The Washington times., 1901-10-27

such cases, the vomiting bethS atttlbut-
able to the anesthetic administered in
the operation.
First unfnvornbIe Developments.
The report then reviews each days
| symptoms and developments.
In cases Of anticipated septic poisoning
the third day is the moment of import
auce. from the medical standpoint In
the FIRST bulletin Of that day, issued at
300 a. m. the physicians were careful to
say only that the President had passed a
fairly good night the wording of the
bulletin indicating that the condition of
the President was not as good might
have been expected. This and the sue
ceeding bulletins proved to be some of the
| most important in the whole record.
\ careful study OF the details given
shows high pulse and temperature, chilly
feeling and restlessness, all of which are
significant symptoms. yet giving no indi-
cation of peritonitis. The observations
of the patients condition made public
| stated some Improvement Seven hypo-
| dermics of digitqlis or strychnine were
given, in addition to nutritive enema OF
| whisky and egg, made necessary by the
fact that the patient was able to take
| no nourishment by Tne mouth.
The fifth day was the first hopeful
one, and on the sixth the favorable signs
continued. The seventh day foreshadow-
| ed the end.
The Final Struggle.
From the first record at ! a. m. on that
day tSeptenber I2) it is stated that the pa
tient was very restless and later on COM
planned of pains; at II a. IN, restless and
depressed with the same rapid pulse, rs,
and respiration, 2S; skin moist and cold;
headache and nausea; all unfavorable
| symptoms Heart stmulants were ad-
ministered at frequent intervals; whisky
by the mouth; digitalis and strychnine
| hypodermically. The physicians, ignorant
, of the real condition Gf the stomach. ad-
ministered nourishment by the mouth
| beef juice. chicken broth, toast, coffee,
and soft-boileG egg-on the mistaken as
| sumption that the wound had healed suf-
| ticiently for the stomach to retain nour-
ishn1ent administered by the mouth.
| The first alarming note in the case was
continued in the $50 bulletin, which an
| nounced the patents condition as not
quite so favorable, and stated that the
| food had been stopped Pulse weak and
| thready'' at 1890 p. IN. was also distinc-
| ly an ouinous sign.
These symptoms were the most discour-
aging in the days bulletins weak
ana thready'' pulse is always regarded
as of grave Significance. That the danger
at hand was fully appreciated by the
pll9 SitlGIlS Is eNluenCeU IN the or
fetal report, which shows that all the
devices known to modern medicine were
made use of. The treatment Immediately
following this point in the case. accord
ing to emifrent authorities represented
the highest degree of professional knowl-
edge and skill.
The record of the last day (the eighth
is little more than that of the adminis-
tering of powerful stimulants, at inter-
walls Of fifteen minutes. to which the pa
tient responded poorly. Periods of un-
consciousness ensued. The 6:l5 bulletin
read:
"The Presidents physicians report
that his condition is most serious in
spite of vigorous stimulation. The de-
preston continues and is profound.
Unless IL can be relieved the end is
only a question of time"
The succeeding record shows that at
6:25 p. m time was reached when there
was no longer any response to stimulants
At 7:i0 o'clock the patient was almost
pulseless. The record concludes:
'9 D. m.-Heart sounds very feeble
Oxygen continued; slight reflex move
ments. and at 2:f5 a. M, September
II, 1901. the President died.
The Post Mortem Bulletin
At 5 o'clock on that day. Saturday, Sep
tember Il, the following bulletin was is
sued:
THE bullet which struck over the
breastbone did not pass through the
i
bullet passed through both walls of
the stomach near its lower border.
Both holes were found to be perfectly
closed by the stitches. but the tissue
around each hole had become gam
greuous. After passing through the
stomach the bullet passed into the
back walls of the abdomen. hitting and
tearing the upper end of the kidney.
This portion of the bullet track was
also gangrenous, the gangreue involv-
ing the pancreas The bullet has not
peritonftis or disease of other organs.
The heart walls were very thin. There
was no evidence of any attempt at re-
pair on the part of nature, and death
resulted frog, the gaHgrene, which af-
fected the stomach around the bullet
wounds as well the Tissues around
the further course Of the bullet. Death
was unavoidable by any surgical or
medical treatment and was the direct
result of the bullet wound.
The physicians and surgeons present at
the autopsy and signing the above were:
HENRY D. GAYLORD, NJ D.
HERMAN C. MATZINGER, VI. D.
p. NJ RIXEY. L. : y
MATTHEW d. MANN VI. d.
HERMAN AIYNTER, N. d.
ROSWELL PARK, ". d.
EUGENE NASDIN, L. ;. NJ II. 5.
CHARLES G. STOCKTON NJ d.
EDWARD G.. JANEWAY, VI. d.
". ". JOHNSTON, ". D.
". p. KENDALL, L. 5. A.
CHARLES CAREY VI. d.
EDWARD L. MlNSoN. L. ). A
HERMANUS L. BAER. NJ. d.
The anatomical diagnosis by Dr. CAY |
lord, in the main very technical in char
acter. concludes by saying that the orig |
nal injuries to the stomach wall had been
repaired by suture. and this repair seems |
to have been effective. The stitches were |
in place and the openings in the stomach |
wall effectuaIly closed" a" Regarding the
of the heart, this authority says:
The extensive brown atrophy and diffuse |
fatty degeneration Of the muscle. but es- |
pecially the extent to which the peri |
cardial fat had invaded the atrophic |
muscle fibres of the right ventricuar wall |
sufficiently explain the rapid pulse and |
lack of response Of this organ TO stlmula- |
ton during life