system. In response to interrogatories relative to moving the patient from the Executive Mansion, the doctor said that nothing could yet be determined, as the President was in no condition to be moved. He thought, however, when the proper time arrived, that a trip down the Potomac would be decidedly beneficial, and would hasten his recovery.

In accordance with the custom which the physicians had now adopted, only two bulletins were issued during the day, and they were of a sort to create no excitement.

"8:30 A. M.-The President continues to improve. He slept well during the night, and this morning looks and expresses himself cheerfully. Another satisfactory day is anticipated. At present his pulse is 90; temperature, 98.4; respiration, 18. 7 P. M.-As the morning bulletin indicated would probably be the case, the President has passed another good day without drawback or unpleasant symptoms of any kind. At 10:30 P. M. his pulse was 96; temperature, 98.4; respiration, 18. The afternoon rise of temperature came on late and was moderate in degree. Now his pulse is 102; temperature, 100.2; respiration, 19."

Thus from day to day, and from week to week, the time wore on, the people regarding it merely as a matter of time when their beloved President would be restored to life and health. At this date they did not anticipate an alternative issue.

The thirty-fifth day.-In the leading papers of August 5th, no more than a quarter of a column was devoted to President Garfield. The citizens of Newport, Rhode Island, sent, through the mayor of the city, an invitation to the President to come to their famous resort as soon as his wound would permit, and to remain as their guest until complete recovery. The bulletins of the day contained the only information. They said:

"8:30 A. M.-The President slept naturally the greater part of the night, although he has taken no morphia during the last twenty-four hours. His improved condition warranted, several days ago, a diminution in the quantity of morphia administered hypodermically at bedtime, and it was reduced at first to one-twelfth and afterward to onesixteenth of a grain in the twenty-four hours, without any consequent unpleasant result, and finally has been altogether dispensed with. His

condition this morning exhibits continued improvement, and another good day is anticipated. At present his pulse is 88; temperature, 98.4; respiration, 18. 7 P. M.-The President has passed another good day. He has taken an adequate quantity of nourishment, and has had several pleasant naps during the day. At 12:30 P. M. his pulse was 98; temperature, 98.4; respiration, 18. After 4 P. M. his temperature began to rise as usual, but to a moderate degree and without perceptible dryness of skin. His pulse is 102; temperature, 100.4; respiration, 19.

The thirty-sixth day. The public had now accepted, with abiding trust, the oft-repeated assurances of the surgeons that the President was on the road to health. The White House, from being the center of interest for the people of the whole country, as it had been two weeks before, had become the dullest place in Washington. Doctors came in and went out, and casual inquirers continued their visits. The military guards patrolled the space in front of the one gate through which access was had to the grounds, but beyond this nothing in the appearance or surroundings of the place indicated that public attention was, in any marked degree, turned in that direction. Great interest in the progress of the case continued, but it was not so intense and all-absorbing as hitherto. The bulletins were again the only news:

"8:30 A. M.-The President has passed an excellent night, sleeping sweetly the greater part of the time. This morning he is cheerful, and all the indications promise another favorable day. Pulse, 92; temperature, 98.4; respiration, 18. 7 P. M.-The President passed a comfortable morning, his symptoms and general condition being quite satisfactory. At 12:30 P. M. his pulse was 100; temperature, 98.5; respiration, 19. The afternoon rise of temperature began as late as yesterday, but has been higher, though unaccompanied by dryness of skin. At 7 P. M. his pulse was 102; temperature, 101.8; respiration, 19. The appearance of the wound at the evening dressing was, however, good, and there has been no interruption to the flow of pus."

The thirty-seventh day.-The 7th of August was probably the most quiet day since the President was wounded. There was some comment about the city regarding the information contained in the morning bulletin, the language of which was, that the Presi

dent "this morning is in good condition, although the effects of the febrile disturbance of yesterday are still slightly perceptible in pulse and temperature." Many persons construed this sentence as indicative of unfavorable symptoms; but the general public accepted it as reassuring, and consequently there were but few inquiries at the Mansion in the course of the day.

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 spicule 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."

The thirty-ninth day. The effect of the surgical operation was salutary in so far as to make it practicable to dispense with the drainage-tube, to the great relief of the patient. The effects of the etherization, however, were somewhat distressing, and the shock of the operation no doubt told unfavorably on the President's small reserve of vitality. None the less, his condition was so far from unfavorable that Dr. Agnew returned to Philadelphia and Secretary Blaine made preparations to take a brief respite from care by a visit to his own State. The ripple of anxiety, excited by the recent operation, passed away, and matters went on as before. The official reports of the day were as follows:

"8:30 A. M.-Notwithstanding the effects of yesterday's operation, the President slept the greater part of the night without the use of morphia. This morning his pulse is 98; temperature, 99.8; respiration, 19. Since yesterday afternoon small quantities of liquid nourishment, given at short