The Washington times., 1901-09-16
TWO VIEWS ON GANGRENE
The Nature of Gunshot Wounds
and Their Effects Described.
Distinguished Physicians Make Au-
thorifative Statements the
Symptoms in the Dead Presidents
Case Judged From the Autopsy.

Dr. James Kerr. a specialist in gun
| shot wounds and one of the foremost sur
geons in the country, has expressed the
| opinion given below, concerning the au-
topsy on the President. DIR. Kerr has
| operated in more surgical cases due to
gunshot wounds than any other surgeon
in this city. probably. il not In the United
States. His view of the Presidents case
is interesting as well ss authoritative.
He says:
THE whole case is very puzzling to me,
| and entirely unique in my own experience.
have never seen condition such as
that found in the autopsy, following a
sunshot wound of the abdomen, and it
would be merely guess work to account
for it. Until the result of the cultures
has been examined, accept DR.. Roswell
Parks assumption as being the correct
explanation, namely, that it nay be due
to the escape of pancreatic fluid.
Something extraordinary undoubtedly
has occurred, to account for this extern
sive infection, causing gangrene and is
more probably accounted for by the in
fection carried with the bullet, than any
conditions that We're present There are
various malignant forms of infection
which produce gangrenous Inflammation,
ana are not infrequeN in gunshot wounds.
1t may have been one of those.
1T is perfectly idle. at any rate, at
present, to account for the condition
found at the autopsy until the character
of the infection is known by the exami-
nation of the cultures One thing is GER
tain. the operation in itself was beyond
criticism. 1t would have been impossible
at the time of the operation to have re-
moved every particle of tissue touched
by the bullet
In my opinion the probable cause of
TINS peculiar form of gangrene described
IN the autopsy is some unusual form of
injection carried in with the bullet which
would be a very improoa bic assumption
TO conclude was poison put there by the
assassin. In my own experience cases of
fatal form of gangreneous infection
have occurred as the result of the gas
bacillus carried in the course of bullet
wound.
There was no symptom in the Presi-
dents case during life that could have
indicated in any way the condition found
al the autopsy
The opinion of DIR. George T Vaughan,
also q surgeon of national reputation,
upon the results of the autopsy is as fol-
lows:
so far as any special poisoning of the
bullet is concerned, l think it is all nom
scnse-absUlute.
he bullet produced larger area of
ganSrene than usual. The cause of this
is hard to tell The bullet may have car
ried infectious germs, but was not ac-
tually coated with poison for the fell pur-
pose.
THE examination to show whether the
number OF white cells in the blood has
increased, test for general infection, or
leucocytosis, has been used as a test for
only few years, and is not infallible.
The cause for the lack OF repair in the
tissues of the patient is difficult TO eX-
plain. 1t may be that the effect of the
bullet on the wounded tissue was so de-
vitalizing as TO prevent repair.
The sustained high pulse. to my mind,
meant either hemorrhage or Infection. ]
do not care so much for the temperature
record. So far as the prognoses of the
case were concerned it IS evident that
the physicians We're in error. They were
all able men, however, and undoubtedly
did their best
Even if the physicians had known that
there was a gangreneous process in the
wound. the doctors would have been un-
able to do anything.
There was the shock of the injury
there was the shock of the operation, and
these added to the shock of the infec-
tion killed the President. The huge
purgative was also great Oppressive.
Il had hopes that the present instance
would have been a triumph for modern
surgery But il was unfortunate in the
outcome. 1t is a curious thing that this
infection should develop in some cases
and not in others. My own experience
is very varied in this particular.
The gangrenous process began at once.
1t was impossible for the surgeons to
know how it would develop"