The Abdominal Wound

     The gravity of the wound, arising from the important and vital structures in its close proximity, was recognized by abdominal surgeons, and it was the general belief that forty-eight to seventy-two hours must elapse before a reasonable hope for recovery could be entertained. It was, therefore, a source of intense satisfaction, not only to the medical attendants, but to the whole medical profession, that this limit was reached with all the symptoms—save one—pointing towards a rapid and uncomplicated recovery. The rapidity of the heart’s action was not accounted for. The steady improvement in every other respect justified the hopeful view of the case that was taken by those in charge. As we pointed out last week a wound of the pancreas did not seem to be indicated because of the favorable progress of the case. The next contingency, a wound of the kidney, was contraindicated by the absence of blood in the urine. The fact that, in spite of a wound of the pancreas, the patient lived for a week, is one of the most noteworthy in the case. The wound of the kidney was so slight as to be insignificant. The fatal collapse which dashed expectations to the ground so abruptly and so irretrievably, could meet with no adequate explanation. Late sepsis, heart-failure, hemorrhage, indiscretion in feeding, all were suggested, but none was satisfactory to those who by long experience knew what to expect and how to recognize the nature of the complication when it came. Now that the track of the wound has been laid bare an exclamation of surprise has swept over the land. Gangrene, the result of intense devitalization of tissues or possibly of the irritating action of some unrecognized germ or virus, had destroyed the patient. The unexpected had happened. The proper course had been pursued, the dreaded complications that were common had been averted, and the medical and surgical men who had labored so loyally and conscientiously in behalf of their patient, had the satisfaction of knowing that no mistake had been made. The unusual sequel against which no precautions could have been taken, had only revealed itself in its latent stage by rapidity of the pulse, a symptom which might have been purely functional, and one common to many conditions. We as medical men may point with satisfaction to the surgical records of the two great national patients, President Garfield and President McKinley, as an exemplification of the vast strides that have been made in the technique of surgery during the last two decades.