Savannah morning news. [volume] (Savannah) 1868-1887, 1881-08-17
Ex-SurgeOn General HammOnd's
Criticism ON the Presidents MedI-
cal Attendants.

A. Hammond, Of New York, in which, 1t Is
said, che takes strong ground against the
course pursued by President Garield's at
tending surgeons. l am no spologist for
those gentlemen, nor do intend to take up
the gauntlet In their defense, as presume
they are abuniantly capable Of taking care
of their own professional regulations.
think It remarkable that gentleman
of DR.. Hammond's professional stand
ing, and member OF the National Medi-
cal Association" should commit, in the first
place, such breach OF professional etiquette
as to arraign the Presidents medical at
tendants, among whom l see the name OF
the Surgeon General of the United States
army, on the charge of incompetencY and
want OF skill in the management OF the
Presidents case, in letter addressed to a
secular paper, as I understand it. His re-
marks might be justified If he confined his
criticism to some Of his medical friends and
acquaintance in private, but when he
writes letter to daily print, he not only
| does Injustice to those gentlemen, but in
| lures the profession at large, in my view,
hy bringing them before the public and ex-
posing their mistakes, If they made any, to
| the public gaze. Thousands have, ere this,
| read his letter, and think, no doubt, what
set OF asses the President must have had
around him as his medical advisers. What
are medical mems opinions and knowledge
worth, IL the President was allowed TO
lie sufferer on his back for thirty five days,
when DR. Hammond or some other astute
| surgeon like himself could, In the incipien-
| cy of the case, have discovered the situation
Of the bsll, removed the fragments of cloth
ing and of bone, snd thus saved the great
suffering of the President while "his
strength was at the maximum, and before
the track had been partially closed by the
swelling of the soft psrtsS"
In order to get at the facts of the case
quote from the New York Medical Record
the account first of DR.. Townshend, Health
| Officer of the District, who is reported to
| have said, 81 found the President, about five
minutes after the shooting occurred, in a
vomiting and fainting condition. From the
| pulse at the wrist | thought he was dying.
| After administering restoratives, he goes on
/ to say, che (the President) rallied cOnsidera-
bly,, and proceeded to examine his wounds.
| | found that the last bullet had entered his
| back about two and half inches to the
right Of the vertebr@. | introduced my
| finger into the bullet wound. Some hem
| orrhage followed"
Besides the official bulletins. It mad been
stated, prior TO July Ar, that the wound was
/ located between the tenth and eleventh ribs,
/ four inches to the right of the median line
| OF the back; that finger introduced into
the wound had felt that the eleventh rib
was fractured; that at another exploration
| the finger had felt the substance of the
| liver; that probe had been passed in a dis
| lance of three inches. By the two latter
examinations the direction of the wound
| was found to be downward and forward.
! "On July 4th a careful analysis of the
| symptoms that had presented up to that date
was made by Faneuil d. Weisse, d. d Pro
| fessor of Practical Surgical Anatomy, Medi-
! cal Department of the University of the City
Of New York" l will here briefly state the
result of his analysis. First A pistol wound
was located between the tenth and eleventh
ribs, four inches from the median line Of
the back. Second. Upon receipt of the
wound the President fell, or rather sank
down to the right side, not losing conscious
ness. Third. Vomiting occurred as he fell,
which had continued from time to time.
| Fourth. Within five minutes alarming fall
ure Of hearts action occurred. Fifth. I'm
mediate pain of right leg and foot. Sixth.
| HemOrrhage from wound, though not
excessive. Seventh. Lowering of the
! temperature o 9S S degrees Fair. dur
ing shock. Eighth. Equable, almost nor
NAL standard CT respiration. Ninth. Pulse
| fuctuating from slight causes Tenth, Pains
in legs aud feet. Eleventh, Slight tympanitis.
