inquiry he said he ex
per ~ ~ dai Hb3b ,ya o suddan and mn c,d
although in unantcpatcd there is no incident
in the last Two or three days for worse
of his death and the result Of the subsequent
I'VE here insert the Official bnllepn.-Ed.
pest mortem examination of the body OF President
Garfield was MADE, eighteen hours ater death IN the
presence and with the assistance OF Drs Hamilton,
snIth, of Elbcron and Acting Assistant Surgeon d. S.
Lamb, OF the Army Medical Museum Washington. The
that the ball. after iraeturns the right eleventh rib had
passed through the spinal column in front of the spinal
driving number Of small fragments Of bone into the
sG% soft parts ana o 9d Y below eff the
behind the peritoneu, when had become completely
heorrhagc from one of the mesenteric arteries adoi-
Ing the track OF the ball. the blood rupturing the peri
cavity. This hcmorrlage is believed to have been the
cause OF the pain in the lower part Of the chest
complained Of just before death, An abscess cavity SIX
inches by four IN dimensions wasfound IA the vicinity Of
the ga bladder between the liver and the transverse
eco when were strongly adherent IL dld not involve
sne substance Of the liver, and no communication was
channel extended from the external wound, between
tne oin muscles and the right kidney almost to the right
rowing OF pus from the wound, supposed during life
" nave been the track Of the ball on an examination
were found both sides, with broncho pneumonia OF
ne lower portions of the right lung and though to al
assesses and the heart cots The liver was enlarged
atty out Tree II I'm aDScesses nor were any Lod