Savannah morning news. [volume] (Savannah) 1868-1887, 1881-07-25

the following statement: ''The direction
taken by the ball after it entered the body
was forward and slightly downward until It
struck one OF the ribs. 1t was thence de-
fected still further downward and a little to
the right so as to make an angle with the
line OF the back. In other words, when q
probe was introduced into the wound to a
depth of three or three and a half inches its
direction was such that its inner end was
only about an inch and half from the
outside of the body at a point
lower down. The examination which was
made In the presence Of Drs. Agnew and
Hamilton this morning showed that q pus
cavity had formed in the track OF the ball
near or beyond the point where it glau eed
from the rib, and that this cavity could be
reached by direct incisiOn three inches be-
low the mouth of the wound.
1T was decided at once to perform the
operation. No ar@stheties were used, but
the part to be operated upon was benumbed
by a spray of ether, and a wide cut was
made in the Bus cavity, which was reached
at the depth of little more than an inch.
With the aid of probe and a pair OF for
ceps, a drainage tube, which is a small
flexible tube Of rubber, perforated with
holes, was then introduced In the
wound made by the ball, and after
being carried through the pus cavity
was brought out through the newly made
incision. One end of the tube then pro-
jected from the cut made by the surgeon S
knife, and the other from the mouth Of the
original wound. AS the pus oozed into the
tube through the perforation it could es-
cape from either end, and was repeatedly
washed out with weak solution of car
bolic acid and water, which was thrown
through the tube in a stream. The dis
charge which followed the opening of the
pus cavity was entirely satisfactoryto the sur
geon, and was soon followed by relief to the
patient. The drainage tube has been left as
it was placed and will remain so for the
present. II the wound discharges freely
through the new opening the tube may,
perhaps, be withdrawn from the old one In
order to allow the latter to heal. The In
cisOn made to-day is in a direct line with
the deeper parts of the wound, and it is
thought that the pus will escape through It
without any obstruction, which impeded its
outflow along the track of the ball, and
which caused the pus cavity"
In reply to a question whether another
pus cavity is likely to form and bring about
a recurrence of the alarming symptoms of
yesterday, DR.. Reyburn said: 81 cannot
answer positively, but the pus has now free
egress. | do not think 1t probable that
another will form" Upon being asked
whether there were or had been any
symptoms in the Presidents case of
pyaemia or blood poisoning, DR.. Reyburn
said: "None whatever. Rigor, of course,
may be symptom of pyaemia, but it is also
a symptom of various other complications,
and 1t does not point to pysemia in the
present use. The pus continues healthy,
and the characteristic symptoms of pyaemia
are wanting. You may say on authority
that no indications of blood poisoning have
been observed, and we have no reason to
expect any" In conclusion DIR. Rey burn said
that the Presidents condition and symptoms
to night are more favorable and encouraging
than any time since the chill of yesterday
morning.
SATURDAYS BULLETINS.
EXECUTIVE MANSION, 5 p. MA special
train conveying DR.. Hamilton, one of the
consulting surgeons, left Jersey at 2:30 D.
m. and arrived at Philadelphia at 4:40 D. m.,
where a second special train, with DR.. Ag-
new on board, waited the arrival of DR..
Hamilton's train. 1t left Philadelphia about
4:30 p. m, and is expected to arrive in
Washington about half past seven.
EXECUTIVE MANSION, 10 P. M. Unofficial
Bulletin The explanation given by the
attending surgeons of the u1fAvorable
symptoms which manifested themselves in
the Presidents case to day is brit fly as fol
lows: Sometime during the night or early
this morning the Presidents wound, which
had for several days been discharging freely,
became Obstructed at or near the inner end
OF the draining tube, while the process of
suppuration in the deeper parts of the
wound continued. A partial or complete pus
cavity was thus formed, and discharges
from the mouth of the wound nearly ceased.
The natural result of this state of things
was chill, followed by higher fever, the
PATIENTS pulse rising to the maximum of
about 100 and bis temperature to l04. As
the rigor, followed by increased fever, is
the symptom of pyaemia, of the formation
of an abcess, and of other unfavorable COM
plications, it caused at first good deal of
anxiety. A careful examination, however,
of the pus discharged by the wound
perfectly normal and healthy, and. 80
far as appeared from the PATIENTS general
condition, all indications of pyaemia were
absent. These facts relieved at once the
fear of blood poisoning. An external
examination was then made of the abdomi
nal ard hepatic regions with view of
ascertaining whether there were any signs
of abscess at the supposed location Of the
bullet, and no unusual tenderness was
found in that part of the body or any other
indication of a changed condition. From
these facts, taken In connection with the
scanty Ou' flow of pus, the conclusion
was drawn that the obstruction existed near
the inner end of the drainage tube, which
prevented free discharge. This imprison.
ment of pus, technically known as the for
nation of pus cavity, is entirely adequate
to explain the chill and increased fever,
since they are its natural and almost
inevitable consequence. 1t was at st
thought that the obstruction might be the
result of the process of healing, which ha I
wholly or In part closed the wound between
the end of the draining tube and he deeper
surface. Early in the after
noon, however, the obstruction wholly or
partially gave way, the outflow of pus be-
came freer, nausea from which the patient
had suffered subsiding, and be obtained re-
lief. This proved that the obstruction had
not been of permanent character. At the
evening dressing of the wound the discharge
of pus was quite as copious as usual. Since
that time the PATIENTS fever has been
steadily abating, and at the present hour 40
p. m. his pulse has fallen to LOG, and he is
sleeping quietly. The consulting surgeons,
Drs. Agnew and Hamilton, do not regard
his situation as grave as they had feared,
and express renewed confidence.
The following kilograms were sent by Sec
retaries James and Blaine at 10 o'clock to-
night:
WASHINGTON, July 23.-U Union League
Club, New York City: At this hour no
o'clock, the President is sleeping quietly.
Pulse LOG. There is manifest subsistence Of
the dlsquieting symptoms of the day.
THOMAS L. JAMES,
POSTMASTER General"
"WAsHINGToN, July 23.--LOaOeH, London;
At 10 o'clock to night the Presidents symp-
toms are better. Pulse, temperature and
respiration are improved. The distressing
nausea has left, and there is no reappear-
ance of chills. BLAINE"
EXECUTIVE MANSION, july %. IL p M
Unofficial Bulletin The Presidents pulse
has fallen to 100, and he is now sleeping
without any manifestation of restlessness
and without anV disquieting symptoms
Ors Agnew and Hamilton did not think 1t
best to disturb him by making an examination
TO- night, and did not even see him, but had
4 consultation of an hour and three quarters
with the attending surgeons. They express
qualification at finding his symptoms much
more favorable than they anticipated. All
the surgeons have now left the mansion ex.
eept Drs. Bliss and Woodward, who are on
luty.
Yesterdays BULLETINS.
EXECUTIVE MANSION, p. M--Dr, Bliss,
during the course of conversation in rela-
Sion to the operation performed on the Pres
dent this morning, said that during his ex-
animation yesterday he discovered that a
slight sac or pus cavity had formed i'm
at the turn in the track of the
ball, and at ONCE decided that the proper
course to pursue would be to make an
ncision which would stTaighten the /
rack, and permit free discharge OF the |
pus. 1t was determined, however, before
the operation, that it would be
best to notify the consulting physicians and
request their attendance, which was done |
forthwith. TIE formation of q pus cavity