Negative evidence existed which seemed to
exclude injury having been inflicted to
either of the following parts, which would in
all probability have seriously complicated
the case, II not have proved fatal; No ar
| terry or vein OF any considerable size was
wounded; neither the lung nor pleurs was
| injured; the diaphragm was not Injured, Tor
the right kidney; the spinal cord was net
injured, nor the ascending colon, when not
covered by peritOnsum. From the Presi
dents good general condition up to that
time, there appeared a chance that the peri
toneum snd the organs invested by it-the
liver, stomach, small intestine, large intestine
aud spleen-had escaped injury. 1t remain ed
TO determine how bullet, entering where
the President was wounded, could escape
| ipjuFing the right pleura, the right lung, the
diaphragm, the peritOneum, the liver, the
right kidney, the ascending colon, the small
intestine, or the spinal column, and the life
of the wounded person be spared, by de
frctiOn of the bullet In such q peculiar way
as to reach one or more of the nerves that
contribute TO the sscral pleXus, and which
was the cause, doubtless, OF the pains in the
legs and feet"
Neither time nor space will allow me to
follow up the analysis CT Prot. Weisse, nor
will 1. be interesting to the majority of the
readers OF your paper. | will here only in
/ trOduce an extract from q letter Of Prof.
York city. whose reputation as a surgeon
presume DR.. Hammond will not gainssy, TO
Prof Wesse, in which he remarks: Il
have from the first sought 10 encourage you
In your present line of study, not because
had by any means determined ia my Ol1R
mind the course of the bullet, but because
il seemed proper 20 determine anatOmically
all the possibilities in the case.n Now, sir,
we read Prof. Hamilton, an experienced,
erudite surgeon, writing that he had not by
any mesns determined In his own mind the
course the bullet had taken, and that after
be had seen and presumably had made salts
factory, IL not thorough, examination. 1t
IS the ground taken II not laid down by sll
teachers of the science and art of surgery,
as well in their oral teachings as in their
writings, that none of the great cavities of
the body should be probed, especially In
gun shot wounds of the abdominal cavity or
of the head, lest, in the latter case, II the
brain is penetrated bv ball. increased in
jury may be done to that organ. Even If the
locality OF the ball in the brain could
be discovered, how could 1t be got outt In
the former case, If the liver or kidney is
! injured, irrepTessible hemOrrhage might be
! occasioned, and II the intestines were pene-
! trated an increased outflow Of its contents
might be brought about, developing fatal
peritonitis. And yet DIR. Hammond has the
! temeTity to arTsign the surgeons In attend
of the wound, which two of them had al
ready done with their fingers, one Of them
having had the whole length of his finger
! In the wound.
Again he arraigns them for neglect In not
removing the fragments OF clothing and
bone, and for negleeting to extract the ball
while the "strengjh of the patient was at its
maximum" II these gentlemen were so
unskillful, why did not the great New York
surgeon and the great Philadelphia surgeon,
the consulting surgeons, do this at their first
visit to the Presidents No, they wait for
days, IL not some weeks after, when an alb
scess has evidently formed, and after
| great parade, while the patient was under
the influence Of ether, they open the abscess
aud discover that there was piece Of bone
| and a fragment of clothing contained in the
abscess with the pus. And now, while they
have ascertained the exact position Of the
| ball imbe5ded In the muscular tissues out
| side the peritoneum, they refrain from cut
ting down and extracting it where there are
| no important blood vessels, no vital organ
to be Injured by this surgical procedure.
Ny remarks being sufficiently extended,
| thought might say much more about the
| track of the ball, how it fills up, and what is
the usual course of treatment in such cases,
| | will finish by saying that In my Judgment
| DR. Hammond has violated the code of
| ethics of the National Medical Association,
| and II the bail ought 10 be taken out so
| easily, why does DR.. Hammond not offer
to 60 on to Washington and extract the
| ball, one cause at least Of the Presidents
| continued suffering, Because it is easier TO
| criticise at q distance than to do the right
| thing 10 the right place aud at the right