The Saint Paul globe. (St. Paul, Minn.) 1896-1905, 1901-09-20
VITALITY VERY Low
NEW YORK MEDICAL NEWS RE.
VIEWS TREATMENT OF PRESI-
DENT M'KINLEY'S WOUND
NATURE sHIRKED HER TASK
Nc Process of Repair Had Begun in
the Path of the Bullet, and
Death Resulted Directly
From GanErcne.

NEW YORK, Sept. 1s.-The Medical
News in it's issue of September p will
print a review of President McKinley's
case from medical point of view. The
article recites the circumstances of the
shooting and reprints the official report
or the autopsy and unofficial statements
creolted by the press to the doctors in
attendance. 1t then takes up the subject
OF the sansrenous condition of the wound
and in this connection says:
The gangrene, extensive as it was.
seems TO us not so different from other
such cases under analogous circum-
stances as to cause the assumption of
exceptional causes for it's explanation
Necrosis OF tissue in a thinner Or thick
er cylinder along the track of a bullet
is thought to be the rule and ordinarily
1t IS easily taken care of by liquidation
and absorption. And necrosis. when of
considerable extent in feeble patients,
known, if rare, and is explained ebv in
reference with the local circulation
rather than by tension or the spread of
coagulation within the blood vessels.
The spread of the process in a pa
tlent of low relative power would not be
SO very exceptional or surprising. Was
the president such a patient? Appar-
entity he was. According to Dr. Wasdin
When the 1nciSion was reopened toward
the end of the fifth day no effort was
required to open it throughout it's en-
tire length, although the only track of the
bullet was affected That expression
would hardly have been used unless he
mad intended to indicate that the amount
of repair usual after that lapse of time
mad not taken place. Then the president
was So years of age had led sedenta1-v
laborious and anxious life and had a com
pleX1on and appearance which for some
years had been commented upon as indie
ative of impaired vitality
1t is evident that the surgeons notably
Doctors Mann and Mynter with whom
the first decision lay, acted with com
mendable promptitude and courage in
Undertaking the operation and showed
excellent judgement in it's course and
skill in its execution. They did all that
could have properly been done, and
nothing could have been left undone The
usual causes of death after such injury
and operation We're escaped, or removed,
or prevented and their patient suecumbed
to complication which is so rare that
it could not reasonably have been antic-
lpated and could not have been averted
The president died because he could not
carry on the process of repair, and be-
cause the effort to do SO was more than
the vitality of the tissues involved could
support. This, of course, excluded the
possible presence of poison brought by
the bullet or of destructive action by the
pancreatic juices. If either of those was
factor it need be only necessary to
substitute it in the statement for the
assumed defective vitality of the pa
lent. Whatever cause acted, it was un-
recognizable at the operation and I'M
controllable then or subsequently,.
There has been some criticism of the
confident assurances of recovery made
by those in attendance after the fifth
day. To us the progress of the case up
TO that time appears to have required
them
The review of the case closes with the
following reference to the doctors:
They did their work skillfully and
judiciously, their behavior was dignified,
restrained and worthy of the best tradi-
ditions of the profession, and they had
the misfortune, when success ought to
have been assured, of seeing 1t overcome
been foreseen nor avoided They deserve
our admiration and sympathy, not our
criticism