Year: 1878

nervous results Of great injuries. They gave it up
4 mystery related Immediately to the mystery OF
life ITSELF and esteemed it topic behind the vel
that drawn between human perceptions and
Divine But the wonderful OF later
years the study of cerebral and spinal physiology
have changed all that-have removed the landmarks
Of the limit of everyday knowledge and given us
familiar acquaintance with things that in the days OF
Dupreyton not esteemed as within human COM
prehension.


Dr. Carnochan began his study OF these subjects in
the third hraison with a category OF the injuries
accompanied by shock and commonly followed by
collapse. and with lucid and comprehensive state
ment of the symptoms strkingiy illustrated by the
of a over BY the street cars, who died
without recovery from the nervous disturbance
caused by the injury


He then proceeded TO a study of the causation of
these symptoms contemplated in the light of the
modern additions to the knowledge of the physiology
and pathology of the system ana especially
OF the relations of the sympathetic to the cerebro-
spinal In this minute and elaborate study of
symptoms, which goes the whole field of physi-
oogy and considers especially the relations of the
respiration and the circulation. the symptoms of
the conditions considered for the first time in
surgical literature set forth in strictly scientific
order and in distinct and. definite relation to the
facts.


Indeed this study presents to the mind simply and
clearly the mechanism of collapse and each element
of the condon-the oppressed heart the lost pulse.
the disordered respiration. the apathy the changed
temperature the jacttation the arrested secretions
is examined exhaustiyely in its aspects symptom
as well in its relation part Of the sequence Of
vital changes 1t is in the nature Of the testimony
one of great experience and acute perceptve powers
on subject which surpasses in interest any other
that falls under al observation


In this publication is given mature view OF some
that have historical aspect in this community
and We reproduce, as having general, well
professional interest what is said OF the deaths Of
Poole, Fisk and Tweed by the surgeon who saw all
these cases, but not charged with them in such
way to be responsible for the results:--


The case Of William Poole. the pugilist who
ceived gunshot wound in the heart. furnished
instance OF the fallacious calm that takes place in
injuries between the time ol the receipt of the
shock and its termination in death Poole received
his wounds during deliberate onslaught made ON
him by some five or SIX persons armed with Colts
revovers The first ball took effect his right thigh
and brought him to the ground While thus PROSTATE
another assailant placed the muZze OF pistol close
to his chest and discharged its contents He imaedi
atey jumped up and reeling toward door rested
if stunned. against it for support during min
utes. He then fell, excaiming that he dying.
and remained senseless cold almost pulseless and
apparently morbund for about four hours. From
this condition he rallied, and became so free from
the usual symptoms OF severe injury that his medical





trated into the thoracic cavity, and my opinion
sought corroborate dspe this favorable view of
the


found him sitting up in bod his back resting on
pillows support, apparently at ease. and convers
ing with numerous acquaintances who had come to
visit him. His countenance exhibited no express
sion of anxiety, and he answered placidly and
without effort the questions put to him. His
pulse eighty, the respiration easy the surface of
the body normal in temperature and moist. The
stethoscope revealed the existence of no difficulty in
the respiratory passages and the normal tcktack OF
tltp heart bpa
signs of Inflammation or OF efuson into the peri
cardiun. These favorable symptoms continued until
the eighth day after the accident when he received
against positive orders the visits OF more than a
hundred people, with whom he conversed. His
statement that he felt quite WELL The next
morning about eight O'Clock he in high state
OF irritability pulse 100; skin hot and dry;
more frequent. An aperient ordered by which
the symptoms were much allevatcd. On the tenth
day the pulse was 100; countenance anxious;
the adnata tinged yellow; complained of debility,
but said he had no pain about the heart; signs
OF cffusion. He passed restless night, notwith-
standing the administration of anodyne; pulse,
100: countcnance anxious; respiration much
troubled; inability to remain in the recumbent pos
ture; symptoms gradually becoming more grave. At
two o'clock the next morning the patient rapidly
sinking; pulse almost mperceptible and with dii-
Guilty counted; respiration short frequent and diff
cult cxtrcmities cold; countenance pallid and hip
pocratic. From this time he continued TO sink, and
expired, without struggle, at five \. VI.


1t win be remembered that one OF the persons who
in the number Of the hundred he received against
orders the famous pauBene one OF his assailans
in the fight.


ager, presented also an instance where the injury
exceedingly and yet the distressing syinp
toms following the shock soon subsidized Fisk was
shot the stairs of the Grand Central Hotel about
four =. NJ with revolver. The ball entered the alb
dofhen on the left side, about Ave inches above the
level of the umbilicus and two inches to the right
the medan line passing obi luely downward and to
the lett through the abdominal wall and traversng the
small and large nestines and megenery, pierced the
tissues below Pouparts Lgament and lodged in the
groin on the opposite side near the insertion Of the
psoas magnus Upon. receipt Of the injury
he fell and taken 70 in the
hotel. the symptoms o. collapse following imme-
diately upon the shock. he complained OF great
pain in the abdomen the surface was cold clalnmy
and moist, pulse rapid and feeble. respiration fire.
quent. his features pinched. and he less
stupid in answering questions These symptoms
passed or and saw him at eleven r. NJ, seven
hours after he had been shot In the meantime he
had been seen by the hotel physician, through whom
several Others had been called in. passive reaction
was being established but morphine subcutaneously
and internally had been administered in large quant
ties. found him with few signs Of collapse. His
countenance was somewhat pale. the pulse
seyenty-two. tho respiration rather slow, in
tolligence dull but correct and when qucs
toned nc stated that he had very little pain fha
to return to the country Immediately, and left sug-
gestng caution in the further administration of
opium. The morphine, however, was continued in
unusual quantities. and Fisk died apoplectic at We
A. NJ about thirteen hours after the receipt of.the
injury. Fisk's wound was severe and might have
proved mortal. yet there abdominal c.fusion
Of any kind except small portion OF blood 10 the
extent Of silver naf dollar in form or clot. There



and the orifces male by the bullet closed and
apparently would have become united. There is no
doubt that his death accelerated by the OF
morphine that administered.


Fisk died rom combination of asthenia and coma
from death beginning at the heart and at the head
but might have died from ashenia alone death be-
ginning at the heart had he not been overwhelmed
with the cumulative toxic influence OF the narcotic
drug too freely administered. The post-nortcm re-
yeaed. among other pathological conditions serous
cffusion the surface and in the vcntrcles Of the
brain


Apropos to psychologist causes of death is given
this record OF the Of the famous statesman 80


have no doubt that psychological cmb0lsin Of
the heart and pulmonary artery ~ times takes place.
that Il, BY prolonged mental emotion aad agitation a
condition of the blood IL brought about that fayors
its disntegratiOn. and that the dislnie.qation il
more less rapidly effected upon the occurrence of
some suaden or unexpected intcrcurrcIt additional
cause


The of William NJ Tweed al time the DO.
litcal dictator Of this State j. example of This
kind. lie had suffered much from Imprisonment and
meniaI agitation for as.nra A..Ll- AL Lnni hn