Knoxville daily chronicle. [volume] (Knoxville, Tenn.) 1870-1882, 1881-07-26
THE UNEAyORABLE TURN
EXPLAINED.
Caused by an Obstruction Near
the Inner End Of the
Drainage Pine.


EXECUTIVE MANSION, WASHINGTON,
July 23-ll p. m.-The explanation
given by the attending surgeons of
the unfavorable symptoms which
manifested themselves in the Presi.
dents case to-day, is briefly as fol-
lows:
Some time in the course of the
night or early this morning the pa
tient's wound, which had for several
days been discharging freely, be-
came obstructed at or near the inner
end of the drainage pipe, while the
process of suppuration in the deeper
parts of the wound continued. A
D artial or complete pus cavity was
thus formed and the discharge from
the mouth of the. wound near
ly ceased. The natural result Of
this state of things was chill, fol-
lowed by higher fever, the patients
pulse rising to a maximum OF about
l30 and his temperature to 1O4. As
rigor followed by increased fever is
symptom of pyamia. or the forma-
ton of an abscess, and of other un-
favorable complications, it caused at
first a good deal of anxiety. A
careful examination, however, of the
pus discharged by the wound showed
that it's character was perfectly nor
NAL and healthy, and, 80 far as ap-
peared from the patients general
condition, all the indications of
pyamia were absent. These facts
relieved at once the fear of blood>
poisoning. An externsl examination
was then made of the abdominal and
hepatic regions with a view of ascer-
tanning whether there were any signs
of an abscess at the spot where the
bullet is supposed to be.
No unusual tenderness was found
in that part of the body, or any
other indication of a changed condi-
ton. For these facts. taken in con-
nection Mth the scanty outflow Of
pus, the conclusion was drawn that
an obstruction existed near the
inner end of the drainage tube,
which prevented free discharge.
This Imprisonment of the pus, tech
nically known as the formation of a
"pus cavity" is entirely adequate to
explain the chill and the increased
fever, since they are the natural and
almost inevitable consequences.
It was at first thought that the
obstruction might be the result of q
process of healing which had wholly
or in part closed the wound between
the end of the drainage tube and the
deeper suppurating surface. Early
in the afternoon, however, the OBJ
struction wholly or partially gave
way, the outflow of pus became
freer, the nausea from which
the patient had suffered subsided,
and he obtained relief. This proved
that the obstruction had not been oi
a permanent character. At the even
ing dressing of the wound the dis
charge of pus was quite as copioue
as usual. Since that time the pa
tents fever has been steadily abat.
ing, At lOp. m. his pulse had faller
to lO6, and he was sleeping quietly
At 1 1 p. IN. the Presidents pulse hac
fallen to 100, and he continued tc
sleep without any manifestations o
res lessness and without any disqui'
eting symptoms. Drs. Agnew ani
Hamilton did not think it best tx
disturb him by making an examina
ton to>night, and did not even SCI
him, but had consultation lasting
an hour and threesquarters with tn
attending surgeons. They express
qualification at finding his symptom
much more favorable than they an
ticipated. The surgeons had left th
mansion, except Drs. Bliss and Wood
ward, who were on duty.