The Life and Work of James A. Garfield, Twentieth President of the United States / Embracing an Account of the Scenes and Incidents of His Boyhood; the Struggles of His Youth; the Might of His Early Manhood; His Valor As a Soldier; His Career As a Statesman; His Election to the Presidency; and the Tragic Story of His Death.

by John Clark Ridpath

Within a narrower and better informed circle it was suspected that another pus sac was forming in the President’s body, but the opinion did not, for the time, obtain publicity. The two official bulletins of the day were as follows:

“8:30 A. M.—Shortly after the bulletin of last evening was issued the President fell into a pleasant sleep, during which the febrile rise subsided and was no longer perceptible when he awoke at 10 P. M. Subsequently he slept well, though with occasional breaks during the rest of the night. No morphia or other anodyne was administered. This morning he is in good condition, although the effects of the febrile disturbance of yesterday are still slightly perceptible in pulse and temperature. At present his pulse is 96; temperature, 98.7; respiration, 18. 7 P. M.—The President has been comfortable during the day, although his temperature began to rise earlier than yesterday, and rose almost as high. At 12:30 P. M. his pulse was 104; temperature, 100; respiration, 20. At this hour his pulse is 104; temperature, 101.2; respiration, 20. He has taken nourishment as usual, and has had several refreshing naps during the day.”

One of the unofficial reports of the day was to the effect that an effort was making to trace out exactly the course of the wound, and that to this end an instrument, called the electric probe, was to be inserted in the track of the ball. Professor Taintor was called to the Executive Mansion late in the afternoon to consult with the attending surgeons regarding the use of the electric probe. After the consultation, he was requested to return in the morning and to bring with him a battery of two cells. The purpose was, should it be determined to experiment with the instrument, to endeavor to ascertain the exact course of the wound from the surface of the body to the spot where the ball was lodged, and if possible to discover whether there was a pus cavity, and, if so, its exact location.

The thirty-eighth day.—On this morning the physicians held a consultation. The question of the President’s afternoon fever was discussed, and Dr. Agnew was reported as having urged upon the surgeons the fact that the febrile rise was greater and more persistent than it should be if occasioned by the natural and inevitable processes of healing. The opinion was freely expressed that the channel of the wound was in some measure obstructed, and the propriety of a second operation to relieve the difficulty was suggested as the proper remedy. Accordingly, after the morning dressing of the wound, a second operation was performed, of which Dr. Bliss has given the following official account in the Medical Record for October 8, 1881:

“The necessity of the operation was plainly developed by passing a flexible catheter through the opening previously made, which readily coursed toward the crest of the ilium, a distance of about seven inches. This cavity was evacuated twice daily, by passing through the catheter, previously inserted in the track, an aqueous solution of permanganate of potash from a small hand-fountain, slightly elevated, the water and pus returning and escaping at the opening externally.

“The indications for making a point of exit in the dependent portion of this pus sac were urgent, and on August 8th the operation was performed by extending the incision previously made, downward and forward through the skin, subcutaneous fascia, external and internal oblique muscles, to a sinus or pus channel. The exposed muscle contained a considerable number of minute spiculæ of bone. Upon carrying a long, curved director through the opening between the fractured rib downward to the point of incision, there was a deeper channel which had not been exposed by the operation thus far, and the incision was carried through the transversalis muscle and transversalis fascia, opening into the deeper track and exposing the end of the director. A catheter was then passed into the portion of the track below the incision, a distance of three and one-half inches, and in a direction near the anterior superior spinous process of the ilium. The President was etherized during this operation.”

This description of the operation, as narrated by Dr. Bliss, may doubtless be accepted, though involving many technical expressions which, under the circumstances, are unavoidable, as in every way correct and adequate. The regular bulletins were issued as usual and presented the following summary of symptoms:

“8:30 A. M.—The President passed a comfortable night and slept well without an anodyne. The rise of temperature of yesterday afternoon subsided during the evening, and did not recur at any time through the night. At present he appears better than yesterday morning. Pulse, 94; temperature, 98.4; respiration, 18.

“10:30.—It having become necessary to make another opening to facilitate the escape of pus, we took advantage of the improved condition of the President this morning. Shortly after the morning bulletin was issued he was etherized. The incision tended downward and forward, and a counter-opening was made into the track of the ball below the margin of the twelfth rib, which it is believed will effect the desired object. He bore the operation well, and has now recovered from the effects of the etherization and is in excellent condition.

“7 P. M.—After the last bulletin was issued the President suffered somewhat for a time from nausea due to the ether, but this has now subsided. He has had several refreshing naps, and his general condition is even better than might have been expected after the etherization and operation. At noon his pulse was 104; temperature, 100.2; respiration, 20. At present his pulse is 108; temperature, 101.9; respiration, 19.”