Evening star., 1901-09-20
PRESIDENTS VITALITY WAS Low.
Medical News Ascribes His Death to
Tint Cause.

Medical News Ascrfbes His Death to
That Cause.
| The New York Medical News, in it's issue
| of September 21, will print a review Of
President Mckinleys case from medical
| point Of view. The article recites the cir
cumstances Of the shooting and reprints the
| official report Of the autopsy and certain
| unofficial statements credited by the press
to the doctors in attendance. 1t then takes
up the subject of the gangrenous condition
of the wound, and in this connection says:
THE gangrene extensive as 1t was,
seems to us not so different from others
| observed under analogous circumstances
| as to require the assumption of exception
al causes for it's explanation. Necrosis of
| tissue in thinner or thicker cylinder
along the track of a bullet is thought to
| be the rule, and. ordinarily, 1t is easily
taken care of by eiquefaction and absorp-
| ton. And necrosis even of considera-
| sturted wound is certainly not unknown
even II rare, and Is explained by interfer-
! ence with the local circulation either by
tension or by the spread of coagulation
| within the blood vessels.
! THE spread of the process In patient
! of low reparativeS power would not be so
| very exceptional ar surprising. Was the
President such patient? Apparently he
| was. According to DR.. Wasdin, when the
| incision was reopened toward the end of
| the fifth day,i EnofJ effort was required to
| open 1t throughout it's entire length, al
| though only the track Of the bullet was
| affected. That expression would hardly
| have been 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 age, had led a sedentary, laborious
and anxious life, and had a complexion and
| appearance which for some years had been
commented upon as indicative of impaired
| vitality.
| 1T is evident that the surgeons notably
| Drs Mann and Mynter. with whom the
| first decision lay, acted with commendabe
| promptitude and courage in undertaking
the operation, and showed excellent judg-
| ment in its course and skill in it's execu-
| tion. They did all that could properly
have been done and nothing that should
| have been left undone. The usual causes
of death after such injury and operation
| were escaped or removed or prevented
and their patient succumbed to a compli-
/ cation which is so rare that 1t could not
| reasonably have been anticipated and
| could not have been averted. The Presi-
| dent died because he could not carry on
| the processes OF repair and because the
] effort to do so was mere 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. II either Of those was factor II
! needs only to substitute it In the state
| ment for the assumed defective vitality
of the patient Whatever cause acted, It
! was uHfecosHlAdpie at the operation and
| uncomfortable 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 fully to have justified those as
surances, and the public anxiety to have
| required them"
The review Of the case closes with the
| following reference to the doctors:
They did their work skillfully and Judi
! ciously, their behavior was dignified re-
| strained, and worthy of the best traditions
OF the profession, and they had the mis-
secured, of seeing it overthrown by q COM
plication which could not have been fore
seen nor avoided. They deserve our admi-
ration and sympathy, not our criticism