Evening times-Republican. [volume] (Marshalltown, Iowa) 1890-1923, 1901-09-19

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in jeopardy by unskillful or meddlesome
operative procedures. and he was not
killed by premature feeding by the
mouth. The operation was begun one
hour and twenty-three minutes after
the assault, there was but little shock.
the operation was finished in fortyfive
minutes, and the subsequent care was
of the highest scientific order.
1t Is not worth While to consider here
anything but the official reports of the
professional attendants, not even indi-
vidual utterances of the surgeons to
faithful and conscientious reporters,
who undoubtedly did their best to re-
port correctly. That the surgeons were
over-sanguine, there can be no doubt;
and they looked upon the case more
from surgical than from medical
point of view; but the necropsy shows
that the most skillful medical diagnosis
clan or therapeutist could not, by his
advice, have changed the progress or
the result Of the conditions following
the injury.
AS regards the operation itself. the
high standing of the operator and his
assistants, altho the surgeon deviated
from the usual procedure of making the
incislon in the median line instead of
following the wound, justifies the as
sumption that their judgment was COR
rect; and this view is fully sustained
by the consultants. The incision of five
inches was small for thorough exam
ination of the abdominal organs; but
the smaller the incision and the less
the exposure OF the abdominal contents,
the greater are the chances of speedy
convalescence. The wounds of the.
stomach were promptly and securely
closed and the abdominal cavity was
thoroughly cleansed.
That which gave the greatest anxiety
to physicians was the persistently rapid
pulse. The rate was seldom below 100,
and at 8 a. m. on the second day 1t was
146. 1t was a pulse suggestive OF septi-
camia rather than of peritonitis; indeed,
the absence of pain practically excluded
,peritonitis.
On the evening of the fifth day the
patient was reported, in the official bull
letin. "as we'll enough to begin to take
ncurishment by the mouth in the form
of pure beef juice" AT 9 a. m. on the
sixth day 1t was reported that "his
stomach tolerates the beef juice well.
and it is taken with great satisfaction
AT $3.50 p. m. it was reported: THE
nourishment taken into the stomach Is
m. on the seventh day: HE has taken
& little solid food this morning and he
relished It," AT 8 p. m. on the same day
he continued ito take a sufficient
amount Of food" but at $3.50 p. m. I'M
favorable symptoms appeared; the food
had mot agreed with him." and was
stopped.
With the developments OF unfavorable
on Friday it was assumed by
many that the administration of food by
the mouth had been premature. Indeed,
one of the attending surgeons Is re-
ported to have said that "intestinal tox-
,eemia" had developed from putrefact-
i've changes in the intestine This con-
dition is rarely dangerous. An increase
of indican in the urine is probably due
to changes OF proteids in the intestines.
in indol and analogous sub
stances. These, when taken into tie !
blood, are changed into corrugated sul-
pilates, which are innOcuous. They are |
afterward eliminated in the urine, in the
form of indican Qndoxyl-s ulphuric acid) |
and this process Is conservative.
The brief official report of the necrop-
sy shows that feeding by the mouth did |
no harm; and the concluding sentence:
Death was unavoidable by any surgi-
cal or medical treatment and was the
direct result Of the bullet wound is
fully justified.
The track of the bullet and the It's
,ypo Si1rr0rpdiy,ry In ,,,oprds ~ xf,ns
were gangrenous These gan
srenous Cor necrotic) tissues constituted
'oci for the development of toxines
which entered the blood. The clinical
history Of Friday, as far as 1t is given
n the official bulletins. g consistent
with the results of the necropsy. The
cultures made from the necrosed parts
will probably reveal streptococcus and
Infection and perhaps
Infection with other pathogenic organ
SINS. The origin of the infection is the
obscure question. Did 1t come from the
juliet itself or from parts Of clothing or
organisms from the clothing, are ques-
ions which possibly will not be an
;wered satisfactorily. even when the
examinations shall have
,een completed. AS matter of fact,
10 human foresight or skill could have
.revented the infection, and its cure
vas beyond the reach OF science. All
lonor. however, to those who SO ably
nd SO devotedly fought against the in
vitable.
The safe in the bank Of I. c. Brainard
Co., Blooming Prairie. Mimi, was
'lown up by cracksmen Tuesday night.
Between $1,000 and $4,000 in currency