The Montgomery advertiser., 1901-09-20
COULD NOT HAVE LIVED
PRESIDENTS DEATH COULD
 NOT HAVE BEEN AVOIDED.
Patients Recupsrative Power Not Sufficient to Repair the Damage Done by the Bullet of
 The Assassin.

New York. Sept. 1o.-The Medical News in it's issue of Sept q. will print review of President Mcklnley's case from a 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 H1e 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 gangreEe, extensive as it was, seems to us not so different from other observed under analogous circumstances as to require the assumption of excep- tionai causes for It's explanation. Necrosis of tissue In thinner or thicker cylinder along the track of & bullet is thought to be the rule. and ordinarily it is easily taken care of by liquidation and absorIa tion. And necrosis even Of a considera- hle extent, in, feeble patients, about a sutured wound is certainly not unknown. even If rare, and is explained by inter ference with the local circulation, either by tension or by the spread of coagulItion within the blood-vesses.
 The spread of the process in patient of low recuperative power would not be so very exceptional or surprising. Was the President such d patient? Apparent iy he was. According to Dr. Wasdin, when the incision was re-opened toward the end of the fifth day, No effort was required to open it throughout its entire length, although 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 5S years of age, had led sedentary, lahorious and anxious life, and had complexion and appearance which for some years had been commented upon as indicative of impaired vitality.
 It Is evident that the surgeons, nota- whom the first decision lay. acted with commendable promptitude and courage In undertaking the operation, and showed excellent Judgment in it's course and could properly have been done. and nothing that should have been left un- oone The usual causes of death after such injury and operation were escaped tient succupnbed to a complication which Is so rare that 1t could not reasonably have been anticipated and could not have been adverted: The President. died be- cause he could not carry on the process or repair, and because the effort to do so was more than the vitality of the tis- sues involved could support. This, of course, excluded the possible presence of poison brought by the bullet or by de- structive action by the pancreatic juices If either of those was a factor, it needs only to substitute 1t in the statement for the assumed defective vitality of the patient Whatever cause acted, it was unrecosnizable at the operation and un- controllable then or subsequently,.
 mere mas been some criticism or 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 jus tified those assurances"
 The review of the case closes with the following reference to the doctors:
 They did their work skilfully and ju- diciously. their behavior was dignified. restrained and worthy of the best tra- ditions of the profession, and they had the misfortune. when success seemed to have been secured, of seeing it over thrown by a complication which could not have been foreseen nor avoided. They deserve our admiration and sym nathY not OUT criticism'