The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1901-09-20
MEDICAL POINT OF VIEW
MIR. SIKINLEY's CASE INVOLVED UN-
KNOwABLE COMPLICATIONS.
The Surgeons Did All That should
Have Been Done; Nothing That
Should Not Have Been Done.

NEW YORK, Sept. 19.-The Medical
News, in its issue OF Sept. p, will print a
review of President McKinley's case from
medical point OF view The article re-
cites the circumstances of the shooting and
reprints the official report OF the autopsy
and certain unofficial statements credited
by the press TO the doctors in attendance
IL then takes up the subject OF the gan
grenous condition of the wound, and in
this connection says:
THE gangrene, extensive as il was. seems
10 Us not 50 Inherent from others observed
unoer analogous circumstances as 20 re-
qulre the assumption or exceptional causea
Tor It's explanation. Necrosis OF tissue IA =
thinner OF thicker cylinder along the track
OF bullet Is thought 10 be the rule, and
ordinarily II IS easily taken care OF by
liquidation anC absorption. And necrosis
even OF a considerable extent, in feeble pa
uents, about a sutured wound, is certainly
not unknown, even II rare, and is ca
piained by interference with the local cir
culation either by tension or by the spread
OF cOagulation within the blood vessels.
The spread Of the process IN a patient
of low repardIiVe power would not be "a
very exceptional or surprising Was TIE
President such patient? Apparently hs
was. According 10 DR.. Wasdin when Tia
incision was reOpened toward the end Of fbs
NTH day, no effort was required to omen
II throughout its entire length. although
That expression would hardly have bsea
used unless he had intended to indicate
that the amount OF repair usual after that
lapse OF time had not taken place Then
the President was fifty-eight Years OF aga
mad led a sedentary, labOriOus and anxi0ua
lie, and had complexion and appearances
which for some years had been commented
upon as indicative Of impaired vitality IL
Is evident that the surgeons notably Ora
Mann and Mynter, with whom the first de-
cision lay, acted with cOmmendabls
promptitude and courage in underta king
the operation and showed excellent judg-
ment and skill IN its execution. They did
have a M
nothing that should have been left undons
The usual causes OF death after such in
jury and operation We're escaped or re-
moved or prevented, and their patient sue
cumbed to a complication which Is 80 rare
that II could not reasonably have been an
ucipated, and could not have been aEerted.
The President died because he could not
carry on the processes OF repair. ana De-
cause the effort to do so was more than
the vitality OF the tissues involved could
support. This. OF course. excluded the pos
sihle Dreserce Of Doison brought by the
bullet or by destructive action oy the pan
creatic juices. II either or those was
factor. il needs only to substitute ~ IN the
statements for the assumed defective VI
tality OF the patient " hdleNer Gauss
acted. il was unrecognizable al the opera
ton and uncomfortable then OF suose-
quently.
There has been some criticism OF the con-
fident assertions Of recovery made by those
i'm attendance after the NTH day To rs
the nrovress OF the case IN 20 that time
apDears fully TO have justified those as
suranoes and the public anxiety to have
REQUIRED them.
following reference TO the doctors:
'"rhev did their work skillfully and ~
SiciousiV thei- behavior was diCnihed. re-
strained ard worthy OF the best traditions
OF the profession: and they had the mis-
| fortune when success seemed 20 haze been
| plication which could not have been fore
seen nor avoided. They deserve our al
miration and sympathy. not our criticism