5oo 



SCIENCE. 



body, in the horizontal plane (supposing the body 

 standing), and figured of the life size in Braune's mag- 

 nificent "Atlas." Such a diagram more accurately 

 represents the course of the bullet topographically, 

 than the ones selected by Dr. Bliss seem to us to do. 



It is a noteworthy fact, that on marking the topo- 

 graphical projection of the fracture of the nth rib, 

 that is the point of impact (XI), the fracture of the 

 1 2th rib (XII), the aperture of entry into the lumbar 

 vertebra (c'), the aperture of exit (c"), and the termi- 

 nus of the bullet track, where the bullet was found 

 encysted, on this frozen section, and connecting all 

 ' these points by a line, that line is found to be perfectly 



straight I It will be seen on examining the figures 4 

 and 5 furnished by the President's physician, that the 

 bullet track was as straight as an arrow in its frontal 

 projection, and as far as it involved the bony struc- 

 tures. 



Now, a line which appears as a straight line in two 

 projections of space, is a straight line in fact, and 

 from this point of view, the case merits renewed dis- 

 cussion. 



It must be recollected that our diagram represents 

 a horizontal plane of the body, and the one where the 

 bullet was found encysted. The point of impact lies 

 much higher, the liver in that higher level occupies a 

 greater area of the section, and the bullet in passing 

 the peritoneum seems to have grazed the latter. It 

 could hardly have done so without " nicking" the lower 

 part of the pleural cavity, which descends to this 

 level as a fine slit. The pleuritic adhesions found at 

 the lower part of the right lung, sustain this view. 



In the light of modern surgery, an examination of 

 this wound could have presented no difficulties. It is 

 illustrative of the unfortunate position in which the 

 President's physicians find themselves placed, when 

 attempting to defend their course, that the only exam- 

 ination of the wound, which they are able to refer to, 

 is that made by the Surgeon General of the Navy, 

 who was checked in his examination, and excluded 

 from the President's bed-side by those later in charge 

 of the patient. That the fracture of the ribs was not 

 recognized by the attendants, until suppuration near the 

 point of impact necessitated the removal of dead and 

 decaying fragments of bone, is also a remarkable 

 feature of the case. The course of the bullet from 

 the point of impact, being a direct one to the lumbar 

 vertebra, it is difficult to conceive how a thorough digi- 

 tal and instrumental examination could have failed to 

 detect the irregularity produced on the vertebral body 

 by the entrance of the bullet. 



None of the procedures necessary to have deter- 

 mined the bullet track from the point of impact to the 

 point of entry into the spinal column, would have 

 been unwarrantable to the most conservative surgeon. 



None of these procedures would have been more risky 

 than the one later resorted to in the case, when the false 

 bullet track was repeatedly probed to a distance of 

 twelve inches. 



At this point criticism must necessarily pause, with 

 reference to the question of the examination of the 

 wound. The perforation of the lumbar vertebra 

 having been detected, a bold surgeon might shrink 

 from passing his probe further and following up the 

 bullet-track into the regions beyond, through a per- 

 forated segment of the spinal column. What now, 

 in the light of the post mortem seems perfectly 

 feasable, during the President's life would have been 

 considered as "heroic" a surgery, asxan well be con- 

 ceived. That a surgeon endowed with the necessary 

 amount of daring, and that great essential the tactus 

 eruditus, could have passed a probe through the ver- 

 tebra and touched the bullet, without injuring any 

 important organ, must be admitted by every impartial 

 expert who bears in mind the directness of the bullet 

 track. 



This question, however, represents rather a side- 

 issue, when it is recollected that it was not the location 

 of the ball, or its presence in the body, that killed 

 the President. It is only as an illustration of the 

 extent to which the public was misled, and we fear 

 intentionally misled, by some of the President's phy- 

 sicians, that it merits being referred to. 



One of the consulting surgeons stated in an ironical 

 way that the bullet could have been removed if its 

 situation had been known, provided the surgeon had, 

 as a preliminary, removed several lumbar vertebras, 

 and groped his way among the great nerves, the 

 thoracic duct, the Aorta and the Vena Cava. This 

 assertion is stated by no less a one than Dr. Ham- 

 mond, to be an intentional deception of the people, 

 as it was made through the columns of the daily 

 papers. The reader will see in our diagram that the 

 Aorta and Vena Cava have absolutely no relations to 

 the bullet-track or to the seat of the bullet. Had the 

 situation of the latter been appreciated during life, an 

 incision on the left side of the spinal column would 

 have been in order. This incision and the entire 

 operation would have been the strict counterparts of 

 certain of the legitimate operations of modern surgery, 

 namely of nephrotomy and lumbo-colotomy. It is bad 

 surgery which insists that in every bullet wound, the 

 bullet has to be extracted through its own track. A 

 bullet perforating the thigh to within an inch of the 

 surface on the other side, is to be extracted from the 

 point where it is nearest the surface. 



The reader will find the left kidney indicated at K, 

 this is operated on in the operation of nephrotomy, 

 he will find the descending colon at (C. d.), this is 

 opened into in the operation of lumbo-colotomy; 



