CHAPTER XL.

THE STORY OF THE BULLETINS.

W

HEN the President lay wounded in the railway station, the first physician to reach his side was Dr. Smith Townshend, Health Officer of the District of Columbia. Dr. Townshend, on arriving, found that a faint and slight vomiting had just occurred. There was no pulse perceptible. Aromatic spirits of ammonia and brandy were immediately administered. The clothing having been loosened, Dr. Townshend examined the wound, and was impressed with a belief that it was necessarily fatal. Dr. Townshend was succeeded by Dr. D. W. Bliss, whom the President immediately asked to take charge of his case. A number of doctors answered the summons for medical aid with promptness, and from those who came, three more were selected to assist Dr. Bliss, namely, Surgeon-General J. K. Barnes, of the army; and Doctors J. J. Woodward and Robert Reyburn. During Saturday and the ever-eventful Sunday, these gentlemen decided that the best thing to do was to do very

men.

little. The wound was situated on the right side, four inches from the spine, and passed between the tenth and eleventh ribs, fracturing the upper edge of the latter. The ball then passed apparently through the liver, and lodged in the abdoThe wound was dressed antiseptically (i. e., the preventing of putrefaction of the wounded parts) quinine was administered to prevent malaria seizing on the system, and a hypodermic injection of morphine was also given to induce sleep and quiet the bowels. It was deemed advisable to send for further medical advice, and Doctors Frank H. Hamilton, of New York, and D. Hayes Agnew, of Philadelphia, were summoned by telegraph. They arrived Monday morning, and with the surgeons already in attendance, held a consultation. They fully approved the course of treatment that had been adopted, and urged its continuance.

It was then decided, in order to satisfy the extreme anxiety of the public, to issue official bulletins three times daily. The use of technical terms in these bulletins could not be avoided, especially when the necessity of condensation, in order that they might be quickly prepared and frequently issued, is taken into consideration. It is but natural that very many persons should be unfamiliar with these terms, and, with the view of rendering the bulletins intelligible to all, the surgeons accompanied the figures showing

temperature, pulse and respiration with a brief remark, to the effect that "the President's condition continues favorable."

The following tables will enable the reader to obtain a correct diagnosis of the case on three points-pulse, temperature, respiration-from the first day until July 15th, on which day, convalescence seemed so sure that I stopped compiling the tables. The letters M, N and E, stand for morning, noon and evening, and the positions of the dots on each square of the diagram show the upward and downward fluctuations from better to worse and from worse to better during each day of the President's illness, the normal condition being shown by the horizontal lines of dots in the tables of respiration, pulse-beats and temper

MNE MNE MNE MNE MNE MNE MNE MNE MNE MNE MNE MNE MNE

+Norma respirtion.

102

Days of Diseasc.

MNE MNE MNE MNE MNE MNEMNEMNE│MN EMNE MNE MNE MNE

MNEMNE MNE MNEMNEMNE MNE MNE MNE MNE MNE MNE MNE

1040

103°

1010

100P.

99...

93...

A word in explanation of these tables. "Pulse," on a bulletin, means the number of beats per minute of the patient's pulse. This, as every

1 Nurmal pulse.

body understands, is determined by counting the pulsations, watch in hand. "Temperature" means the degree of heat, Fahrenheit, of the patient's body. This is ascertained by placing the bulb of a small thermometer, specially arranged and adapted for the purpose, in the mouth of the patient, or under the armpit, as the attending surgeon may see fit. The highest degree registered by the mercury shows the temperature of the body. "Respiration" means the number of breathings per minute, and these, like the pulsations, are ascertained by watching and counting the times the chest rises and falls per minute. In good health, the natural beats of the pulse vary in different persons. The average of adults is from 60 to 70 per minute. There are, however, very wide differences, even in healthy persons. For instance, Bonaparte's natural pulse-beat was only about 42, while that of one of the lord justices of England was as high as 128 per minute. These, however, are extremes. Then, too, the pulse-beats of healthy persons vary at different times of the day, or, according to the position of the body, or to the activity or quiet of the person. The greatest frequency of the beats occurs during the middle of the day, and the least about midnight. As a rule, in health, the pulse is quicker in the morning than in the evening; but in fever, especially in warm weather, this is reversed, and the increase is in the evening.